Public policy changes — including increasing the minimum age for purchasing cigarettes to 21 and adding fluoride to Springfield’s water — could be introduced to local municipalities this year to improve health in Springfield and Clark County.

The Clark Combined Health District released its goals for improving the overall health of the community as part of the 2016 Community Health Improvement Plan at the Springfield Center of Innovation: The Dome on Tuesday morning.

The plan will serve as a road map for the health community over the next three years, Health Commissioner Charles Patterson said.

The process began in late January with the release of the Community Health Assessment. The seven task forces —tobacco, chronic disease, mental health, substance abuse, physical activity, healthy births and sexuality, and nutrition – met over the past two months to create a living document for the next three years.

“We’re not finished here today,” Patterson said.

A ballot issue for the fluoridation of water was placed on the ballot in 2005, but was defeated as 57 percent of voters came out against the issue. More than a decade later, Patterson said he’s ready to resume the discussion.

Springfield is the largest municipality in Ohio without fluoridated water. New Carlisle also doesn’t fluoridate its water.

By fluoridating the water, Patterson said it would decrease the large number of Springfield residents with tooth decay.

“It’s certainly something we need to work on,” Patterson said.

Five cities in Ohio — including Bexley and Grandview, among others — have enacted a Tobacco 21 ordinance, said Public Health educator Sarah Dahlinghaus. That would increase the minimum age for buying cigarettes to 21, which she said could stop 18-year-olds for purchasing tobacco products for younger friends.