scholarly journals Evaluating Streetscape Modifications in Los Angeles, California with a Health Lens

2019 ◽  
Vol 17 (1) ◽  
pp. 10-23
Author(s):  
Gabrielle Green ◽  
Lauren N. Gase ◽  
Chandini Singh ◽  
Tony Kuo
Keyword(s):  
Los Angeles ◽  
Built Environment ◽  
Driver Behavior ◽  
Health Department ◽  
Local Health Department ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Health Practitioners

Background and Purpose: Despite growing evidence linking health and the built environment, local health departments are often not involved in the evaluation of a streetscape modification project. This paper describes an assessment conducted by a local health department to address this gap by using a health lens to evaluate the installation of painted curb extensions on a commercial corridor in Los Angeles. Methods: The local health department conducted an observational pre-post study of pedestrian and motorist data at both an intersection receiving the painted curb extension and a comparison intersection along the same corridor that had already received the extension. The study also analyzed streetscape features along the corridor related to walkability, to understand the painted curb extension in the context of the broader built environment. Results: The painted curb extension did not appear to significantly impact pedestrian and motorist behavior, though some slight changes were observed. Pedestrians along the corridor generally exhibited safe behavior at intersections, but encountered dangerous driver behavior and built environment barriers, which can discourage walking. Conclusion: This case study demonstrates how health considerations can be integrated into an evaluation of a streetscape modification project, and can provide guidance for other health practitioners developing such evaluation projects in their own jurisdictions.

scholarly journals Using Systems Science to Inform Population Health Strategies in Local Health Departments: A Case Study in San Antonio, Texas

2017 ◽  
Vol 132 (5) ◽  
pp. 549-555 ◽  
Author(s):  
Yan Li ◽  
Norma A. Padrón ◽  
Anil T. Mangla ◽  
Pamela G. Russo ◽  
Thomas Schlenker ◽  
...  
Keyword(s):  
Population Health ◽  
San Antonio ◽  
Systems Science ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments

A Risk-Based Restaurant Inspection System in Los Angeles County

2002 ◽  
Vol 65 (2) ◽  
pp. 367-372 ◽  
Author(s):  
U. BUCHHOLZ ◽  
G. RUN ◽  
J. L. KOOL ◽  
J. FIELDING ◽  
L. MASCOLA
Keyword(s):  
Los Angeles ◽  
Los Angeles County ◽  
Univariate Analysis ◽  
Inspection System ◽  
Health Management Information System ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Food Protection ◽  
Restaurant Inspections

The majority of local health departments perform routine restaurant inspections. In Los Angeles County (LAC), California, approximately $10 million/year is spent on restaurant inspections. However, data are limited as to whether or not certain characteristics of restaurants make them more likely to be associated with foodborne incident reports. We used data from the LAC Environmental Health Management Information System (EHMIS), which records the results of all routine restaurant inspections as well as data regarding all consumer-generated foodborne incidents that led to a special restaurant inspection by a sanitarian (investigated foodborne incidents [IFBIs]). We analyzed a cohort of 10,267 restaurants inspected from 1 July 1997 to 15 November 1997. We defined a “case restaurant” as any restaurant with a routine inspection from 1 July 1997 to 15 November 1997 and a subsequent IFBI from 1 July 1997 to 30 June 1998. Noncase restaurants did not have an IFBI from 1 July 1997 to 30 June 1998. We looked for specific characteristics of restaurants that might be associated with the restaurant subsequently having an IFBI, including the size of restaurant (assessed by number of seats), any previous IFBIs, the overall inspection score, and a set of 38 violation codes. We identified 158 case restaurants and 10,109 noncase restaurants. In univariate analysis, middle-sized restaurants (61 to 150 seats; n = 1,681) were 2.8 times (95% confidence interval [CI] = 2.0 to 4.0) and large restaurants (>150 seats; n = 621) were 4.6 times (95% CI = 3.0 to 7.0) more likely than small restaurants (≤60 seats; n = 7,965) to become case restaurants. In addition, the likelihood of a restaurant becoming a case restaurant increased as the number of IFBIs in the prior year increased (χ2 for linear trend, P value = 0.0005). Other factors significantly associated with the occurrence of an IFBI included a lower overall inspection score, the incorrect storage of food, the reuse of food, the lack of employee hand washing, the lack of thermometers, and the presence of any food protection violation. In multivariate analysis, the size of restaurant, the incorrect storage of food, the reuse of food, and the presence of any food protection violation remained significant predictors for becoming a case restaurant. Our data suggest that routine restaurant inspections should concentrate on those establishments that have a large seating capacity or a poor inspection history. Evaluation of inspection data bases in individual local health departments and translation of those findings into inspection guidelines could lead to an increased efficiency and perhaps cost-effectiveness of local inspection programs.

scholarly journals Building Back Better: Local Health Department Engagement and Integration of Health Promotion into Hurricane Harvey Recovery Planning and Implementation

2019 ◽  
Vol 16 (3) ◽  
pp. 299 ◽  
Author(s):  
Mallory Kennedy ◽  
Shannon Gonick ◽  
Hendrika Meischke ◽  
Janelle Rios ◽  
Nicole Errett
Keyword(s):  
Disaster Recovery ◽  
Technical Assistance ◽  
Health Department ◽  
Decision Makers ◽  
Health Impacts ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Recovery Planning ◽  
Resilient Communities

Disaster recovery provides an opportunity to build healthier and more resilient communities. However, opportunities and challenges encountered by local health departments (LHDs) when integrating health considerations into recovery have yet to be explored. Following Hurricane Harvey, 17 local health and emergency management officials from 10 agencies in impacted Texas, USA jurisdictions were interviewed to describe the types and level of LHD engagement in disaster recovery planning and implementation and the extent to which communities leveraged recovery to build healthier, more resilient communities. Interviews were conducted between December 2017 and January 2018 and focused on if and how their communities were incorporating public health considerations into the visioning, planning, implementation, and assessment phases of disaster recovery. Using a combined inductive and deductive approach, we thematically analyzed interview notes and/or transcripts. LHDs reported varied levels of engagement and participation in activities to support their community’s recovery. However, we found that LHDs rarely articulated or informed decision makers about the health impacts of recovery activities undertaken by other sectors. LHDs would benefit from additional resources, support, and technical assistance designed to facilitate working across sectors and building resilience during recovery.

Disparities in well water outreach and assistance offered by local health departments: A North Carolina case study

2020 ◽  
Vol 747 ◽  
pp. 141173
Author(s):  
Kory Wait ◽  
Adrienne Katner ◽  
Daniel Gallagher ◽  
Marc Edwards ◽  
Wilson Mize ◽  
...  
Keyword(s):  
North Carolina ◽  
Well Water ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments

Employer Requirements to Work during Emergency Responses: Key Ethics Considerations

2017 ◽  
Vol 45 (S1) ◽  
pp. 73-76 ◽  
Author(s):  
Lainie Rutkow ◽  
Holly A. Taylor ◽  
Tia Powell
Keyword(s):  
Emergency Preparedness ◽  
Health Workers ◽  
Health Department ◽  
The United States ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Local Public Health ◽  
Public Health Workers ◽  
Emergency Responses

Local health departments and their employees are at the forefront of emergency preparedness and response. Yet, recent studies have found that some local public health workers are unwilling to report to work in a variety of disaster scenarios. This can greatly compromise a response, as many local health departments need “all hands on deck” to effectively meet increased demands. To address these concerns, local health departments have employed varied policy strategies to ensure that employees do report to work. After describing different approaches taken by local health departments throughout the United States, we briefly identify and explore key ethics considerations that arise for local health departments when employees are required to report to work for emergency responses. We then discuss how these ethics considerations may inform local health department practices intended to promote a robust emergency response.

scholarly journals Indicators to Guide and Monitor Climate Change Adaptation in the US Pacific Northwest

2020 ◽  
Vol 110 (2) ◽  
pp. 180-188
Author(s):  
Annie Doubleday ◽  
Nicole A. Errett ◽  
Kristie L. Ebi ◽  
Jeremy J. Hess
Keyword(s):  
Climate Change ◽  
Pacific Northwest ◽  
Climate Change Adaptation ◽  
Health Department ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
The Us ◽  
State And Local ◽  
Context Specific

Objectives. To develop a set of indicators to guide and monitor climate change adaptation in US state and local health departments. Methods. We performed a narrative review of literature on indicators of climate change adaptation and public health service capacity, mapped the findings onto activities grouped by the Centers for Disease Control and Prevention’s Ten Essential Services, and drafted potential indicators to discuss with practitioners. We then refined the indicators after key informant interviews with 17 health department officials in the US Pacific Northwest in fall 2018. Results. Informants identified a need for clarity regarding state and local public health’s role in climate change adaptation, integration of adaptation into existing programs, and strengthening of communication, partnerships, and response capacity to increase resilience. We propose a set of climate change indicators applicable for state and local health departments. Conclusions. With additional context-specific refinement, the proposed indicators can aid agencies in tracking adaptation efforts. The generalizability, robustness, and relevance of the proposed indicators should be explored in other settings with a broader set of stakeholders.

Leveraging Limited Resources Through Cross-Jurisdictional Sharing: Influences on Breastfeeding Rates

2020 ◽  
pp. 089033442096363
Author(s):  
M. Elizabeth Gyllstrom ◽  
Marcia Burton McCoy ◽  
Gianfranco Pezzini ◽  
Adam Atherly
Keyword(s):  
Public Health ◽  
Community Health ◽  
Relative Rate ◽  
Health Department ◽  
Rate Of Change ◽  
Local Health Department ◽  
Breastfeeding Initiation ◽  
Local Health ◽  
Health Departments ◽  
Health Boards

Background Cross-jurisdictional sharing is gaining traction as an option for increasing the effectiveness and efficiency of public health services in local health departments. Research aim Assess whether breastfeeding initiation among participants in the Special Supplemental Nutrition Program for Women, Infants and Children changed with the addition of a trained breastfeeding specialist funded by cross-jurisdictional integration. Methods A longitudinal retrospective comparative difference in difference design using state-based program data, pre- and post-integration was undertaken. Three local county health departments ( n = 5) that fully integrated into one Community Health Board during January 2015, and four neighboring Community Health Boards ( n = 4) that did not integrate, were included. Results Controlling for confounders and interactions, the relative rate of change over time in breastfeeding initiation rates was greater in the integrated jurisdiction than neighboring Community Health Boards, but not statistically significant. When the integrated Community Health Board’s original three local health departments were considered separately, the relative rate of change over time in breastfeeding rates was greater for one local health department in comparison to three neighbor Community Health Boards ( p = .037, .048, and .034, respectively). Conclusions The addition of a specialized breastfeeding nutritionist led to improved breastfeeding initiation rates. The increase was significant only in the largest original local health department, which also had the lowest breastfeeding initiation rate pre-merger. The greatest positive change was seen in this local health department where the specialist staff was physically located. Public health staff specialization can lead to increases in economic efficiency and in improved delivery of public health services.

scholarly journals The 2007 Los Angeles Mommy and Baby Study: A Multilevel, Population-Based Study of Maternal and Infant Health in Los Angeles County

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Shin M. Chao ◽  
Fathima Wakeel ◽  
Dena Herman ◽  
Chandra Higgins ◽  
Lu Shi ◽  
...  
Keyword(s):  
Los Angeles ◽  
Los Angeles County ◽  
Ethnic Disparities ◽  
Health Department ◽  
Obstetric Outcomes ◽  
Local Health Department ◽  
Local Health ◽  
Research Database ◽  
Racial Ethnic ◽  
Successful Collaboration

Objectives. In order to comprehensively examine the risks and resources associated with racial-ethnic disparities in adverse obstetric outcomes, the Los Angeles County Department of Public Health and the University of California, Los Angeles, joined efforts to design and implement the 2007 Los Angeles Mommy and Baby (LAMB) study. This paper aims to present the conceptual frameworks underlying the study’s development, highlight the successful collaboration between a research institution and local health department, describe the distinguishing characteristics of its methodology, and discuss the study’s implications for research, programs, and policies.Methods. The LAMB study utilized a multilevel, multistage cluster design with a mixed-mode methodology for data collection. Two samples were ultimately produced: the multilevel sample (n = 4,518) and the augmented final sample (n = 6,264).Results. The LAMB study allowed us to collect multilevel data on the risks and resources associated with racial-ethnic disparities in adverse obstetric outcomes. Both samples were more likely to be Hispanic, aged 20–34 years, completed at least 12 years of schooling, and spoke English.Conclusions. The LAMB study represents the successful collaboration between an academic institution and local health department and is a theoretically based research database and surveillance system that informs effective programmatic and policy interventions to improve outcomes among LAC’s varied demographic groups.

scholarly journals Regional Governance of Syndromic Surveillance for the Texas Gulf Coast

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Wesley McNeely ◽  
Eunice R. Santos ◽  
Biru Yang ◽  
Kiley Allred ◽  
Raouf R. Arafat
Keyword(s):  
Public Health ◽  
Communities Of Practice ◽  
Syndromic Surveillance ◽  
Health Department ◽  
Regional Governance ◽  
Local Health ◽  
Health Departments ◽  
Care Providers ◽  
Local Health Departments ◽  
Syndromic Surveillance System

ObjectiveDescribe and explain the transition of the syndromic surveillanceprogram at the Houston Health Department (HHD) from being alocally managed and aging system to an ESSENCE system governedby a regional Consortium of public health agencies and stakeholdersin the 13-county area of the southeast Texas.IntroductionSyndromic surveillance systems are large and complex technologyprojects that increasingly require large investments of financial andpolitical capital to be sustainable. What was once a minor surveillancetool in the mid-2000s has evolved into a program that is regardedas valuable to public health yet is increasingly difficult to maintainand operate for local health departments. The Houston HealthDepartment installed a syndromic surveillance system (SyS) sixyears before Meaning Use became known to healthcare communities.The system chosen at the time was the Real-time Outbreak DiseaseSurveillance System (RODS) which, at the time and for its purpose,was a suitable platform for syndromic surveillance. During the past13 years however, maintaining, operating, and growing a SyS by alocal health department has become increasingly difficult. Inclusionin Meaningful Use elevated the importance and profile of syndromicsurveillance such that network growth, transparency of operations,ease of data sharing, and cooperation with other state systems inTexas became program imperatives.MethodsWith support from the informatics group at Tarrant County PublicHealth (TCPH) in the form of mentoring, HHD devised a two prongstrategy to re-invigorate the syndromic program. The first was toreplace RODS with ESSENCE from Johns Hopkins Applied PhysicsLaboratory (JH/APL). The second was to strengthen the regionalnetwork by creating a governance structure that included outsideagencies and stakeholders. The product of this second effort wasthe creation of the Syndromic Surveillance Consortium of SoutheastTexas (SSCSeT) on the Communities of Practice model1usingparliamentary procedure2.ResultsAcquiring ESSENCE and forming SSCSeT were necessary stepsfor the continuing operation of the SyS. The Consortium includesmembers from local health jurisdictions, health care providers, healthpolicy advocates, academicians, and data aggregators. Created asa democratic society, SSCSeT wrote its constitution and by-laws,voted in officers, formed working groups and has begun developingpolicies. The Consortium is cooperating with the Texas Departmentof State Health Services (DSHS) as well as TCPH. Having ESSENCEwill ensure the HHD-SyS will conform to standards being developedin the state and provide a robust syndromic platform for the partnersof the Consortium.ConclusionsSyndromic systems operated by local health departments canadapt to regulatory changes by growing their networks and engagingregional stakeholders using the Communities of Practice model.

Improving Public Health Preparedness Capacity Measurement: Development of the Local Health Department Preparedness Capacities Assessment Survey

2013 ◽  
Vol 7 (6) ◽  
pp. 578-584 ◽  
Author(s):  
Mary V. Davis ◽  
Glen P. Mays ◽  
James Bellamy ◽  
Christine A. Bevc ◽  
Cammie Marti
Keyword(s):  
Public Health ◽  
Factor Analysis ◽  
Health Department ◽  
Local Health Department ◽  
Kappa Statistics ◽  
Local Health ◽  
Health Departments ◽  
Public Health Preparedness ◽  
Assessment Survey ◽  
Legal Infrastructure

AbstractObjectiveTo address limitations in measuring the preparedness capacities of health departments, we developed and tested the Local Health Department Preparedness Capacities Assessment Survey (PCAS).MethodsPreexisting instruments and a modified 4-cycle Delphi panel process were used to select instrument items. Pilot test data were analyzed using exploratory factor analysis. Kappa statistics were calculated to examine rater agreement within items. The final instrument was fielded with 85 North Carolina health departments and a national matched comparison group of 248 health departments.ResultsFactor analysis identified 8 initial domains: communications, surveillance and investigation, plans and protocols, workforce and volunteers, legal infrastructure, incident command, exercises and events, and corrective action. Kappa statistics and z scores indicated substantial to moderate agreement among respondents in 7 domains. Cronbach α coefficients ranged from 0.605 for legal infrastructure to 0.929 for corrective action. Mean scores and standard deviations were also calculated for each domain and ranged from 0.41 to 0.72, indicating sufficient variation in the sample to detect changes over time.ConclusionThe PCAS is a useful tool to determine how well health departments are performing on preparedness measures and identify opportunities for future preparedness improvements. Future survey implementation will incorporate recent Centers for Disease Control and Prevention's Public Health Preparedness Capabilities: National Standards for State and Local Planning. (Disaster Med Public Health Preparedness. 2013;7:578–584)

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