Community Capacity for Environmental Health Promotion: Determinants and Implications for Practice

2004 ◽  
Vol 31 (4) ◽  
pp. 472-490 ◽  
Author(s):  
Nicholas Freudenberg
Keyword(s):  
Public Health ◽  
Environmental Health ◽  
Community Capacity ◽  
Local Health ◽  
Local Health Departments ◽  
Playing Field ◽  
Public Health Professionals ◽  
Health Action ◽  
Science Building ◽  
Public Health Strategies

The human response to an environmental hazard can either reduce or exacerbate its impact on health. This article reviews determinants of community-level responses to environmental health hazards. The aim is to identify factors that can enhance a community’s capacity to protect itself and to suggest public health strategies that can increase such capacity. Four case histories of community environmental health action are presented to test a theoretical model for understanding the determinants of community capacity to promote environmental health. Specific actions public health professionals can take to strengthen community capacity include increasing access to accurate science, building strong relationships between communities and local health departments, and supporting political reforms that level the playing field for communities that seek to challenge corporate or government practices.

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.

scholarly journals Actionable lessons for the US COVID vaccine program

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.

Defining Priorities for Action and Research on the Commercial Determinants of Health: A Conceptual Review

2021 ◽  
Vol 111 (12) ◽  
pp. 2202-2211
Author(s):  
Nicholas Freudenberg ◽  
Kelley Lee ◽  
Kent Buse ◽  
Jeff Collin ◽  
Eric Crosbie ◽  
...  
Keyword(s):  
Public Health ◽  
Health Professionals ◽  
Determinants Of Health ◽  
Health Conditions ◽  
Noncommunicable Diseases ◽  
Public Health Action ◽  
Environmental Threats ◽  
Public Health Professionals ◽  
Health Action ◽  
Definition Of

In recent years, the concept of commercial determinants of health (CDoH) has attracted scholarly, public policy, and activist interest. To date, however, this new attention has failed to yield a clear and consistent definition, well-defined metrics for quantifying its impact, or coherent directions for research and intervention. By tracing the origins of this concept over 2 centuries of interactions between market forces and public health action and research, we propose an expanded framework and definition of CDoH. This conceptualization enables public health professionals and researchers to more fully realize the potential of the CDoH concept to yield insights that can be used to improve global and national health and reduce the stark health inequities within and between nations. It also widens the utility of CDoH from its main current use to study noncommunicable diseases to other health conditions such as infectious diseases, mental health conditions, injuries, and exposure to environmental threats. We suggest specific actions that public health professionals can take to transform the burgeoning interest in CDoH into meaningful improvements in health. (Am J Public Health. 2021;111(12):2202–2211. https://doi.org/10.2105/AJPH.2021.306491 )

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

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 )

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.

scholarly journals Supply-and-demand projections for the health workforce at a provincial level from 2015 to 2025 in Ilam, Iran

2020 ◽  
pp. 201010582094323
Author(s):  
Mohammad Bazyar ◽  
Somayeh Noori Hekmat ◽  
Sima Rafiei ◽  
Amin Mirzaei ◽  
Masoomeh Otaghi ◽  
...  
Keyword(s):  
Public Health ◽  
Human Resources ◽  
Environmental Health ◽  
Health Workforce ◽  
Supply And Demand ◽  
Current Trend ◽  
General Medicine ◽  
Care Staff ◽  
Health Care Staff ◽  
Local Health

Background: Human resources are the key component of health systems. It is critical to have the right number of human resources at anytime and anywhere in the health system. This article aims to help local health decision makers to identify potential gaps between the future supply and demand of human resources and to make necessary changes in medical training processes to fill the gap. Methods: An eight-stage process was applied to project the supply and demand of health workers in Ilam province in 2025 for the following fields: public health, environmental health, general medicine, dentistry, pharmacy, nursing and midwifery. To estimate the demand for human resources, a mainly population-based model (manpower-to-population ratio) was applied. A modified version of the Australian dynamic stock and flow model was used to predict the supply of new recruits in 2025. The potential surplus or shortfall in the health workforce was calculated by comparing the supply and demand in 2025. Results: The demand and supply projections for the chosen fields were estimated respectively as: general medicine 457, 709; pharmacy 131, 86; dentistry 86, 251; nursing 949, 1657; midwifery 24, 247; public health 182, 211; and environmental health 92, 225. Conclusions: The current trend of medical graduates will meet the need for human resources in 2025, and there is no need to increase medical student admission. The Education Deputy of Ilam Medical University should take into account the health needs of its catchment area in medical educational processes and training new health-care staff.

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