scholarly journals Applied Epidemiology Workforce Growth and Capacity Challenges: The Council of State and Territorial Epidemiologists 2017 Epidemiology Capacity Assessment

2019 ◽  
Vol 134 (4) ◽  
pp. 379-385 ◽  
Author(s):  
Jessica Arrazola ◽  
Mia N. Israel ◽  
Nancy Binkin
Keyword(s):  
Public Health ◽  
Health Department ◽  
The United States ◽  
Current Status ◽  
Public Health Department ◽  
Health Departments ◽  
State Health ◽  
Public Health Services ◽  
Full Capacity ◽  
Council Of State

Objectives: To better understand the current status and challenges of the state public health department workforce, the Council of State and Territorial Epidemiologists (CSTE) assessed the number and functions of applied public health epidemiologists at state health departments in the United States. Methods: In 2017, CSTE emailed unique online assessment links to state epidemiologists in the 50 states and the District of Columbia (N = 51). The response rate was 100%. CSTE analyzed quantitative data (27 questions) on funding, the number of current and needed epidemiologists, recruitment, retention, perceived capacity, and training. CSTE coded qualitative data in response to an open-ended question that asked about the most important problems state epidemiologists face. Results: Most funding for epidemiologic activities came from the federal government (mean, 77%). State epidemiologists reported needing 1199 additional epidemiologists to achieve ideal capacity but noted challenges in recruiting qualified staff members. Respondents cited opportunities for promotion (n = 45, 88%), salary (n = 41, 80%), restrictions on merit raises (n = 36, 70%), and losses to the private or government sector (n = 33, 65%) as problems for retention. Of 4 Essential Public Health Services measured, most state epidemiologists reported substantial-to-full capacity to monitor health status (n = 43, 84%) and diagnose and investigate community health problems (n = 47, 92%); fewer respondents reported substantial-to-full capacity to conduct evaluations (n = 20, 39%) and research (n = 11, 22%). Conclusions: Reliance on federal funding negatively affects employee retention, core capacity, and readiness at state health departments. Creative solutions for providing stable funding, developing greater flexibility to respond to emerging threats, and enhancing capacity in evaluation and applied research are needed.

scholarly journals Epidemiology Workforce Capacity in 27 Large Urban Health Departments in the United States, 2017

2019 ◽  
Vol 134 (4) ◽  
pp. 386-394
Author(s):  
Meghan D. McGinty ◽  
Nancy Binkin ◽  
Jessica Arrazola ◽  
Mia N. Israel ◽  
Chrissie Juliano
Keyword(s):  
Public Health ◽  
United States ◽  
Urban Health ◽  
The United States ◽  
Health Problems ◽  
Full Time ◽  
Health Departments ◽  
Public Health Services ◽  
Full Time Equivalent ◽  
Workforce Capacity

Objectives: The Council of State and Territorial Epidemiologists (CSTE) has periodically assessed the epidemiological capacity of states since 2001, but the data do not reflect the total US epidemiology capacity. CSTE partnered with the Big Cities Health Coalition (BCHC) in 2017 to assess epidemiology capacity in large urban health departments. We described the epidemiology workforce capacity of large urban health departments in the United States and determined gaps in capacity among BCHC health departments. Methods: BCHC, in partnership with CSTE, modified the 2017 State Epidemiology Capacity Assessment for its 30 member departments. Topics in the assessment included epidemiology leadership, staffing, funding, capacity to perform 4 epidemiology-related Essential Public Health Services, salary ranges, hiring requirements, use of competencies, training needs, and job vacancies. Results: The 27 (90%) BCHC-member health departments that completed the assessment employed 1091 full-time equivalent epidemiologists. All or nearly all health departments provided epidemiology services for programs in infectious disease (n = 27), maternal and child health (n = 27), preparedness (n = 27), chronic diseases (n = 25), vital statistics (n = 25), and environmental health (n = 23). On average, funding for epidemiology activities came from local (47%), state (24%), and federal (27%) sources. Health departments reported needing a 40% increase from the current number of epidemiologists to achieve ideal epidemiology capacity. Twenty-five health departments reported substantial-to-full capacity to monitor health problems, 21 to diagnose health problems, 11 to conduct evaluations, and 9 to perform applied research. Conclusions: Strategies to meet 21st century challenges and increase substantial-to-full epidemiological capacity include seeking funds from nongovernmental sources, partnering with schools and programs of public health, and identifying creative solutions to hiring and retaining epidemiologists.

scholarly journals Prioritizing Workforce Development Training in State Health Departments Using TRAIN: Challenges and Opportunities

2019 ◽  
Vol 134 (2) ◽  
pp. 172-179
Author(s):  
Magali Angeloni ◽  
Ron Bialek ◽  
Michael P. Petros ◽  
Michael C. Fagen
Keyword(s):  
Public Health ◽  
Core Competencies ◽  
Public Health Workforce ◽  
Current Status ◽  
Full Time ◽  
Health Departments ◽  
State Health ◽  
Training Tool ◽  
Management Platform ◽  
Organizational Features

Objective: The objectives of this study were (1) to obtain data on the current status of public health workforce training and the use of the Training Finder Real-Time Affiliate Network (TRAIN), a public health learning management platform, in state health departments, and (2) to use the data to identify organizational features that might be affecting training and to determine barriers to and opportunities for improving training. Methods: We conducted structured interviews in 2014 with TRAIN administrators and performance improvement managers (n = 14) from 7 state health departments that were using TRAIN to determine training practices and barriers to training. We determined key organizational features of the 7 agencies, including training structure, required training, TRAIN administrators’ employment status (full time or part time), barriers to the use and tracking of core competencies in TRAIN, training needs assessment methods, leadership support of training and staff development, and agency interest in applying for Public Health Accreditation Board accreditation. Results: We identified 4 common elements among TRAIN-affiliated state health departments: (1) underuse of TRAIN as a training tool, (2) inadequate ownership of training within the organization, (3) insufficient valuation of and budgeting for training, and (4) emerging collaboration and changing perceptions about training stimulated by agency preparation for accreditation. Conclusions: Public health leaders can increase buy-in to the importance of training by giving responsibility for training to a person, centralizing training, and setting expectations for the newly responsible training leader to update training policy and require the use of TRAIN to develop, implement, evaluate, monitor, and report on agency-wide training.

scholarly journals 965. Partnering with State Health Departments: A Road Map for Collaboration Using Public Health Enhanced HIV/AIDS Reporting System (eHARS)

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S512-S513
Author(s):  
John R Bassler ◽  
Emily B Levitan ◽  
Lauren Ostrenga ◽  
Danita C Crear ◽  
Kendra L Johnson ◽  
...  
Keyword(s):  
Public Health ◽  
Reporting System ◽  
Health Department ◽  
Distributed Data ◽  
Summary Statistics ◽  
Health Departments ◽  
State Health ◽  
State Health Department ◽  
Data Network ◽  
Hiv Aids

Abstract Background Academic and public health partnerships are a critical component of the Ending the HIV Epidemic: A Plan for America (EHE). The Enhanced HIV/AIDS Reporting System (eHARS) is a standardized document-based surveillance database used by state health departments to collect and manage case reports, lab reports, and other documentation on persons living with HIV. Innovative analysis of this data can inform targeted, evidence-based interventions to achieve EHE objectives. We describe the development of a distributed data network strategy at an academic institution in partnership with public health departments to identify geographic differences in time to HIV viral suppression after HIV diagnosis using eHARS data. Figure 1. Distributed Data Network Methods This project was an outgrowth of work developed at the University of Alabama at Birmingham Center for AIDS Research (UAB CFAR) and existing relationships with the state health departments of Alabama, Louisiana, and Mississippi. At a project start-up meeting which included study investigators and state epidemiologists, core objectives and outcome measures were established, key eHARS variables were identified, and regulatory and confidentiality procedures were examined. The study methods were approved by the UAB Institutional Review Board (IRB) and all three state health department IRBs. Results A common data structure and data dictionary across the three states were developed. Detailed analysis protocols and statistical code were developed by investigators in collaboration with state health departments. Over the course of multiple in-person and virtual meetings, the program code was successfully piloted with one state health department. This generated initial summary statistics, including measures of central tendency, dispersion, and preliminary survival analysis. Conclusion We developed a successful academic and public health partnership creating a distributed data network that allows for innovative research using eHARS surveillance data while protecting sensitive health information. Next, state health departments will transmit summary statistics to UAB for combination using meta-analytic techniques. This approach can be adapted to inform delivery of targeted interventions at a regional and national level. Disclosures All Authors: No reported disclosures

NEWS AND ANNOUNCEMENTS

PEDIATRICS ◽  
1971 ◽  
Vol 47 (3) ◽  
pp. 637-641
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health Services ◽  
Disease Control ◽  
Health Workers ◽  
Health Departments ◽  
State Health ◽  
Public Health Services ◽  
And Control ◽  
The U.S

Course on Tuberculosis: A course on Tuberculosis Today will be offered six times during 1971 by the U.S. Public Health Services Center for Disease Control, Atlanta, Georgia. The course is intended for health workers who are responsible for the management and control of tuberculosis, and for those responsible for providing teaching or training in the fields of tuberculosis or infectious disease. No fees are charged for these courses. Application forms can be obtained from State Health Departments, HEW Regional Offices, or the Tuberculosis Branch, Center for Disease Control, Atlanta, Georgia.

Assessing the Capacity of State Physical Activity Programs—A Baseline Perspective

2010 ◽  
Vol 7 (1) ◽  
pp. 119-126 ◽  
Author(s):  
Tamara Vehige Calise ◽  
Sarah Martin
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Physical Inactivity ◽  
Public Health Practice ◽  
Health Department ◽  
Health Departments ◽  
State Health ◽  
Chi Square ◽  
Prevalence Of Obesity ◽  
Physical Activity Programs

Background:Physical inactivity is one of the top 3 risk factors associated with an increased prevalence of obesity and other chronic diseases. The public health infrastructure positions state health departments to address physical inactivity. To examine preparedness, all 50 health departments were assessed, using the 5 benchmarks developed by CDC for physical activity and public health practice, on their capacity to administer physical activity programs.Methods:States were scored on a 5-point scale for each benchmark. The top 2 high and low scores were combined to create 2 categories. Exact Chi-square analyses were performed.Results:States with CDC obesity funding scored higher on 4 benchmarks than states without. States with a state physical activity plan scored higher on all benchmarks than states without. States with a physical activity coalition scored higher on 2 benchmarks than states without.Conclusions:At the time of the assessment, approximately 20% of state physical activity programs could have improved in the use of evidence-based strategies and planning and evaluation approaches. Furthermore, many programs seemed to have limited sustainability. The findings of this report serve as a baseline of the capacity and infrastructure of state health department physical activity programs.

scholarly journals Epidemiological Effectiveness and Cost of a Fungal Meningitis Outbreak Response in New River Valley, Virginia: Local Health Department and Clinical Perspectives

2017 ◽  
Vol 12 (1) ◽  
pp. 38-46
Author(s):  
Nargesalsadat Dorratoltaj ◽  
Margaret L. O’Dell ◽  
Paige Bordwine ◽  
Thomas M. Kerkering ◽  
Kerry J. Redican ◽  
...  
Keyword(s):  
Public Health ◽  
Health Department ◽  
The United States ◽  
River Valley ◽  
Local Health Department ◽  
Local Health ◽  
Public Health Department ◽  
Outbreak Response ◽  
Fungal Meningitis ◽  
Life Years

AbstractObjectiveWe evaluated the effectiveness and cost of a fungal meningitis outbreak response in the New River Valley of Virginia during 2012-2013 from the perspective of the local public health department and clinical facilities. The fungal meningitis outbreak affected 23 states in the United States with 751 cases and 64 deaths in 20 states; there were 56 cases and 5 deaths in Virginia.MethodsWe conducted a partial economic evaluation of the fungal meningitis outbreak response in New River Valley. We collected costs associated with the local health department and clinical facilities in the outbreak response and estimated the epidemiological effectiveness by using disability-adjusted life years (DALYs) averted.ResultsWe estimated the epidemiological effectiveness of this outbreak response to be 153 DALYs averted among the patients, and the costs incurred by the local health department and clinical facilities to be $30,413 and $39,580, respectively.ConclusionsWe estimated the incremental cost-effectiveness ratio of $198 per DALY averted and $258 per DALY averted from the local health department and clinical perspectives, respectively, thereby assisting in impact evaluation of the outbreak response by the local health department and clinical facilities. (Disaster Med Public Health Preparedness. 2018;12:38–46)

scholarly journals Evidence-based lead mitigation strategies: Are the DIY lead mitigation recommendations by health departments supported by research?

2020 ◽  
Vol 3 ◽  
Author(s):  
Seth Losiewicz ◽  
Heidi Beidinger-Burnett ◽  
Christopher Knaub
Keyword(s):  
Literature Review ◽  
Cost Effective ◽  
Health Department ◽  
The United States ◽  
Mitigation Strategies ◽  
Evidence Based ◽  
Health Departments ◽  
State Health ◽  
Lead Levels ◽  
Lead Hazards

Background: Legislation outlawing leaded paint in 1978 and tetraethyl lead from gasoline in 1992 effectively decreased blood lead levels (BLLs), but the effects of lead are still felt in the United States to this day. There is no safe level of lead in the body, and even low level lead exposure can lead to cognitive and developmental delays such as learning delay and disabilities; low IQ; and attention-deficit/hyperactivity disorder. The CDC has determined that a BLL of 5 μg/dL or higher is cause for environmental and educational intervention. Today, the EPA estimates that there are approximately 24 million housing units containing significant lead hazards, with 4 million being home to children. Many of the families that are faced with lead hazards in their homes are minorities and low socioeconomic status. To assist families with possible lead hazards in the home, interim controls of lead hazards may be paramount to reducing lead levels in the household in a simple, cost effective manner. Methods: To that end, our research had two aims (a) conduct a systematic literature review to learn about do-it-yourself (DIY) interim controls that are evidence-based and effective in reducing lead hazards in the home and (b) conduct interviews with key personnel at each state health department to learn more about their lead prevention programs and the DIY mitigation strategies recommended to families. Results: Our provisional findings suggest there is an inconsistent, wide range of mitigation strategies recommended by the state health departments that often lack empirical evidence. . While our literature review identified effective interim controls, the literature is outdated. Conclusion and Potential Impact: We recommend more studies are needed to identify cost effective interim controls and the standardization of health department DIY interim controls across the nation.

scholarly journals 1207. Coronavirus Disease, 2019 (COVID-19) in Long-Term Care Facilities (LTCF): One Large County’s Response, California 2020-2021

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S694-S694
Author(s):  
Raymond Y Chinn ◽  
Sayone Thihalolipavan ◽  
Jennifer Wheeler ◽  
Grace Kang ◽  
John D Malone ◽  
...  
Keyword(s):  
Public Health ◽  
Long Term Care ◽  
Health Department ◽  
The United States ◽  
Infection Prevention And Control ◽  
Public Health Department ◽  
Term Care ◽  
Care Facilities ◽  
Outbreak Investigations

Abstract Background The coronavirus-19 disease (COVID-19) outbreak has had a particularly devasting effect on skilled nursing facility (SNF) residents and healthcare workers (HCWs). While representing only 11% of COVID-19 cases, the residents accounted for 43% of deaths in the United States. Methods We report a retrospective review of the support provided by our local health department (LHD) to long-term care facilities in response to the COVID-19 pandemic. This group comprised of staff from healthcare-associated infections (HAI); the Medical Operations Center (MOC); Testing, Tracing, and Treatment (T3); and the Healthcare Provider Status Taskforce (Table 1 outlines their functions). The HAI team with the State Public Health Department provided infection prevention and control (IPC) outbreak investigation, education, recommendations, and ongoing access to technical assistance. The T3 team focused on rapid response testing and tracing; the HPSTF team collected data and issued questionnaires; the MOC responded to staffing and PPE requests; and the Long-Term Care Facility sector presented routine telebriefings to update the facilities on public health guidance, share resources, and answer questions during and in between briefings. Table 1. Sectors and Function of Response Teams to COVID-19 Results From March 2020 through May 2021, there were 504 outbreaks in LTCFs; the HAI team performed 281 outbreak investigations (Figure 1). In the same period, 308,264 molecular tests were performed using various platforms; laboratory services were outsourced during peak testing requests (Figure 2); “strike teams were deployed to facilitate testing on 404 occasions. Self-reported fully vaccination rate for SNF staff was 73% (March 2021) and 76% for residents (April 2021). There were 568 staff requested; total orders for PPE were 4,839 and 16,892,823 PPE items were fulfilled (Figure 3). In addition to knowledge gaps in IPC, other challenges included shifting IPC guidance, PPE shortages, timeliness of test results that impacted cohorting, community acquisition of disease with transmission to residents, interfacility spread among staff, staffing shortages, and vaccine hesitancy issues. Figure 1. Number of Outbreaks and Number of Outbreak Investigations Figure 2. Number of Tests Performed by the Public Health Laboratory and the Number of Visits by “Strike Teams” Figure 3. Personal Protective Equipment Fulfillment during COVID-19 Pandemic Conclusion The management of the recent COVID-19 outbreaks required a multi-pronged approach. Lessons learned are applicable to other highly transmissible infectious diseases. Disclosures All Authors: No reported disclosures

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