scholarly journals Building Healthy Community Environments: A Public Health Approach

2018 ◽  
Vol 133 (1_suppl) ◽  
pp. 35S-43S ◽  
Author(s):  
Kirsten Koehler ◽  
Megan Latshaw ◽  
Thomas Matte ◽  
Daniel Kass ◽  
Howard Frumkin ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Built Environment ◽  
Environmental Health ◽  
Chronic Diseases ◽  
Environmental Quality ◽  
Burden Of Disease ◽  
Systems Approach ◽  
Health Impact ◽  
Health Practitioners

Environmental quality has a profound effect on health and the burden of disease. In the United States, the environment-related burden of disease is increasingly dominated by chronic diseases. At the local level, public health practitioners realize that many policy decisions affecting environmental quality and health transcend the authorities of traditional health department programs. Healthy decisions about the built environment, including housing, transportation, and energy, require broad collaborative efforts. Environmental health professionals have an opportunity to address the shift in public health burden toward chronic diseases and play an important role in the design of healthy communities by bringing data and tools to decision makers. This article provides a guide for community leaders to consider the public health effects of decisions about the built environment. We present a conceptual framework that represents a shift from compartmentalized solutions toward an inclusive systems approach that encourages partnership across disciplines and sectors. We discuss practical tools to assist with environmental decision making, such as Health Impact Assessments, environmental public health tracking, and cumulative risk assessment. We also identify priorities in research, practice, and education to advance the role of public health in decision making to improve health, such as the Health Impact Assessment, as a core competency for environmental health practitioners. We encourage cross-disciplinary communication, research, and education that bring the fields of planning, transportation, and energy in closer collaboration with public health to jointly advance the systems approach to today’s environmental challenges.

Applying precaution to environmental health issues at the local level: A proposed guide based on the research and experiences of Toronto Public Health

2012 ◽  
Vol 55 (01) ◽  
pp. 11-18 ◽  
Author(s):  
Loren Vanderlinden ◽  
Donald C. Cole ◽  
Monica Hau ◽  
Monica Campbell ◽  
Ronald Macfarlane ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Environmental Health ◽  
Local Level ◽  
Health Issues ◽  
Support Tool ◽  
Case Examples ◽  
Trade Offs ◽  
Health Practitioners ◽  
Public Health Practitioners

While the Precautionary Principle (PP) is an important policy innovation relevant to public health, practitioners do not agree on how or when it should be applied. Action on environmental health issues at Toronto Public Health (TPH) has clearly been informed by the PP. We have recently developed a guide to applying precaution that can be used to assist local public health practitioners in decision making to address environmental health hazards in the community. We applied the Guide retrospectively to TPH case examples involving education, program, policy, legislative, and advocacy interventions to manage exposures to environmental hazards. This exercise served to refine the Guide and increase our understanding of how and when TPH has applied precaution in the past. Our Guide promises to be a useful decision making support tool that will help users (1) assess what degree of precaution is appropriate for a given context; (2) systematically document evidence about harms and exposures (including uncertainties) while making the assumptions about evidence more explicit and transparent; (3) highlight potential trade-offs (including consideration of both risks and benefits), explore alternatives, and assess feasibility of interventions; (4) plan adequate communication and stakeholder engagement; and (5) institute monitoring and evaluation so as to ensure interventions still meet users’ needs. We see the Guide as a tool that deepens the process of learning and enquiry on issue management in environmental health practice. We urge others to share their applications of the PP using our Guide to promote mutual learning.

scholarly journals The Importance of Using Public Health Impact Criteria to Develop Environmental Health Indicators: The Example of the Indoor Environment in New Zealand

2018 ◽  
Vol 15 (8) ◽  
pp. 1786 ◽  
Author(s):  
Kylie Mason ◽  
Kirstin Lindberg ◽  
Deborah Read ◽  
Barry Borman
Keyword(s):  
Public Health ◽  
New Zealand ◽  
Environmental Health ◽  
Burden Of Disease ◽  
Selection Criteria ◽  
Indoor Environment ◽  
Health Indicators ◽  
Health Impact ◽  
Public Health Impact ◽  
Environmental Burden

Developing environmental health indicators is challenging and applying a conceptual framework and indicator selection criteria may not be sufficient to prioritise potential indicators to monitor. This study developed a new approach for prioritising potential environmental health indicators, using the example of the indoor environment for New Zealand. A three-stage process of scoping, selection, and design was implemented. A set of potential indicators (including 4 exposure indicators and 20 health indicators) were initially identified and evaluated against indicator selection criteria. The health indicators were then further prioritised according to their public health impact and assessed by the five following sub-criteria: number of people affected (based on environmental burden of disease statistics); severity of health impact; whether vulnerable populations were affected and/or large inequalities were apparent; whether the indicator related to multiple environmental exposures; and policy relevance. Eight core indicators were ultimately selected, as follows: living in crowded households, second-hand smoke exposure, maternal smoking at two weeks post-natal, asthma prevalence, asthma hospitalisations, lower respiratory tract infection hospitalisations, meningococcal disease notifications, and sudden unexpected death in infancy (SUDI). Additionally, indicators on living in damp and mouldy housing and children’s injuries in the home, were identified as potential indicators, along with attributable burden indicators. Using public health impact criteria and an environmental burden of disease approach was valuable in prioritising and selecting the most important health impacts to monitor, using robust evidence and objective criteria.

Assessing the health of populations

2020 ◽  
pp. 28-41
Author(s):  
Julian Flowers ◽  
Sian Evans
Keyword(s):  
Public Health ◽  
Resource Allocation ◽  
Impact Assessment ◽  
Health Inequality ◽  
Burden Of Disease ◽  
Health Impact ◽  
Service Evaluation ◽  
Public Health Activity ◽  
Health Assessments ◽  
Allocation Planning

Assessing population health is a fundamental element of most public health activity. We cannot improve health and measure success without being able to conduct health assessments. These may be components of, for example: measuring burden of disease; needs assessment; assessing health equity and health inequality; resource allocation; planning; health impact assessment (HIA); service evaluation.

scholarly journals Strengthening the Capacity of Local Health Agencies through Community-Based Assessment and Planning

2009 ◽  
Vol 124 (6) ◽  
pp. 875-882 ◽  
Author(s):  
Carlyn Orians ◽  
Shyanika Rose ◽  
Brian Hubbard ◽  
John Sarisky ◽  
Letitia Reason ◽  
...  
Keyword(s):  
Public Health ◽  
Environmental Health ◽  
Case Studies ◽  
National Survey ◽  
Local Health ◽  
Public Health Agencies ◽  
Health Agencies ◽  
Health Practitioners ◽  
Building Community ◽  
Problem Solving Competency

Objectives. We evaluated the effectiveness of the Protocol for Assessing Community Excellence in Environmental Health (PACE EH) in building competency in essential environmental health services and renewing efforts to engage the community in problem solving. Competency and community engagement have been identified by environmental health practitioners as important to meet new threats to public health. Methods. We conducted a national survey and 24 case studies of public health agencies. We invited 917 organizations to participate in the national survey because they had requested a copy of the protocol. Results. We received 656 total responses: 354 had not considered implementation, 302 had considered implementation, and 66 had implemented PACE EH. For the 24 case studies, we interviewed 206 individuals in communities implementing PACE EH. We found that PACE EH has had a positive effect on building community and professional networks, enhancing leadership, developing workforce competence, and expanding definitions of environmental health practice. Conclusions. With appropriate investments, PACE EH can be an effective tool to meet the environmental health challenges identified by local environmental health practitioners and state, tribal, and federal agencies.

Interactive Media for Diabetes Self-Management: Issues in Maximizing Public Health Impact

2010 ◽  
Vol 30 (6) ◽  
pp. 745-758 ◽  
Author(s):  
Russell E. Glasgow
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Interactive Media ◽  
Health Impact ◽  
Self Management ◽  
Public Health Impact ◽  
Shared Decision

Background . Diabetes self-management presents a series of challenging tasks, and primary care, where the majority of cases of adult diabetes are treated, is hard-pressed to address these issues given competing demands. This article discusses how interactive media (IM) can be used to support diabetes self-management. Methods . Following a brief review of the literature, the 5 As framework for enhancing the effectiveness of health behavior counseling and the RE-AIM model for estimating and enhancing public health impact are used to frame discussion of the strengths and limitations of IM for diabetes shared decision making and self-management support. Results . Data and lessons learned from a series of randomized trials of IM for diabetes self-management education are summarized around 2 key issues. The first is enhancing patient engagement in decision making and includes enhancing user experience and engagement, improving quality of care, and promoting collaborative action planning and follow-up. The second is getting such resources into place and sustaining them in real-world primary care settings and involves enhancing participation at patient, clinician, and health care system levels and enhancing the generalizability of results. Conclusions . Key opportunities for IM to support diabetes self-management include assessment of information for shared decision making, assistance with problem-solving self-management challenges, and provision of follow-up support. A key current challenge is the linkage of IM supports to the rest of the patient’s care, and collection of cost-effectiveness data is a key need for future research.

scholarly journals Experiences of community service environmental health practitioners

2017 ◽  
Vol 1 (2) ◽  
Author(s):  
Anusha Karamchand ◽  
Emilie J. Kistnasamy
Keyword(s):  
Public Health ◽  
Environmental Health ◽  
South African ◽  
Human Resource ◽  
Community Service ◽  
Tertiary Education ◽  
Health Sector ◽  
Family Structures ◽  
Health Practitioners ◽  
Managerial Implications

Orientation: The community service initiative, a 1-year placement of health graduates, significantly improved human resource availability in the South African public health sector, even though the process was fraught with challenges. Although experiences in the curative health sector were assessed, the experiences of environmental health practitioners were yet to be studied.Research purpose: This study assessed the experiences of environmental health practitioners during their community service year.Motivation for the study: Anecdotal evidence suggested problems with the process. This study endeavoured to identify the challenges whilst taking cognisance of its effectiveness.Method: A total of n = 40 environmental health graduates from the Durban University of Technology who had concluded community service completed questionnaires in this crosssectional quantitative study. Descriptive statistics, means and standard deviations were used to analyse the data.Main findings: The timing of community service placements was critical as 58% of respondents had to repay study loans. The placement of married respondents (10%) outside KwaZuluNatal, however, could have had impacts on family structures. Only 68% felt stimulated by their job functions, and there arose challenges with accommodation and overtime duties. Respondents felt that their tertiary education did equip them and that engagement with senior personnel helped in their professional development. Even though most of the review of the community service year appeared to be positive, a majority of respondents did not intend to continue working or recommending their workplaces. Future career pathing showed that 79% would prefer to be employed outside the public sector.Practical and managerial implications: The process needs to be reviewed to strengthen human resource management and enhance retention in the often overloaded and under-resourced South African public health sector.Contribution: Relevant stakeholders can better plan, communicate and support affected parties through empowering management structures and providing logistical aid.

scholarly journals Multiparametric Analysis of Urban Environmental Quality for Estimating Neighborhood Renewal Alternatives

2021 ◽  
Vol 6 (4) ◽  
pp. 172-188 ◽  
Author(s):  
Dalit Shach-Pinsly ◽  
Stefan Bindreiter ◽  
Idan Porat ◽  
Shai Sussman ◽  
Julia Forster ◽  
...  
Keyword(s):  
Decision Making ◽  
Built Environment ◽  
Urban Renewal ◽  
Environmental Quality ◽  
Scenario Analysis ◽  
Water Infiltration ◽  
Decision Making Process ◽  
Sense Of Security ◽  
The City

The neighborhood renewal process is an important opportunity to update the built environment; however, major changes to the built environment might decrease spatial performance and environmental quality. In these processes, there is a need to evaluate urban renewal alternatives, especially the quality of the environment, to understand the performance of the newly designed built environment. The quality of the built environment depends on a variety of aspects (such as walkability, energy level, security, open spaces, water permeability, etc.), several of which can be assessed using diverse measurements and evaluation models. Current new technological developments, based on GIS, enable the evaluation of diverse aspects of environmental quality and promote urban renewal decision-making processes. Urban renewal needs to harness these models in the decision-making approaches to improve assessment processes of urban renewal alternative estimations that consider future performance and quality of the built environment. In this article, we present a 3D-GIS multiparametric scenario analysis for neighborhood renewal alternatives estimation to evaluate the performance and quality of the built environment as part of the decision-making process. The multiparametric approach will include an evaluation analysis of several aspects of environmental quality, including walkability, accessibility, sense of security, energy, shade, water infiltration, visibility, and more. The analysis results will indicate the level of performance for each aspect as indices for environmental quality. The multiparametric scenario analysis for neighborhood renewal will be conducted on three renewal alternatives for one neighborhood in the city of Hatzor HaGlilit, Israel.<p>In this article, we present a 3D-GIS multiparametric scenario analysis for neighborhood renewal alternatives estimation to evaluate the performance and quality of the built environment as part of the decision-making process. The multiparametric approach will include evaluation analysis of several aspects of the environmental quality, including walkability, accessibility, sense of security, energy, shade, water infiltration, visibility, and more. The analysis results will indicate the level of performance for each aspect, as indices for environmental quality. The multiparametric scenario analysis for neighborhood renewal will be conducted on three renewal alternatives for one neighborhood in the city of Hatzor-HaGlilit, Israel.</p>

scholarly journals Evidence-to-decision frameworks: a review and analysis to inform decision-making for environmental health interventions

2021 ◽  
Author(s):  
Susan L Norris ◽  
Max T Aung ◽  
Nicholas Chartres ◽  
Tracey Woodruff
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Environmental Health ◽  
Systematic Reviews ◽  
Clinical Medicine ◽  
The Body ◽  
Health Interventions ◽  
Convenience Sample ◽  
Starting Point ◽  
Health Objectives

Background Evidence-to-decision (EtD) frameworks provide a structured and transparent approach for groups of experts to use when formulating recommendations or making decisions. While extensively used for clinical and public health recommendations, EtD frameworks are not in widespread use in environmental health. Objectives This review sought to identify, compare and contrast key EtD frameworks for decisions or recommendations on interventions used in clinical medicine, public health or environmental health. Our goal was to identify best practices and guidance which will be used to inform the development of an EtD framework for formulating recommendations regarding interventions to prevent or mitigate the harmful effects of exposure to substances in the environment. Methods We identified a convenience sample of EtD frameworks used by a range of organizations. We searched Medline for systematic reviews of EtD frameworks used in clinical medicine, and public or environmental health. In a qualitative manner, we summarized the decision criteria in the selected frameworks and in the reviews. Results Fourteen key organizations provided 18 EtD frameworks; most frameworks focused on clinical medicine or public health interventions; four focused on environmental health and three on economic considerations. Only one framework was based on an underlying conceptual model, and rarely was a systematic review of potential criteria performed during the frameworks development. GRADE encompasses a set of closely related frameworks for different types of decisions. Harms of interventions were examined in all frameworks and benefits in all but one. Other criteria included certainty of the body of evidence (15 frameworks), resource considerations (15), feasibility (13), equity (12), values (11), acceptability (11), and human rights (2). There was variation in how specific criteria were defined. The five identified systematic reviews reported a similar spectrum of EtD criteria. Discussion The EtD frameworks examined encompassed similar criteria, with tailoring to specific audience needs. However, there is variation in development processes, terminology, level of detail provided and presentation of the criteria. Existing frameworks are a useful starting point for development of one tailored to decision-making in environmental health.

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