PERSONNEL POLICIES AND PRACTICES. FULL-TIME PUBLIC HEALTH POSITIONS IN LOCAL HEALTH DEPARTMENTS

AbstractObjectiveWe identify characteristics of local health departments, which enhance collaborations with community- and faith-based organizations (CFBOs) for emergency preparedness and response.MethodsOnline survey data were collected from a sample of 273 disaster preparedness coordinators working at local health departments across the United States between August and December 2011.ResultsUsing multiple linear regression models, we found that perceptions of CFBO trust were associated with more successful partnership planning (β=0.63; P=0.02) and capacity building (β=0.61; P=0.01). Employee layoffs in the past 3 years (β=0.41; P=0.001) and urban location (β=0.41; P=0.005) were positively associated with higher ratings of resource sharing between health agencies and CFBOs. Having 1-3 full-time employees increased the ratings of success in communication and outreach activities compared with health departments having less than 1 full-time employee (β=0.33; P=0.05). Positive attitudes toward CFBOs also enhanced communication and outreach (β=0.16; P=0.03).ConclusionsStaff-capacity factors are important for quick dissemination of information and resources needed to address emerging threats. Building the trust of CFBOs can help address large-scale disasters by improving the success of more involved activities that integrate the CFBO into emergency plans and operations of the health department and that better align with federal-funding performance measures. (Disaster Med Public Health Preparedness. 2018;12:57–66)

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TRENDS

PEDIATRICS ◽

10.1542/peds.9.1.130 ◽

1952 ◽

Vol 9 (1) ◽

pp. 130-134

Keyword(s):

Public Health ◽

Medical Care ◽

Local Health ◽

Full Time ◽

Federal Aid ◽

Health Departments ◽

Local Health Departments ◽

Public Health Services ◽

Active Attention ◽

State And Local

ONE of the pending medical bills which will undoubtedly receive active attention in the second session of the 82d Congress is the Local Health Units Bill (S.445). This bill, to which we have referred in this column (March 1951 ), proposes an increase in Federal aid to the States to help establish and maintain a Nation-wide network of full-time local health departments. The stimulating effect of a tie-in with the defense program was given to the measure when the President urged Congress to approve such legislation in order that communities in defense areas may be provided with the means of meeting the increased burdens of sanitation, protection of food and water supplies, services for preschool and school children and other services to prevent disease and promote health. S.445 was passed by the Senate. The House Interstate Commerce Committee is now considering this and similar bills. Several points at issue are whether this measure should be limited to the defense emergency period ; how public health services should be defined; and the kind of minimum standards to be required. While this legislation is currently under discussion, new light has been thrown upon many of the important questions involved. A highly significant report, recently published by the American Public Health Association, describes the changing concepts of the functions of local health departments and the extent to which they are now operating general medical care programs. in the first place, this report calls attention to the trend to place responsibility for medical care of the indigent and the needy in state and local departments of health.

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Patterns of Cross-Sector Collaboration in Local Health Departments: A Cluster Analysis

Health Promotion Practice ◽

10.1177/1524839920972982 ◽

2020 ◽

pp. 152483992097298

Author(s):

Alexis K. Grant

Keyword(s):

Public Health ◽

Cluster Analysis ◽

Determinants Of Health ◽

Local Health ◽

Health Departments ◽

Local Health Departments ◽

Structural Determinants ◽

Cluster Assignment ◽

Cross Sectional ◽

Top Executive

Local health departments (LHDs) are positioned to act as the community health strategist for their catchment area, which requires cross-sector collaboration. However, little research exists to understand how much and what types of cross-sector collaboration occur and its impact on LHD practice. Data from 490 LHDs who participated in the 2016 National Profile of Local Health Departments survey were analyzed to identify patterns of cross-sector collaboration among LHDs. In the survey, LHDs reported the presence of collaborative activities for each of 22 categories of organizations. Factor analysis was used to identify patterns in the types of organizations with which LHDs collaborate. Then, cluster analysis was conducted to identify patterns in the types of cross-sector collaboration, and cross-sectional analyses examined which LHD characteristics were associated with cluster assignment. LHDs collaborated most with traditional health care–oriented organizations, but less often with organizations focused on upstream determinants of health such as housing. Three distinct clusters represented collaboration patterns in LHDs: coordinators, networkers, and low-collaborators. LHDs who were low-collaborators were more likely to serve smaller populations, be unaccredited, have a smaller workforce, have a White top executive, and have a top executive without a graduate degree. These findings imply that public health practitioners should prioritize building bridges to a variety of organizations and engage in collaboration beyond information sharing. Furthermore, LHDs should prioritize accreditation and workforce development activities for supporting cross-sector collaboration. With these investments, the public health system can better address the social and structural determinants of health and promote health equity.

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Actionable lessons for the US COVID vaccine program

Israel Journal of Health Policy Research ◽

10.1186/s13584-021-00452-2 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Gary L. Freed

Keyword(s):

Public Health ◽

Local Health ◽

National Strategy ◽

Individual State ◽

Health Departments ◽

Local Health Departments ◽

Public Health Infrastructure ◽

Health Infrastructure ◽

The Us ◽

Vaccine Distribution

AbstractWhen attempting to provide lessons for other countries from the successful Israeli COVID-19 vaccine experience, it is important to distinguish between the modifiable and non-modifiable components identified in the article by Rosen, et al. Two specific modifiable components included in the Israeli program from which the US can learn are (a) a national (not individual state-based) strategy for vaccine distribution and administration and (b) a functioning public health infrastructure. As a federal government, the US maintains an often complex web of state and national authorities and responsibilities. The federal government assumed responsibility for the ordering, payment and procurement of COVID vaccine from manufacturers. In designing the subsequent steps in their COVID-19 vaccine distribution and administration plan, the Trump administration decided to rely on the states themselves to determine how best to implement guidance provided by the Centers for Disease Control and Prevention (CDC). This strategy resulted in 50 different plans and 50 different systems for the dissemination of vaccine doses, all at the level of each individual state. State health departments were neither financed, experienced nor uniformly possessed the expertise to develop and implement such plans. A national strategy for the distribution, and the workforce for the provision, of vaccine beyond the state level, similar to that which occurred in Israel, would have provided for greater efficiency and coordination across the country. The US public health infrastructure was ill-prepared and ill-staffed to take on the responsibility to deliver > 450 million doses of vaccine in an expeditious fashion, even if supply of vaccine was available. The failure to adequately invest in public health has been ubiquitous across the nation at all levels of government. Since the 2008 recession, state and local health departments have lost > 38,000 jobs and spending for state public health departments has dropped by 16% per capita and spending for local health departments has fallen by 18%. Hopefully, COVID-19 will be a wakeup call to the US with regard to the need for both a national strategy to address public health emergencies and the well-maintained infrastructure to make it happen.

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Full-Time Employees of U.S. Local Health Departments, 1992–1993

Journal of Public Health Management and Practice ◽

10.1097/00124784-199905000-00003 ◽

1999 ◽

Vol 5 (3) ◽

pp. 1-9 ◽

Cited By ~ 13

Author(s):

Robert B. Gerzoff ◽

Carol K. Brown ◽

Edward L. Baker

Keyword(s):

Local Health ◽

Full Time ◽

Health Departments ◽

Local Health Departments

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Application for Public Health Accreditation Among US Local Health Departments in 2013 to 2019: Impact of Service and Activity Mix

American Journal of Public Health ◽

10.2105/ajph.2020.306007 ◽

2020 ◽

pp. e1-e8

Author(s):

Jonathon P. Leider ◽

Jessica Kronstadt ◽

Valerie A. Yeager ◽

Kellie Hall ◽

Chelsey K. Saari ◽

...

Keyword(s):

Public Health ◽

United States ◽

Latent Class ◽

The United States ◽

Local Health ◽

Health Departments ◽

Local Health Departments ◽

Profile Data ◽

The Public ◽

Funding Support

Objectives. To examine correlates of applying for accreditation among small local health departments (LHDs) in the United States through 2019. Methods. We used administrative data from the Public Health Accreditation Board (PHAB) and 2013, 2016, and 2019 Profile data from the National Association of County and City Health Officials to examine correlates of applying for PHAB accreditation. We fit a latent class analysis (LCA) to characterize LHDs by service mix and size. We made bivariate comparisons using the t test and Pearson χ2. Results. By the end of 2019, 126 small LHDs had applied for accreditation (8%). When we compared reasons for not pursuing accreditation, we observed a difference by size for perceptions that standards exceeded LHD capacity (47% for small vs 22% for midsized [P < .001] and 0% for large [P < .001]). Conclusions. Greater funding support, considering differing standards by LHD size, and recognition that service mix might affect practicality of accreditation are all relevant considerations in attempting to increase uptake of accreditation for small LHDs. Public Health Implications. Overall, small LHDs represented about 60% of all LHDs that had not yet applied to PHAB. (Am J Public Health. Published online ahead of print December 22, 2020: e1–e8. https://doi.org/10.2105/AJPH.2020.306007 )

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