scholarly journals Performance and Priorities: A Cross-sectional Study of Local Health Department Approaches to Essential Public Health Services

2019 ◽  
Vol 135 (1) ◽  
pp. 97-106 ◽  
Author(s):  
Megan Wallace ◽  
Joshua Sharfstein ◽  
Justin Lessler
Keyword(s):  
Public Health ◽  
Health Services ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Public Health Services ◽  
Cross Sectional ◽  
Local Public Health ◽  
Essential Public Health Services ◽  
Per Capita

Objectives: Despite a push for increased local public health capacity, no clear baseline for performance of local health departments (LHDs) exists. The objectives of this study were to quantify the self-reported performance of LHDs on the 10 Essential Public Health Services (EPHSs) and describe the relationships between performance and characteristics of LHDs. Methods: We used data on 2000 LHDs from the 2013 National Profile of Local Health Departments survey to develop principal components analysis–based scores to evaluate each LHD on the performance of EPHSs. Scores ranged from 0 to 100. LHDs that performed no activities within an EPHS had a score of 0, and LHDs that performed all activities within an EPHS had a score of 100. We explored the relationships between EPHS scores and LHD characteristics by using multivariate linear regression and cluster analysis. Results: Performance scores varied greatly by LHDs and EPHSs; however, LHDs typically scored <50, indicating that they performed fewer than half of the activities evaluated. LHDs that served larger populations (vs smaller populations) and LHDs that had higher per-capita funding (vs lower per-capita funding) had higher EPHS scores. We identified 6 EPHS performance score–based LHD clusters, which suggests similarities in which EPHSs LHDs focused on. Conclusions: Our results suggest weaknesses in many LHDs’ fulfillment of the EPHSs, particularly in low-population and low-funding settings. LHDs should be given the resources to increase capacity and ensure the EPHSs are met in communities.

scholarly journals The impact of the COVID-19 response on the provision of other public health services in the U.S.: A cross sectional study

2021 ◽  
Author(s):  
Kristina W. Kintziger ◽  
Kahler W. Stone ◽  
Meredith Jagger ◽  
Jennifer A. Horney
Keyword(s):  
Public Health ◽  
Health Services ◽  
Cross Sectional Study ◽  
Health Departments ◽  
Public Health Services ◽  
Cross Sectional ◽  
Career Plans ◽  
Public Health Departments ◽  
Essential Public Health Services ◽  
The U.S

Abstract Background Funding and staff formerly dedicated to routine public health tasks (e.g., responding to communicable and non-communicable diseases, investigating foodborne outbreaks, conducting routine surveillance) and services (e.g., environmental health, substance abuse, maternal-child health) may no longer be available in many public health departments due to the COVID-19 response. The objective of this study was to assess the extent to which staffing for essential public health services has been redirected to the COVID-19 response. Methods This is a cross-sectional study using a survey distributed through the Qualtrics platform. Individuals (N = 298) working in public health across governmental and academic public health departments in the U.S. during the ongoing COVID-19 pandemic response were surveyed. Survey items measured multiple domains including professional experience (i.e., training, years of experience, content expertise, job functions), mental and physical health status (i.e., generalized anxiety, depression, burnout), and career plans (i.e., pre-pandemic vs. current career plans). Results The total number of content expertise areas and programmatic functions covered by individual public health workers increased between January and September of 2020, with 26% (73 of 282) of respondents reporting an increase in both. The total number of respondents working in infectious disease and preparedness remained constant, while declines were reported in program evaluation (-36%) and health education (-27%) and increases were reported in disease investigation (+ 35%). Conclusions The provision of many essential public health functions and tasks have been limited or eliminated while the U.S. public health workforce responds to the COVID-19 pandemic. These findings highlight opportunities for funding and professional development of public health systems, both during and after the COVID-19 response, to help ensure the continuity of essential public health services, staffing sustainability, and preparedness for future public health emergencies in the U.S. Trial registration: Not applicable.

Quantifying Disaster Impacts on Local Public Health Agency’s Leadership, Staffing, and Provision of Essential Public Health Services

2021 ◽  
pp. 1-6
Author(s):  
Lauren A. Clay ◽  
Kahler W. Stone ◽  
Jennifer A. Horney
Keyword(s):  
Public Health ◽  
Health Services ◽  
Disaster Response ◽  
Professional Staff ◽  
Local Health ◽  
Public Health Services ◽  
Local Public Health ◽  
Incident Command ◽  
Essential Public Health Services ◽  
The Impact

Abstract Objective: The objective of this study is to assess the impact that natural disaster response has on local health departments’ (LHD) ability to continue to provide essential public health services. Methods: A web-based survey was sent to all North Carolina Local Health Directors. The survey asked respondents to report on LHD functioning following Hurricanes Florence (2018) and Dorian (2019). Results: After Hurricane Florence, the positions who most frequently had regular duties postponed or interrupted were leadership (15 of 48; 31.3%), and professional staff (e.g., nursing and epidemiology: 11 of 48; 22.9%). Staffing shelters for all phases – from disaster response through long-term recovery – was identified as a burden by LHDs, particularly for nursing staff. Approximately 66.6% of LHD jurisdictions opened an Emergency Operations Center (EOC) or activated Incident Command System in response to both hurricanes. If an EOC was activated, the LHD was statistically, significantly more likely to report that normal duties had been interrupted across every domain assessed. Conclusions: The ability of LHDs to perform regular activities and provide essential public health services is impacted by their obligations to support disaster response. Better metrics are needed to measure the impacts to estimate indirect public health impacts of disasters.

Snow Storms and Vulnerable Populations: Local Public Health Activities in Response to the 2014-2015 Severe Winter Weather

2018 ◽  
Vol 13 (03) ◽  
pp. 647-649
Author(s):  
Dorothy Bernard ◽  
Souleymane Konate ◽  
Elena Savoia
Keyword(s):  
Public Health ◽  
Vulnerable Populations ◽  
Winter Season ◽  
Severe Weather ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Public Health Services ◽  
Local Public Health ◽  
The Impact

ABSTRACTThe Northeastern United States experienced some of its coldest and snowiest conditions ever recorded during the winter of 2014-2015. The snowfall and extreme temperatures created significant challenges for local health departments attempting to continue critical services and respond to storm-related needs of the community. This report from the field aims to describe the impact of the severe weather on local health departments’ operations, to examine the disruption to public health services, and to document public health support provided to vulnerable populations during the 2014-2015 winter season. Our findings show that the severe weather exposed major challenges in continuity of public health operations across health departments of various sizes and highlighted some key issues as well as effective strategies, such as collaborations with community-based organizations, to identify and address the needs of the most vulnerable during the winter storms. (Disaster Med Public Health Preparedness. 2019;13:647-649)

scholarly journals The impact of the COVID-19 response on the provision of other public health services in the U.S.: A cross sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0255844
Author(s):  
Kristina W. Kintziger ◽  
Kahler W. Stone ◽  
Meredith A. Jagger ◽  
Jennifer A. Horney
Keyword(s):  
Public Health ◽  
Health Services ◽  
Cross Sectional Study ◽  
Health Departments ◽  
Public Health Services ◽  
Cross Sectional ◽  
Career Plans ◽  
Public Health Departments ◽  
Essential Public Health Services ◽  
The U.S

Introduction Funding and staff formerly dedicated to routine public health tasks (e.g., responding to communicable and non-communicable diseases, investigating foodborne outbreaks, conducting routine surveillance) and services (e.g., environmental health, substance abuse, maternal-child health) may no longer be available in many public health departments due to the COVID-19 response. The objective of this study was to assess the extent to which staffing for essential public health services has been redirected to the COVID-19 response. Materials and methods This is a cross-sectional study using a survey distributed through the Qualtrics platform. Individuals (N = 298) working in public health across governmental and academic public health departments in the U.S. during the ongoing COVID-19 pandemic response were surveyed. Survey items measured multiple domains including professional experience (i.e., training, years of experience, content expertise, job functions, hours worked), mental and physical health status (i.e., generalized anxiety, depression, burnout), and career plans (i.e., pre-pandemic vs. current career plans). Results The total number of content expertise areas and programmatic functions covered by individual public health workers increased between January and September of 2020, with 26% (73 of 282) of respondents reporting an increase in both. The total number of respondents working in infectious disease and preparedness remained constant, while declines were reported in program evaluation (-36%) and health education (-27%) and increases were reported in disease investigation (+35%). Conclusions The provision of many essential public health functions and tasks have been limited or eliminated while the U.S. public health workforce responds to the COVID-19 pandemic. These findings highlight opportunities for funding and professional development of public health systems, both during and after the COVID-19 response, to help ensure the continuity of essential public health services, staffing sustainability, and preparedness for future public health emergencies in the U.S.

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

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.

TRENDS

PEDIATRICS ◽  
1951 ◽  
Vol 7 (2) ◽  
pp. 259-261
Keyword(s):  
Public Health ◽  
Child Health ◽  
Health Services ◽  
Presidential Address ◽  
Child Health Services ◽  
Local Health ◽  
Health Departments ◽  
Local Public Health ◽  
Clinical Session ◽  
Study Results

A MONTH ago in this column, we drew attention to the status of the Local Public Health Units Bill as it stood in early December in the 81st Congress. We have been watching with special interest the further course of this Bill in view of its direct relationship to the oft' expressed objective of the Academy to extend child health services into areas of need. One of the needs most clearly demonstrated by the Academy's study results from the inequity of health services in rural and isolated areas in comparison with metropolitan areas. The Local Public Health Units Bill proposes to stimulate the development of local health departments, one of the recognized functions of which would be an extension of maternal and child health services. The support which this Bill has received and the fate of this Bill in the 81st Congress may be summarized by the following quotations: In his presidential address, presented at the Fourth Annual Clinical Session of the AMA in Cleveland, December 5 to 8, Dr. E. L. Henderson said: "The American Medical Association has long believed that the existence of effective and properly operated public health units is basic to the maintenance and improvement of the health of the people. As early as 1883, a report was made at the annual meeting of the Association covering a survey conducted to ascertain what states and counties had health departments.

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