Profile-IQ: Web-based data query system for local health department infrastructure and activities.

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Shah, Gulzar H; Leep, Carolyn J; Alexander, Dayna

2014-01-01

To demonstrate the use of National Association of County & City Health Officials' Profile-IQ, a Web-based data query system, and how policy makers, researchers, the general public, and public health professionals can use the system to generate descriptive statistics on local health departments. This article is a descriptive account of an important health informatics tool based on information from the project charter for Profile-IQ and the authors' experience and knowledge in design and use of this query system. Profile-IQ is a Web-based data query system that is based on open-source software: MySQL 5.5, Google Web Toolkit 2.2.0, Apache Commons Math library, Google Chart API, and Tomcat 6.0 Web server deployed on an Amazon EC2 server. It supports dynamic queries of National Profile of Local Health Departments data on local health department finances, workforce, and activities. Profile-IQ's customizable queries provide a variety of statistics not available in published reports and support the growing information needs of users who do not wish to work directly with data files for lack of staff skills or time, or to avoid a data use agreement. Profile-IQ also meets the growing demand of public health practitioners and policy makers for data to support quality improvement, community health assessment, and other processes associated with voluntary public health accreditation. It represents a step forward in the recent health informatics movement of data liberation and use of open source information technology solutions to promote public health.

Extent and patterns of community collaboration in local health departments: An exploratory survey

Directory of Open Access Journals (Sweden)

Fisher John W

2011-10-01

Full Text Available Abstract Background Local public health departments (LHDs in the United States have been encouraged to collaborate with various other community organizations and individuals. Current research suggests that many forms of active partnering are ongoing, and there are numerous examples of LHD collaboration with a specific organization for a specific purpose or program. However, no existing research has attempted to characterize collaboration, for the defined purpose of setting community health status priorities, between a defined population of local officials and a defined group of alternative partnering organizations. The specific aims of this study were to 1 determine the range of collaborative involvement exhibited by a study population of local public health officials, and, 2 characterize the patterns of the selection of organizations/individuals involved with LHDs in the process of setting community health status priorities. Methods Local health department officials in North Carolina (n = 53 responded to an exploratory survey about their levels of involvement with eight types of possible collaborator organizations and individuals. Descriptive statistics and the stochastic clustering technique of Self-Organizing Maps (SOM were used to characterize their collaboration. Results Local health officials vary extensively in their level of collaboration with external collaborators. While the range of total involvement varies, the patterns of involvement for this specific function are relatively uniform. That is, regardless of the total level of involvement (low, medium or high, officials maintain similar hierarchical preference rankings with Community Advisory Boards and Local Boards of Health most involved and Experts and Elected Officials least involved. Conclusion The extent and patterns of collaboration among LHDs with other community stakeholders for a specific function can be described and ultimately related to outcome measures of LHD performance.

Local health department food safety and sanitation expenditures and reductions in enteric disease, 2000-2010.

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Bekemeier, Betty; Yip, Michelle Pui-Yan; Dunbar, Matthew D; Whitman, Greg; Kwan-Gett, Tao

2015-04-01

In collaboration with Public Health Practice-Based Research Networks, we investigated relationships between local health department (LHD) food safety and sanitation expenditures and reported enteric disease rates. We combined annual infection rates for the common notifiable enteric diseases with uniquely detailed, LHD-level food safety and sanitation annual expenditure data obtained from Washington and New York state health departments. We used a multivariate panel time-series design to examine ecologic relationships between 2000-2010 local food safety and sanitation expenditures and enteric diseases. Our study population consisted of 72 LHDs (mostly serving county-level jurisdictions) in Washington and New York. While controlling for other factors, we found significant associations between higher LHD food and sanitation spending and a lower incidence of salmonellosis in Washington and a lower incidence of cryptosporidiosis in New York. Local public health expenditures on food and sanitation services are important because of their association with certain health indicators. Our study supports the need for program-specific LHD service-related data to measure the cost, performance, and outcomes of prevention efforts to inform practice and policymaking.

A comparative study of 11 local health department organizational networks.

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Merrill, Jacqueline; Keeling, Jonathan W; Carley, Kathleen M

2010-01-01

Although the nation's local health departments (LHDs) share a common mission, variability in administrative structures is a barrier to identifying common, optimal management strategies. There is a gap in understanding what unifying features LHDs share as organizations that could be leveraged systematically for achieving high performance. To explore sources of commonality and variability in a range of LHDs by comparing intraorganizational networks. We used organizational network analysis to document relationships between employees, tasks, knowledge, and resources within LHDs, which may exist regardless of formal administrative structure. A national sample of 11 LHDs from seven states that differed in size, geographic location, and governance. Relational network data were collected via an on-line survey of all employees in 11 LHDs. A total of 1062 out of 1239 employees responded (84% response rate). Network measurements were compared using coefficient of variation. Measurements were correlated with scores from the National Public Health Performance Assessment and with LHD demographics. Rankings of tasks, knowledge, and resources were correlated across pairs of LHDs. We found that 11 LHDs exhibited compound organizational structures in which centralized hierarchies were coupled with distributed networks at the point of service. Local health departments were distinguished from random networks by a pattern of high centralization and clustering. Network measurements were positively associated with performance for 3 of 10 essential services (r > 0.65). Patterns in the measurements suggest how LHDs adapt to the population served. Shared network patterns across LHDs suggest where common organizational management strategies are feasible. This evidence supports national efforts to promote uniform standards for service delivery to diverse populations.

Use of Local Health Department Websites: A Study of E-Government Adoption and Diffusion

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Aaltonen, Pamela Massie

2013-01-01

Two distinct but converging activities have the potential to alter the way local public health departments conduct business. These activities are the emergence of e-government and the addition of preparedness as a basic function of the public health system. Preparedness implies timely collaboration with government entities, community partners and…

Institution-to-Institution Mentoring to Build Capacity in 24 Local US Health Departments: Best Practices and Lessons Learned

OpenAIRE

Veatch, Maggie; Goldstein, Gail P.; Sacks, Rachel; Lent, Megan; Van Wye, Gretchen

2014-01-01

Introduction Institutional mentoring may be a useful capacity-building model to support local health departments facing public health challenges. The New York City Department of Health and Mental Hygiene conducted a qualitative evaluation of an institutional mentoring program designed to increase capacity of health departments seeking to address chronic disease prevention. The mentoring program included 2 program models, a one-to-one model and a collaborative model, developed and implemented ...

The Journey toward Voluntary Public Health Accreditation Readiness in Local Health Departments: Leadership and Followership Theories in Action.

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Carman, Angela L

2015-01-01

Local health department directors' intent on getting their organizations ready for accreditation must embrace the blurring of leader/follower lines and create an accreditation readiness team fueled not by traditional leader or follower roles but by teamship.

The Journey toward Voluntary Public Health Accreditation Readiness in Local Health Departments: Leadership and Followership Theories in Action

OpenAIRE

Carman, Angela L.

2015-01-01

Local health department directors’ intent on getting their organizations ready for accreditation must embrace the blurring of leader/follower lines and create an accreditation readiness team fueled not by traditional leader or follower roles but by teamship.

CDC's National Environmental Public Health Tracking Program in Action: Case Studies From State and Local Health Departments.

Science.gov (United States)

Eatman, Shana; Strosnider, Heather M

The Centers for Disease Control and Prevention's (CDC's) National Environmental Public Health Tracking Program (Tracking Program) is a multidisciplinary collaboration that involves the ongoing collection, integration, analysis, interpretation, and dissemination of data from environmental hazard monitoring, human exposure surveillance, and health effects surveillance. With a renewed focus on data-driven decision-making, the CDC's Tracking Program emphasizes dissemination of actionable data to public health practitioners, policy makers, and communities. The CDC's National Environmental Public Health Tracking Network (Tracking Network), a Web-based system with components at the national, state, and local levels, houses environmental public health data used to inform public health actions (PHAs) to improve community health. This article serves as a detailed landscape on the Tracking Program and Tracking Network and the Tracking Program's leading performance measure, "public health actions." Tracking PHAs are qualitative statements addressing a local problem or situation, the role of the state or local Tracking Program, how the problem or situation was addressed, and the action taken. More than 400 PHAs have been reported by funded state and local health departments since the Tracking Program began collecting PHAs in 2005. Three case studies are provided to illustrate the use of the Tracking Program resources and data on the Tracking Network, and the diversity of actions taken. Through a collaborative network of experts, data, and tools, the Tracking Program and its Tracking Network are actively informing state and local PHAs. In a time of competing priorities and limited funding, PHAs can serve as a powerful tool to advance environmental public health practice.

Three Hundred Sixty Degree Feedback: program implementation in a local health department.

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Swain, Geoffrey R; Schubot, David B; Thomas, Virginia; Baker, Bevan K; Foldy, Seth L; Greaves, William W; Monteagudo, Maria

2004-01-01

Three Hundred Sixty Degree Feedback systems, while popular in business, have been less commonly implemented in local public health agencies. At the same time, they are effective methods of improving employee morale, work performance, organizational culture, and attainment of desired organizational outcomes. These systems can be purchased "off-the-shelf," or custom applications can be developed for a better fit with unique organizational needs. We describe the City of Milwaukee Health Department's successful experience customizing and implementing a 360-degree feedback system in the context of its ongoing total quality improvement efforts.

Timing of Clinical Billing Reimbursement for a Local Health Department.

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McCullough, J Mac

2016-01-01

A major responsibility of a local health department (LHD) is to assure public health service availability throughout its jurisdiction. Many LHDs face expanded service needs and declining budgets, making billing for services an increasingly important strategy for sustaining public health service provision. Yet, little practice-based data exist to guide practitioners on what to expect financially, especially regarding timing of reimbursement receipt. This study provides results from one LHD on the lag from service delivery to reimbursement receipt. Reimbursement records for all transactions at Maricopa County Department of Public Health immunization clinics from January 2013 through June 2014 were compiled and analyzed to determine the duration between service and reimbursement. Outcomes included daily and cumulative revenues received. Time to reimbursement for Medicaid and private payers was also compared. Reimbursement for immunization services was received a median of 68 days after service. Payments were sometimes taken back by payers through credit transactions that occurred a median of 333 days from service. No differences in time to reimbursement between Medicaid and private payers were found. Billing represents an important financial opportunity for LHDs to continue to sustainably assure population health. Yet, the lag from service provision to reimbursement may complicate budgeting, especially in initial years of new billing activities. Special consideration may be necessary to establish flexibility in the budget-setting processes for services with clinical billing revenues, because funds for services delivered in one budget period may not be received in the same period. LHDs may also benefit from exploring strategies used by other delivery organizations to streamline billing processes.

An integrative review of information systems and terminologies used in local health departments.

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Olsen, Jeanette; Baisch, Mary Jo

2014-02-01

The purpose of this integrative review based on the published literature was to identify information systems currently being used by local health departments and to determine the extent to which standard terminology was used to communicate data, interventions, and outcomes to improve public health informatics at the local health department (LHD) level and better inform research, policy, and programs. Whittemore and Knafl's integrative review methodology was used. Data were obtained through key word searches of three publication databases and reference lists of retrieved articles and consulting with experts to identify landmark works. The final sample included 45 articles analyzed and synthesized using the matrix method. The results indicated a wide array of information systems were used by LHDs and supported diverse functions aligned with five categories: administration; surveillance; health records; registries; and consumer resources. Detail regarding specific programs being used, location or extent of use, or effectiveness was lacking. The synthesis indicated evidence of growing interest in health information exchange groups, yet few studies described use of data standards or standard terminology in LHDs. Research to address these gaps is needed to provide current, meaningful data that inform public health informatics research, policy, and initiatives at and across the LHD level. Coordination at a state or national level is recommended to collect information efficiently about LHD information systems that will inform improvements while minimizing duplication of efforts and financial burden. Until this happens, efforts to strengthen LHD information systems and policies may be significantly challenged.

The Journey toward Voluntary Public Health Accreditation Readiness in Local Health Departments: Leadership and Followership Theories in Action

Directory of Open Access Journals (Sweden)

Angela eCarman

2015-03-01

Full Text Available Local health department directors’ intent on getting their organizations ready for accreditation must embrace the blurring of leader/follower lines and create an accreditation readiness team fueled not by traditional leader or follower roles but by teamship.

Local Health Department Food Safety and Sanitation Expenditures and Reductions in Enteric Disease, 2000–2010

Science.gov (United States)

Yip, Michelle Pui-Yan; Dunbar, Matthew D.; Whitman, Greg; Kwan-Gett, Tao

2015-01-01

Objectives. In collaboration with Public Health Practice–Based Research Networks, we investigated relationships between local health department (LHD) food safety and sanitation expenditures and reported enteric disease rates. Methods. We combined annual infection rates for the common notifiable enteric diseases with uniquely detailed, LHD-level food safety and sanitation annual expenditure data obtained from Washington and New York state health departments. We used a multivariate panel time-series design to examine ecologic relationships between 2000–2010 local food safety and sanitation expenditures and enteric diseases. Our study population consisted of 72 LHDs (mostly serving county-level jurisdictions) in Washington and New York. Results. While controlling for other factors, we found significant associations between higher LHD food and sanitation spending and a lower incidence of salmonellosis in Washington and a lower incidence of cryptosporidiosis in New York. Conclusions. Local public health expenditures on food and sanitation services are important because of their association with certain health indicators. Our study supports the need for program-specific LHD service-related data to measure the cost, performance, and outcomes of prevention efforts to inform practice and policymaking. PMID:25689186

Putting Chronic Disease on the Map: Building GIS Capacity in State and Local Health Departments

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Casper, Michele; Tootoo, Joshua; Schieb, Linda

2013-01-01

Techniques based on geographic information systems (GIS) have been widely adopted and applied in the fields of infectious disease and environmental epidemiology; their use in chronic disease programs is relatively new. The Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention is collaborating with the National Association of Chronic Disease Directors and the University of Michigan to provide health departments with capacity to integrate GIS into daily operations, which support priorities for surveillance and prevention of chronic diseases. So far, 19 state and 7 local health departments participated in this project. On the basis of these participants’ experiences, we describe our training strategy and identify high-impact GIS skills that can be mastered and applied over a short time in support of chronic disease surveillance. We also describe the web-based resources in the Chronic Disease GIS Exchange that were produced on the basis of this training and are available to anyone interested in GIS and chronic disease (www.cdc.gov/DHDSP/maps/GISX). GIS offers diverse sets of tools that promise increased productivity for chronic disease staff of state and local health departments. PMID:23786907

Putting chronic disease on the map: building GIS capacity in state and local health departments.

Science.gov (United States)

Miranda, Marie Lynn; Casper, Michele; Tootoo, Joshua; Schieb, Linda

2013-06-20

Techniques based on geographic information systems (GIS) have been widely adopted and applied in the fields of infectious disease and environmental epidemiology; their use in chronic disease programs is relatively new. The Centers for Disease Control and Prevention's Division for Heart Disease and Stroke Prevention is collaborating with the National Association of Chronic Disease Directors and the University of Michigan to provide health departments with capacity to integrate GIS into daily operations, which support priorities for surveillance and prevention of chronic diseases. So far, 19 state and 7 local health departments participated in this project. On the basis of these participants' experiences, we describe our training strategy and identify high-impact GIS skills that can be mastered and applied over a short time in support of chronic disease surveillance. We also describe the web-based resources in the Chronic Disease GIS Exchange that were produced on the basis of this training and are available to anyone interested in GIS and chronic disease (www.cdc.gov/DHDSP/maps/GISX). GIS offers diverse sets of tools that promise increased productivity for chronic disease staff of state and local health departments.

Public Health Employees' Perception of Workplace Environment and Job Satisfaction: The Role of Local Health Departments' Engagement in Accreditation.

Science.gov (United States)

Ye, Jiali; Verma, Pooja; Leep, Carolyn; Kronstadt, Jessica

To examine the association between local health departments' (LHDs') engagement in accreditation and their staffs' perceptions of workplace environment and the overall satisfaction with their jobs. Data from the 2014 Public Health Workforce Interests and Needs Survey (PH WINS) (local data only) and the 2014 Forces of Change survey were linked using LHDs' unique ID documented by the National Association of County & City Health Officials. The Forces of Change survey assessed LHDs' accreditation status. Local health departments were classified as "formally engaged" in the Public Health Accreditation Board accreditation process if they had achieved accreditation, submitted an application, or submitted a statement of intent. The PH WINS survey measured employees' perception of 3 aspects of workplace environment, including supervisory support, organizational support, and employee engagement. The overall satisfaction was measured using the Job in General Scale (abridged). There are 1884 LHD employees who completed PH WINS and whose agencies responded to the question on the accreditation status of the Forces of Change survey. When compared with employees from LHDs less engaged in accreditation, employees from LHDs that were formally engaged in accreditation gave higher ratings to all 3 aspects of workplace environment and overall job satisfaction. Controlling for employee demographic characteristics and LHD jurisdiction size, the agency's formal engagement in accreditation remained related to a higher score in perceived workplace environment and job satisfaction. After controlling for perceived workplace environment, accreditation status was marginally associated with job satisfaction. The findings provide support for previous reports by LHD leaders on the benefits of accreditation related to employee morale and job satisfaction. The results from this study allow us to further catalog the benefits of accreditation in workforce development and identify factors that may

Local health departments and specific maternal and child health expenditures: relationships between spending and need.

Science.gov (United States)

Bekemeier, Betty; Dunbar, Matthew; Bryan, Matthew; Morris, Michael E

2012-11-01

As a part of the Public Health Activities and Service Tracking study and in collaboration with partners in 2 Public Health Practice-Based Research Network states, we examined relationships between local health department (LHD) maternal and child health (MCH) expenditures and local needs. We used a multivariate pooled time-series design to estimate ecologic associations between expenditures in 3 MCH-specific service areas and related measures of need from 2005 to 2010 while controlling for other factors. Retrospective expenditure data from LHDs and for 3 MCH services represented annual investments in (1) Special Supplemental Nutrition for Women, Infants, and Children (WIC), (2) family planning, and (3) a composite of Maternal, Infant, Child, and Adolescent (MICA) service. Expenditure data from all LHDs in Florida and Washington were then combined with "need" and control variables. Our sample consisted of the 102 LHDs in Florida and Washington and the county (or multicounty) jurisdictions they serve. Expenditures for WIC and for our composite of MICA services were strongly associated with need among LHDs in the sample states. For WIC, this association was positive, and for MICA services, this association was negative. Family planning expenditures were weakly associated, in a positive direction. Findings demonstrate wide variations across programs and LHDs in relation to need and may underscore differences in how programs are funded. Programs with financial disbursements based on guidelines that factor in local needs may be better able to provide service as local needs grow than programs with less needs-based funding allocations.

Forecasting the Revenues of Local Public Health Departments in the Shadows of the "Great Recession".

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Reschovsky, Andrew; Zahner, Susan J

2016-01-01

The ability of local health departments (LHD) to provide core public health services depends on a reliable stream of revenue from federal, state, and local governments. This study investigates the impact of the "Great Recession" on major sources of LHD revenues and develops a fiscal forecasting model to predict revenues to LHDs in one state over the period 2012 to 2014. Economic forecasting offers a new financial planning tool for LHD administrators and local government policy makers. This study represents a novel research application for these econometric methods. Detailed data on revenues by source for each LHD in Wisconsin were taken from annual surveys conducted by the Wisconsin Department of Health Services over an 8-year period (2002-2009). A forecasting strategy appropriate for each revenue source was developed resulting in "base case" estimates. An analysis of the sensitivity of these revenue forecasts to a set of alternative fiscal policies by the federal, state, and local governments was carried out. The model forecasts total LHD revenues in 2012 of $170.5 million (in 2010 dollars). By 2014, inflation-adjusted revenues will decline by $8 million, a reduction of 4.7%. Because of population growth, per capita real revenues of LHDs are forecast to decline by 6.6% between 2012 and 2014. There is a great deal of uncertainty about the future of federal funding in support of local public health. A doubling of the reductions in federal grants scheduled under current law would result in an additional $4.4 million decline in LHD revenues in 2014. The impact of the Great Recession continues to haunt LHDs. Multiyear revenue forecasting offers a new financial tool to help LHDs better plan for an environment of declining resources. New revenue sources are needed if sharp drops in public health service delivery are to be avoided.

Relationships among providing maternal, child, and adolescent health services; implementing various financial strategy responses; and performance of local health departments.

Science.gov (United States)

Issel, L Michele; Olorunsaiye, Comfort; Snebold, Laura; Handler, Arden

2015-04-01

We explored the relationships between local health department (LHD) structure, capacity, and macro-context variables and performance of essential public health services (EPHS). In 2012, we assessed a stratified, random sample of 195 LHDs that provided data via an online survey regarding performance of EPHS, the services provided or contracted out, the financial strategies used in response to budgetary pressures, and the extent of collaborations. We performed weighted analyses that included analysis of variance, pairwise correlations by jurisdiction population size, and linear regressions. On average, LHDs provided approximately 13 (36%) of 35 possible services either directly or by contract. Rather than cut services or externally consolidating, LHDs took steps to generate more revenue and maximize capacity. Higher LHD performance of EPHS was significantly associated with delivering more services, initiating more financial strategies, and engaging in collaboration, after adjusting for the effects of the Affordable Care Act and jurisdiction size. During changing economic and health care environments, we found that strong structural capacity enhanced local health department EPHS performance for maternal, child, and adolescent health.

Evaluation of Syndromic Surveillance Systems in 6 US State and Local Health Departments.

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Thomas, Mathew J; Yoon, Paula W; Collins, James M; Davidson, Arthur J; Mac Kenzie, William R

Evaluating public health surveillance systems is critical to ensuring that conditions of public health importance are appropriately monitored. Our objectives were to qualitatively evaluate 6 state and local health departments that were early adopters of syndromic surveillance in order to (1) understand the characteristics and current uses, (2) identify the most and least useful syndromes to monitor, (3) gauge the utility for early warning and outbreak detection, and (4) assess how syndromic surveillance impacted their daily decision making. We adapted evaluation guidelines from the Centers for Disease Control and Prevention and gathered input from the Centers for Disease Control and Prevention subject matter experts in public health surveillance to develop a questionnaire. We interviewed staff members from a convenience sample of 6 local and state health departments with syndromic surveillance programs that had been in operation for more than 10 years. Three of the 6 interviewees provided an example of using syndromic surveillance to identify an outbreak (ie, cluster of foodborne illness in 1 jurisdiction) or detect a surge in cases for seasonal conditions (eg, influenza in 2 jurisdictions) prior to traditional, disease-specific systems. Although all interviewees noted that syndromic surveillance has not been routinely useful or efficient for early outbreak detection or case finding in their jurisdictions, all agreed that the information can be used to improve their understanding of dynamic disease control environments and conditions (eg, situational awareness) in their communities. In the jurisdictions studied, syndromic surveillance may be useful for monitoring the spread and intensity of large outbreaks of disease, especially influenza; enhancing public health awareness of mass gatherings and natural disasters; and assessing new, otherwise unmonitored conditions when real-time alternatives are unavailable. Future studies should explore opportunities to

CDC’s National Environmental Public Health Tracking Program in Action: Case Studies From State and Local Health Departments

Science.gov (United States)

Eatman, Shana; Strosnider, Heather M.

2017-01-01

The Centers for Disease Control and Prevention’s (CDC’s) National Environmental Public Health Tracking Program (Tracking Program) is a multidisciplinary collaboration that involves the ongoing collection, integration, analysis, interpretation, and dissemination of data from environmental hazard monitoring, human exposure surveillance, and health effects surveillance. With a renewed focus on data-driven decision-making, the CDC’s Tracking Program emphasizes dissemination of actionable data to public health practitioners, policy makers, and communities. The CDC’s National Environmental Public Health Tracking Network (Tracking Network), a Web-based system with components at the national, state, and local levels, houses environmental public health data used to inform public health actions (PHAs) to improve community health. This article serves as a detailed landscape on the Tracking Program and Tracking Network and the Tracking Program’s leading performance measure, “public health actions.” Tracking PHAs are qualitative statements addressing a local problem or situation, the role of the state or local Tracking Program, how the problem or situation was addressed, and the action taken. More than 400 PHAs have been reported by funded state and local health departments since the Tracking Program began collecting PHAs in 2005. Three case studies are provided to illustrate the use of the Tracking Program resources and data on the Tracking Network, and the diversity of actions taken. Through a collaborative network of experts, data, and tools, the Tracking Program and its Tracking Network are actively informing state and local PHAs. In a time of competing priorities and limited funding, PHAs can serve as a powerful tool to advance environmental public health practice. PMID:28763381

Community views and public health priority setting: how do health department priorities, community views, and health indicator data compare?

Science.gov (United States)

Earle-Richardson, Giulia; Scribani, Melissa; Wyckoff, Lynae; Strogatz, David; May, John; Jenkins, Paul

2015-01-01

New York, like many other states, provides county-level health statistics for use in local priority settings but does not provide any data on public views about priority health issues. This study assessed whether health department priorities are notably different from community concerns about health, and how both groups' priorities compare with local health statistics. Data from a 2009 rural survey on community health concerns were compared to priorities named by the seven area county health departments, and to local health indicator data. Health care/insurance cost (60%), obesity (53%), and prescription cost (41%) were leading community concerns, regardless of age, education, sex, or Internet in the home. Six of seven county health departments selected access to quality health care (which includes health care/insurance cost) as a leading public health priority, but only three identified obesity. The following leading local health issues were suggested by health indicators: Physical activity and nutrition, Smoking, and Unintentional injury. Health departments diverged from community priorities, from health indicator data, and from one another in choosing priorities. Adding a question about community health priorities to existing state telephone surveys on health behavior and lifestyle would provide an important tool to local health departments. © 2014 Society for Public Health Education.

Creating community-based access to primary healthcare for the uninsured through strategic alliances and restructuring local health department programs.

Science.gov (United States)

Scotten, E Shirin L; Absher, Ann C

2006-01-01

In 2003, the Wilkes County Health Department joined with county healthcare providers to develop the HealthCare Connection, a coordinated and continuous system of low-cost quality care for uninsured and low-income working poor. Through this program, local providers of primary and specialty care donate specialty care or ancillary services not provided by the Health Department, which provides case management for the program. Basing their methods on business models learned through the UNC Management Academy for Public Health, planners investigated the best practices for extending healthcare coverage to the underinsured and uninsured, analyzed operational costs, discovered underutilized local resources, and built capacity within the organization. The HealthCare Connection is an example of how a rural community can join together in a common business practice to improve healthcare access for uninsured and/or low-income adults.

Where Is Obesity Prevention on the Map? Distribution and Predictors of Local Health Department Prevention Activities in Relation to County-Level Obesity Prevalence in the US

Science.gov (United States)

Stamatakis, Katherine A.; Leatherdale, Scott T.; Marx, Christine; Yan, Yan; Colditz, Graham A.; Brownson, Ross C.

2013-01-01

Context The system of local health departments (LHD) in the US has potential to advance a locally-oriented public health response in obesity control and reduce geographic disparities. However, the extent to which obesity prevention programs correspond to local obesity levels is unknown. Objective This study examines the extent to which LHDs across the US have responded to local levels of obesity by examining the association between jurisdiction level obesity prevalence and the existence of obesity prevention programs. Design Data on LHD organizational characteristics from the Profile Study of Local Health Departments and county-level estimates of obesity from the Behavioral Risk Factor Surveillance System were analyzed (n=2,300). Since local public health systems are nested within state infrastructure, multilevel models were used to examine the relationship between county-level obesity prevalence and LHD obesity prevention programming and to assess the impact of state-level clustering. Setting 2,300 local health department jurisdictions defined with respect to county boundaries Participants Practitioners in local health departments who responded to the 2005 Profile Study of Local Health Departments. Main Outcome Measures Likelihood of having obesity prevention activities and association with area-level obesity prevalence Results The existence of obesity prevention activities was not associated with prevalence of obesity in the jurisdiction. A substantial portion of the variance in LHD activities was explained by state-level clustering. Conclusions This paper identified a gap in the local public health response to the obesity epidemic and underscores the importance of multilevel modeling in examining predictors of LHD performance. PMID:22836530

Openness to Change: Experiential and Demographic Components of Change in Local Health Department Leaders

OpenAIRE

Jadhav, Emmanuel D.; Holsinger, James W.; Fardo, David W.

2015-01-01

Background During the 2008–2010 economic recession, Kentucky local health department (LHD) leaders utilized innovative strategies to maintain their programs. A characteristic of innovative strategy is leader openness to change. Leader demographical research in for-profit organizations has yielded valuable insight into leader openness to change. For LHD leaders, the nature of the association between leader demographic and organizational characteristics on leader openness to change is unknow...

Assessing Injury and Violence Prevention in North Carolina's Local Health Departments.

Science.gov (United States)

Mouw, Mary S; Counts, Jennifer; Fordham, Corinne; Francis, Molly Merrill; Bach, Laura E; Maman, Suzanne; Proescholdbell, Scott K

2016-01-01

Injury and violence-related morbidity and mortality present a major public health problem in North Carolina. However, the extent to which local health departments (LHDs) engage in injury and violence prevention (IVP) has not been well described. One objective of the current study is to provide a baseline assessment of IVP in the state's LHDs, describing capacity, priorities, challenges, and the degree to which programs are data-driven and evidence-based. The study will also describe a replicable, cost-effective method for systematic assessment of regional IVP. This is an observational, cross-sectional study that was conducted through a survey of North Carolina's 85 LHDs. Representatives from 77 LHDs (91%) responded. Nearly one-third (n = 23; 30%) reported that no staff members were familiar with evidence-based interventions in IVP, and over one-third (n = 29; 38%) reported that their LHD did not train staff in IVP. Almost one-half (n = 37; 48%) had no dedicated funding for IVP. On average, respondents said that about half of their programs were evidence-based; however, there was marked variation (mean, 52%; standard deviation = 41). Many collaborated with diverse partners including law enforcement, hospitals, and community-based organizations. There was discordance between injury and violence burden and programming. Overall, 53% of issues listed as top local problems were not targeted in their LHDs' programs. Despite funding constraints, North Carolina's LHDs engaged in a broad range of IVP activities. However, programming did not uniformly address state injury and violence priorities, nor local injury and violence burden. Staff members need training in evidence-based strategies that target priority areas. Multisector partnerships were common and increased LHDs' capacity. These findings are actionable at the state and local level. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Local health department translation processes: potential of machine translation technologies to help meet needs.

Science.gov (United States)

Turner, Anne M; Mandel, Hannah; Capurro, Daniel

2013-01-01

Limited English proficiency (LEP), defined as a limited ability to read, speak, write, or understand English, is associated with health disparities. Despite federal and state requirements to translate health information, the vast majority of health materials are solely available in English. This project investigates barriers to translation of health information and explores new technologies to improve access to multilingual public health materials. We surveyed all 77 local health departments (LHDs) in the Northwest about translation needs, practices, barriers and attitudes towards machine translation (MT). We received 67 responses from 45 LHDs. Translation of health materials is the principle strategy used by LHDs to reach LEP populations. Cost and access to qualified translators are principle barriers to producing multilingual materials. Thirteen LHDs have used online MT tools. Many respondents expressed concerns about the accuracy of MT. Overall, respondents were positive about its potential use, if low costs and quality could be assured.

A Performance Management Initiative for Local Health Department Vector Control Programs.

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Gerding, Justin; Kirshy, Micaela; Moran, John W; Bialek, Ron; Lamers, Vanessa; Sarisky, John

2016-01-01

Local health department (LHD) vector control programs have experienced reductions in funding and capacity. Acknowledging this situation and its potential effect on the ability to respond to vector-borne diseases, the U.S. Centers for Disease Control and Prevention and the Public Health Foundation partnered on a performance management initiative for LHD vector control programs. The initiative involved 14 programs that conducted a performance assessment using the Environmental Public Health Performance Standards. The programs, assisted by quality improvement (QI) experts, used the assessment results to prioritize improvement areas that were addressed with QI projects intended to increase effectiveness and efficiency in the delivery of services such as responding to mosquito complaints and educating the public about vector-borne disease prevention. This article describes the initiative as a process LHD vector control programs may adapt to meet their performance management needs. This study also reviews aggregate performance assessment results and QI projects, which may reveal common aspects of LHD vector control program performance and priority improvement areas. LHD vector control programs interested in performance assessment and improvement may benefit from engaging in an approach similar to this performance management initiative.

Perspectives of Community- and Faith-Based Organizations about Partnering with Local Health Departments for Disasters

Directory of Open Access Journals (Sweden)

Michael Stajura

2012-06-01

Full Text Available Public health emergency planners can better perform their mission if they develop and maintain effective relationships with community- and faith-based organizations in their jurisdictions. This qualitative study presents six themes that emerged from 20 key informant interviews representing a wide range of American community- and faith-based organizations across different types of jurisdictions, organizational types, and missions. This research seeks to provide local health department public health emergency planners with tools to assess and improve their inter-organizational community relationships. The themes identified address the importance of community engagement, leadership, intergroup dynamics and communication, and resources. Community- and faith-based organizations perceive that they are underutilized or untapped resources with respect to public health emergencies and disasters. One key reason for this is that many public health departments limit their engagement with community- and faith-based organizations to a one-way “push” model for information dissemination, rather than engaging them in other ways or improving their capacity. Beyond a reprioritization of staff time, few other resources would be required. From the perspective of community- and faith-based organizations, the quality of relationships seems to matter more than discrete resources provided by such ties.

Perspectives of community- and faith-based organizations about partnering with local health departments for disasters.

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Stajura, Michael; Glik, Deborah; Eisenman, David; Prelip, Michael; Martel, Andrea; Sammartinova, Jitka

2012-07-01

Public health emergency planners can better perform their mission if they develop and maintain effective relationships with community- and faith-based organizations in their jurisdictions. This qualitative study presents six themes that emerged from 20 key informant interviews representing a wide range of American community- and faith-based organizations across different types of jurisdictions, organizational types, and missions. This research seeks to provide local health department public health emergency planners with tools to assess and improve their inter-organizational community relationships. The themes identified address the importance of community engagement, leadership, intergroup dynamics and communication, and resources. Community- and faith-based organizations perceive that they are underutilized or untapped resources with respect to public health emergencies and disasters. One key reason for this is that many public health departments limit their engagement with community- and faith-based organizations to a one-way "push" model for information dissemination, rather than engaging them in other ways or improving their capacity. Beyond a reprioritization of staff time, few other resources would be required. From the perspective of community- and faith-based organizations, the quality of relationships seems to matter more than discrete resources provided by such ties.

Assessing Injury and Violence Prevention in North Carolina’s Local Health Departments

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Mouw, Mary S.; Counts, Jennifer; Fordham, Corinne; Francis, Molly Merrill; Bach, Laura E.; Maman, Suzanne; Proescholdbell, Scott K.

2016-01-01

Context Injury and violence-related morbidity and mortality present a major public health problem in North Carolina. However, the extent to which local health departments (LHDs) engage in injury and violence prevention (IVP) is not well described. Objectives 1) Provide a baseline assessment of IVP in the state’s LHDs, describing capacity, priorities, challenges, and the degree to which programs are data-driven and evidence-based. 2) Describe a replicable, cost-effective method for systematic assessment of regional IVP. Design An observational, cross-sectional study, through a survey of NC’s 85 LHDs. Results Representatives from 77 LHDs (91%) responded. Nearly a third (n=23, 30%) reported no staff were familiar with evidence-based interventions in IVP; over a third (n=29, 38%) reported their LHD did not train staff in IVP. Almost half (n=37, 46%) had no dedicated funding. On average, respondents said about half of their programs were evidence-based; however, there was marked variation (mean 52%, SD = 41). Many collaborated with diverse partners including law enforcement, hospitals, and community-based organizations. There was discordance between injury and violence burden and programming. Overall, 53% of issues listed as top local problems were not targeted in their LHDs’ programs. Conclusions Despite funding constraints, NC’s LHDs are engaged in a broad range of IVP activities. Programming did not uniformly address state injury and violence priorities, however, nor local injury and violence burden. Staff need training in evidence-based strategies targeting priority areas. Multi-sector partnerships were common and increased LHDs’ capacity. These findings are actionable at the state and local-level. PMID:27621337

Openness to change: experiential and demographic components of change in in Local Health Department leaders

OpenAIRE

Emmanuel D Jadhav; James W. Holsinger; David W Fardo

2015-01-01

Background: During the 2008-10 economic recession, Kentucky local health department (LHD) leaders utilized innovative strategies to maintain their programs. A characteristic of innovative strategy is leader openness to change. Leader demographical research in for-profit organizations has yielded valuable insight into leader openness to change. For LHD leaders the nature of the association between leader demographic and organizational characteristics on leader openness to change is unknown. Th...

Sustaining a quality improvement culture in local health departments applying for accreditation.

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Verma, Pooja; Moran, John W

2014-01-01

This article focuses on local health departments (LHDs) that are advanced in accreditation and quality improvement (QI) efforts and the barriers and facilitators associated with sustaining improvements and building an organizational culture of QI. To understand the barriers and facilitators associated with building and sustaining progress toward a QI culture in LHDs. Quantitative data from a self-reporting survey and qualitative data from telephone interviews. Twenty-two LHDs across the United States responded to the survey. Ten of the 22 LHD respondents participated in telephone interviews. QI lead staff at LHDs that are advanced in accreditation preparation and QI. Self-reported LHD survey ratings against indicators for a QI culture, and the identified barriers and facilitators around sustaining QI initiatives. Of the 6 domains of a QI culture measured in the survey, the percentages of respondents that scored themselves highly to at least 1 indicator in each domain are as follows: leadership commitment (100%); employee empowerment (100%); teamwork and collaboration (100%); continuous process improvement (86%); customer focus (72%); and QI infrastructure (64%). Qualitative data from 10 telephone interviews revealed that key barriers to sustaining progress around QI included staff turnover, budget cuts, and major crises or events that arise as priority. Key facilitators included leadership commitment, accreditation, and dedication of resources and staff time to QI. When engaging in QI, LHDs should consider investing efforts in gaining leadership support and dedicating staff time early in the QI journey to ensure that QI efforts and initiatives are sustained. Local health departments interested in developing a QI culture should also consider pursuing accreditation, as it provides a structured framework for continuous improvement. They should also actively develop QI knowledge and skills among all staff members to minimize the negative impact of staff turnover.

Improving maternal and neonatal departments in high and low resource settings: the opinion of local health providers.

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Trevisanuto, Daniele; Bavuusuren, Bayasgalantai; Wickramasinghe, Chandani S; Dharmaratne, Saminda M; Doglioni, Nicoletta; Giordan, Alessia; Zanardo, Vincenzo; Carlo, Waldemar A

2011-10-01

We compared local health caregivers' opinions regarding the priority areas for improving the maternal and neonatal departments in low and high resource countries. Personnel involved in maternal and neonatal care operating in level III, teaching hospitals in four countries (Sri Lanka, Mongolia, USA, and Italy) were asked to fill out an anonymous, written questionnaire. The questionnaire was completed by 1112 out of 1265 (87.9%) participants. "Personnel's education" was classified as the first most important intervention by health providers working in high (49.0%) as well as in low (29.9%) resource countries, respectively. Improvement in salary, equipment, internet access, and organizational protocols were considered as the most important interventions by a significantly larger percentage of personnel from low resource countries in comparison with those from high resource countries. Health providers from high resource countries considered organizational aspects (to define specific roles and responsibilities) as a priority more frequently than their colleagues from low resource countries. Although education of personnel was valued as the highest priority for improving maternal and neonatal departments there are substantial differences in priorities associated with the working setting. Local caregivers' opinion may contribute to better design interventions in settings with high or limited resources.

Global agenda, local health: including concepts of health security in preparedness programs at the jurisdictional level.

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Eby, Chas

2014-01-01

The Global Health Security Agenda's objectives contain components that could help health departments address emerging public health challenges that threaten the population. As part of the agenda, partner countries with advanced public health systems will support the development of infrastructure in stakeholder health departments. To facilitate this process and augment local programs, state and local health departments may want to include concepts of health security in their public health preparedness offices in order to simultaneously build capacity. Health security programs developed by public health departments should complete projects that are closely aligned with the objectives outlined in the global agenda and that facilitate the completion of current preparedness grant requirements. This article identifies objectives and proposes tactical local projects that run parallel to the 9 primary objectives of the Global Health Security Agenda. Executing concurrent projects at the international and local levels in preparedness offices will accelerate the completion of these objectives and help prevent disease epidemics, detect health threats, and respond to public health emergencies. Additionally, future funding tied or related to health security may become more accessible to state and local health departments that have achieved these objectives.

Joint Community Health Needs Assessments as a Path for Coordinating Community-Wide Health Improvement Efforts Between Hospitals and Local Health Departments.

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Carlton, Erik L; Singh, Simone Rauscher

2018-05-01

To examine the association between hospital-local health department (LHD) collaboration around community health needs assessments (CHNAs) and hospital investment in community health. We combined 2015 National Association of County and City Health Officials (NACCHO) Forces of Change, 2013 NACCHO Profile, and 2014-2015 Area Health Resource File data to identify a sample of LHDs (n = 439) across the United States. We included data on hospitals' community benefit from their 2014 tax filings (Internal Revenue Service Form 990, Schedule H). We used bivariate and multivariate regression analyses to examine LHDs' involvement in hospitals' CHNAs and implementation strategies and the relationship with hospital investment in community health. The LHDs that collaborated with hospitals around CHNAs were significantly more likely to be involved in joint implementation planning activities than were those that did not. Importantly, LHD involvement in hospitals' implementation strategies was associated with greater hospital investment in community health improvement initiatives. Joint CHNAs may improve coordination of community-wide health improvement efforts between hospitals and LHDs and encourage hospital investment in community health improvement activities. Public Health Implications. Policies that strengthen LHD-hospital collaboration around the CHNA may enhance hospital investments in community health.

New technologies and surgical innovation: five years of a local health technology assessment program in a surgical department.

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Poulin, Paule; Austen, Lea; Kortbeek, John B; Lafrenière, René

2012-06-01

There is pressure for surgical departments to introduce new and innovative health technologies in an evidence-based manner while ensuring that they are safe and effective and can be managed with available resources. A local health technology assessment (HTA) program was developed to systematically integrate research evidence with local operational management information and to make recommendations for subsequent decision by the departmental executive committee about whether and under what conditions the technology will be used. The authors present a retrospective analysis of the outcomes of this program as used by the Department of Surgery & Surgical Services in the Calgary Health Region over a 5-year period from December 2005 to December 2010. Of the 68 technologies requested, 15 applications were incomplete and dropped, 12 were approved, 3 were approved for a single case on an urgent/emergent basis, 21 were approved for "clinical audit" for a restricted number of cases with outcomes review, 14 were approved for research use only, and 3 were referred to additional review bodies. Subsequent outcome reports resulted in at least 5 technologies being dropped for failure to perform. Decisions based on local HTA program recommendations were rarely "yes" or "no." Rather, many technologies were given restricted approval with full approval contingent on satisfying certain conditions such as clinical outcomes review, training protocol development, or funding. Thus, innovation could be supported while ensuring safety and effectiveness. This local HTA program can be adapted to a variety of settings and can help bridge the gap between evidence and practice.

Should they stay or should they go? Leader duration and financial performance in local health departments.

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Jadhav, Emmanuel D; Holsinger, James W; Mays, Glen; Fardo, David

2015-01-01

The delivery of programs by local health departments (LHDs) has shifted from "if we do not have the money we don't do it" to LHD directors should "identify and fund public health priorities." This shift has subsequently increased performance expectations of LHD leaders. In the for-profit sector the leaders' failure to perform has resulted in a shortening tenure trend. Tenure is a proxy for human capital accumulation. In LHDs, the nature of association, if any, between leader tenure and agency performance is unknown. Examine association between financial performance of LHDs with short-, average-, and long-tenured LHD leaders. Variation in leader characteristics and percent change in expenditure were examined using a longitudinal cohort design and positive deviance methodology. Bivariate analysis of LHD financial performance and leader characteristics was conducted, and a logistic regression model was developed to test association between leader tenure and LHDs that experienced a positive percentage expenditure change. From a total of 2523 LHDs, 1453 were examined. The cross-sectional surveys of US public health agencies conducted by the National Association of County and City Health Officials in 2008 and 2010 contain the leader and LHD variables. Approximately 44% of LHDs experienced a positive percentage expenditure change. Leader tenure, age, gender, and education status were significantly associated with a positive percentage expenditure change using a chi-square test of independence. From the logistic regression analysis tenure, educational status, employment status, area population, governance, classification, and jurisdiction were statistically significant. Local health departments with leaders whose tenure was less than 2 years were less likely than those with average tenure to experience a positive percentage expenditure change. The odds ratios for tenure suggest that tenure is positively associated up to a threshold level and then declines. Implying that

Have Maryland local health departments effectively put in place the information technology relevant to emergency preparedness?

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Nguh, Jonas

2013-01-01

Ever since the terrorist attacks of 9/11, the federal government has increased funding for emergency preparedness. However, the literature continues to document several areas of weaknesses in public health emergency management by local health departments (LHD). This lack of preparedness affects the entire public. The purpose of this study was to determine whether or not Maryland LHDs have effectively put in place the information technology (IT) that is relevant for emergency preparedness. Base Firm-wide IT Infrastructure Services and the Feeny/Willcocks Framework for Core IS Capabilities are the two conceptual frameworks used in this study. This qualitative study used the survey method and the data were analyzed through content analysis. The results revealed that utilization, practice, and performance of IT by Maryland LHDs are not efficient or effective. Recommendations included the development of "best practices," increased funding for IT infrastructure and the establishment of strategic management framework for IT initiatives. Implications for positive social change include the development of recommendations to enhance emergency preparedness practice, and advancement of knowledge so as to facilitate the functions, and duties of health departments in emergency preparedness operations.

The Relationship of Policymaking and Networking Characteristics among Leaders of Large Urban Health Departments.

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Leider, Jonathon P; Castrucci, Brian C; Harris, Jenine K; Hearne, Shelley

2015-08-06

The relationship between policy networks and policy development among local health departments (LHDs) is a growing area of interest to public health practitioners and researchers alike. In this study, we examine policy activity and ties between public health leadership across large urban health departments. This study uses data from a national profile of local health departments as well as responses from a survey sent to three staff members (local health official, chief of policy, chief science officer) in each of 16 urban health departments in the United States. Network questions related to frequency of contact with health department personnel in other cities. Using exponential random graph models, network density and centrality were examined, as were patterns of communication among those working on several policy areas using exponential random graph models. All 16 LHDs were active in communicating about chronic disease as well as about use of alcohol, tobacco, and other drugs (ATOD). Connectedness was highest among local health officials (density = .55), and slightly lower for chief science officers (d = .33) and chiefs of policy (d = .29). After accounting for organizational characteristics, policy homophily (i.e., when two network members match on a single characteristic) and tenure were the most significant predictors of formation of network ties. Networking across health departments has the potential for accelerating the adoption of public health policies. This study suggests similar policy interests and formation of connections among senior leadership can potentially drive greater connectedness among other staff.

The Relationship of Policymaking and Networking Characteristics among Leaders of Large Urban Health Departments

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Jonathon P. Leider

2015-08-01

Full Text Available Background: The relationship between policy networks and policy development among local health departments (LHDs is a growing area of interest to public health practitioners and researchers alike. In this study, we examine policy activity and ties between public health leadership across large urban health departments. Methods: This study uses data from a national profile of local health departments as well as responses from a survey sent to three staff members (local health official, chief of policy, chief science officer in each of 16 urban health departments in the United States. Network questions related to frequency of contact with health department personnel in other cities. Using exponential random graph models, network density and centrality were examined, as were patterns of communication among those working on several policy areas using exponential random graph models. Results: All 16 LHDs were active in communicating about chronic disease as well as about use of alcohol, tobacco, and other drugs (ATOD. Connectedness was highest among local health officials (density = .55, and slightly lower for chief science officers (d = .33 and chiefs of policy (d = .29. After accounting for organizational characteristics, policy homophily (i.e., when two network members match on a single characteristic and tenure were the most significant predictors of formation of network ties. Conclusion: Networking across health departments has the potential for accelerating the adoption of public health policies. This study suggests similar policy interests and formation of connections among senior leadership can potentially drive greater connectedness among other staff.

Accredited Health Department Partnerships to Improve Health: An Analysis of Community Health Assessments and Improvement Plans.

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Kronstadt, Jessica; Chime, Chinecherem; Bhattacharya, Bulbul; Pettenati, Nicole

The Public Health Accreditation Board (PHAB) Standards & Measures require the development and updating of collaborative community health assessments (CHAs) and community health improvement plans (CHIPs). The goal of this study was to analyze the CHAs and CHIPs of PHAB-accredited health departments to identify the types of partners engaged, as well as the objectives selected to measure progress toward improving community health. The study team extracted and coded data from documents from 158 CHA/CHIP processes submitted as part of the accreditation process. Extracted data included population size, health department type, data sources, and types of partner organizations. Health outcome objectives were categorized by Healthy People 2020 Leading Health Indicator (LHI), as well as by the 7 broad areas in the PHAB reaccreditation framework for population health outcomes reporting. Participants included health departments accredited between 2013 and 2016 that submitted CHAs and CHIPs to PHAB, including 138 CHAs/CHIPs from local health departments and 20 from state health departments. All the CHAs/CHIPs documented collaboration with a broad array of partners, with hospitals and health care cited most frequently (99.0%). Other common partners included nonprofit service organizations, education, business, and faith-based organizations. Small health departments more frequently listed many partner types, including law enforcement and education, compared with large health departments. The majority of documents (88.6%) explicitly reference Healthy People 2020 goals, with most addressing the LHIs nutrition/obesity/physical activity and access to health services. The most common broad areas from PHAB's reaccreditation framework were preventive health care and individual behavior. This study demonstrates the range of partners accredited health departments engage with to collaborate on improving their communities' health as well as the objectives used to measure community health

Leadership for Public Health 3.0: A Preliminary Assessment of Competencies for Local Health Department Leaders.

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Jadhav, Emmanuel D; Holsinger, James W; Anderson, Billie W; Homant, Nicholas

2017-01-01

The foundational public health services model V1.0, developed in response to the Institute of Medicine report For the Public's Health: Investing in a Healthier Future identified important capabilities for leading local health departments (LHDs). The recommended capabilities include the organizational competencies of leadership and governance, which are described as consensus building among internal and external stakeholders. Leadership through consensus building is the main characteristic of Democratic Leadership . This style of leadership works best within the context of a competent team. Not much is known about the competency structure of LHD leadership teams. The objectives of this study characterize the competency structure of leadership teams in LHDs and identify the relevance of existing competencies for the practice of leadership in public health. The study used a cross-sectional study design. Utilizing the workforce taxonomy six management and leadership occupation titles were used as job categories. The competencies were selected from the leadership and management domain of public health competencies for the Tier -3, leadership level. Study participants were asked to rank on a Likert scale of 1-10 the relevance of each competency to their current job category, with a rank of 1 being least important and a rank of 10 being most important. The instrument was administered in person. Data were collected in 2016 from 50 public health professionals serving in leadership and management positions in a convenience sample of three LHDS. The competency of most relevance to the highest executive function category was that of "interaction with interrelated systems." For sub-agency level officers the competency of most relevance was "advocating for the role of public health." The competency of most relevance to Program Directors/Managers or Administrators was "ensuring continuous quality improvement." The variation between competencies by job category suggests there are

Informatics and communication in a state public health department: a case study.

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Hills, Rebecca A; Turner, Anne M

2008-11-06

State and local health departments are witnessing growth in the area of informatics. As new informatics projects commence, existing methods of communication within the health department may not be sufficient. We gathered information about roles and communication between a development team and a user group working simultaneously on an informatics project in a state public health department in an effort to better define how communication and role definition is best used within an informatics project.

Identifying Local Hotspots of Pediatric Chronic Diseases Using Emergency Department Surveillance

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Lee, David C.; Yi, Stella S.; Fong, Hiu-Fai; Athens, Jessica K.; Ravenell, Joseph E.; Sevick, Mary Ann; Wall, Stephen P.; Elbel, Brian

2016-01-01

Objective To use novel geographic methods and large-scale claims data to identify the local distribution of pediatric chronic diseases in New York City. Methods Using a 2009 all-payer emergency claims database, we identified the proportion of unique children aged 0 to 17 with diagnosis codes for specific medical and psychiatric conditions. As a proof of concept, we compared these prevalence estimates to traditional health surveys and registry data using the most geographically granular data available. In addition, we used home addresses to map local variation in pediatric disease burden. Results We identified 549,547 New York City children who visited an emergency department at least once in 2009. Though our sample included more publicly insured and uninsured children, we found moderate to strong correlations of prevalence estimates when compared to health surveys and registry data at pre-specified geographic levels. Strongest correlations were found for asthma and mental health conditions by county among younger children (0.88, p=0.05 and 0.99, pdisease prevalence with higher geographic resolution. More studies are needed to investigate limitations of these methods and assess reliability of local disease estimates. What’s New This study demonstrated how emergency department surveillance may improve estimates of pediatric disease prevalence with higher geographic resolution. We identified 29% of New York City children with a single year of data and identified local hotspots of pediatric chronic diseases. PMID:28385326

Changes in Local Public Health System Performance Before and After Attainment of National Accreditation Standards.

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Ingram, Richard C; Mays, Glen P; Kussainov, Nurlan

The aim of this study is to investigate the impact of Public Health Accreditation Board (PHAB) accreditation on the delivery of public health services and on participation from other sectors in the delivery of public health services in local public health systems. This study uses a longitudinal repeated measures design to identify differences between a cohort of public health systems containing PHAB-accredited local health departments and a cohort of public health systems containing unaccredited local health departments. It uses data spanning from 2006 to 2016. This study examines a cohort of local public health systems that serves large populations and contains unaccredited and PHAB-accredited local health departments. Data in this study were collected from the directors of health departments that include local public health systems followed in the National Longitudinal Study of Public Health Systems. The intervention examined is PHAB accreditation. The study focuses on 4 areas: the delivery of core public health services, local health department contribution toward these services, participation in the delivery of these services by other members of the public health system, and public health system makeup. Prior to the advent of accreditation, public health systems containing local health departments that were later accredited by PHAB appear quite similar to their unaccredited peers. Substantial differences between the 2 cohorts appear to manifest themselves after the advent of accreditation. Specifically, the accredited cohort seems to offer a broader array of public health services, involve more partners in the delivery of those services, and enjoy a higher percentage of comprehensive public health systems. The results of this study suggest that accreditation may yield significant benefits and may help public health systems develop the public health system capital necessary to protect and promote the public's health.

Leadership for Public Health 3.0: A Preliminary Assessment of Competencies for Local Health Department Leaders

Directory of Open Access Journals (Sweden)

Emmanuel D. Jadhav

2017-10-01

Full Text Available BackgroundThe foundational public health services model V1.0, developed in response to the Institute of Medicine report For the Public’s Health: Investing in a Healthier Future identified important capabilities for leading local health departments (LHDs. The recommended capabilities include the organizational competencies of leadership and governance, which are described as consensus building among internal and external stakeholders. Leadership through consensus building is the main characteristic of Democratic Leadership. This style of leadership works best within the context of a competent team. Not much is known about the competency structure of LHD leadership teams. The objectives of this study characterize the competency structure of leadership teams in LHDs and identify the relevance of existing competencies for the practice of leadership in public health.Materials and methodsThe study used a cross-sectional study design. Utilizing the workforce taxonomy six management and leadership occupation titles were used as job categories. The competencies were selected from the leadership and management domain of public health competencies for the Tier -3, leadership level. Study participants were asked to rank on a Likert scale of 1–10 the relevance of each competency to their current job category, with a rank of 1 being least important and a rank of 10 being most important. The instrument was administered in person.DataData were collected in 2016 from 50 public health professionals serving in leadership and management positions in a convenience sample of three LHDS.ResultsThe competency of most relevance to the highest executive function category was that of “interaction with interrelated systems.” For sub-agency level officers the competency of most relevance was “advocating for the role of public health.” The competency of most relevance to Program Directors/Managers or Administrators was “ensuring continuous quality improvement

Physician training rotations in a large urban health department.

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Alkon, Ellen; Kim-Farley, Robert; Gunzenhauser, Jeffrey

2014-01-01

Hospitals are the normal setting for physician residency training within the United States. When a hospital cannot provide the specific training needed, a special rotation for that experience is arranged. Linkages between clinical and public health systems are vital to achieving improvements in overall health status in the United States. Nevertheless, most physicians in postgraduate residency programs receive neither training nor practical experience in the practice of public health. For many years, public health rotations have been available within the Los Angeles County Department of Public Health (and its antecedent organizations). Arrangements that existed with local medical schools for residents to rotate with Los Angeles County Department of Health hospitals were extended to include a public health rotation. A general model for the rotation ensured that each resident received education and training relevant to the clinician in practice. Some parts of the model for experience have changed over time while others have not. Also, the challenges and opportunities for both trainees and preceptors have evolved and varied over time. A logic model demonstrates the components and changes with the public health rotation. Changes included alterations in recruitment, expectations, evaluation, formal education, and concepts related to the experience. Changes in the rotation model occurred in the context of other major environmental changes such as new electronic technology, changing expectations for residents, and evolving health services and public health systems. Each impacted the public health rotation. The evaluation method developed included content tests, assessment of competencies by residents and preceptors, and satisfaction measures. Results from the evaluation showed increases in competency and a high level of satisfaction after a public health rotation. The article includes examples of challenges and benefits to a local health department in providing a public

Kent County Health Department: Using an Agency Strategic Plan to Drive Improvement.

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Saari, Chelsey K

The Kent County Health Department (KCHD) was accredited by the Public Health Accreditation Board (PHAB) in September 2014. Although Michigan has had a state-level accreditation process for local health departments since the late 1990s, the PHAB accreditation process presented a unique opportunity for KCHD to build on successes achieved through state accreditation and enhance performance in all areas of KCHD programs, services, and operations. PHAB's standards, measures, and peer-review process provided a standardized and structured way to identify meaningful opportunities for improvement and to plan and implement strategies for enhanced performance and established a platform for being recognized nationally as a high-performing local health department. The current case report highlights the way in which KCHD has developed and implemented its strategic plan to guide efforts aimed at addressing gaps identified through the accreditation process and to drive overall improvement within our agency.

State procurement law: facilitating the collaboration between health department and school of public health.

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Huber, George A; Barron, Gerald M; Duchak, Linda S; Raniowski, Martin; Alsahlani, Hazem S; Potter, Margaret A

2014-01-01

The mark of an "academic health department" includes shared activity by academic and practice partners sustained over time. Despite a long history of productive interactivity, the Pennsylvania Department of Health and the University of Pittsburgh's Graduate School of Public Health often faced administrative hurdles in contracting for projects of mutual interest. Seeking to overcome these hurdles, the Commonwealth of Pennsylvania and the University of Pittsburgh's Graduate School of Public Health negotiated a Master Agreement on the basis of statutes designating both as "public procurement units." This provided a template for project specifications, standard financial terms, and a contracting process. Since taking effect, the Master Agreement has supported projects in policy development, capacity building, workforce development, program evaluation, data analysis, and program planning. This experience suggests an approach potentially useful for other states and localities seeking to solidify academic health department partnerships either envisioned for the future or already in place.

Determining Chronic Disease Prevalence in Local Populations Using Emergency Department Surveillance.

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Lee, David C; Long, Judith A; Wall, Stephen P; Carr, Brendan G; Satchell, Samantha N; Braithwaite, R Scott; Elbel, Brian

2015-09-01

We sought to improve public health surveillance by using a geographic analysis of emergency department (ED) visits to determine local chronic disease prevalence. Using an all-payer administrative database, we determined the proportion of unique ED patients with diabetes, hypertension, or asthma. We compared these rates to those determined by the New York City Community Health Survey. For diabetes prevalence, we also analyzed the fidelity of longitudinal estimates using logistic regression and determined disease burden within census tracts using geocoded addresses. We identified 4.4 million unique New York City adults visiting an ED between 2009 and 2012. When we compared our emergency sample to survey data, rates of neighborhood diabetes, hypertension, and asthma prevalence were similar (correlation coefficient = 0.86, 0.88, and 0.77, respectively). In addition, our method demonstrated less year-to-year scatter and identified significant variation of disease burden within neighborhoods among census tracts. Our method for determining chronic disease prevalence correlates with a validated health survey and may have higher reliability over time and greater granularity at a local level. Our findings can improve public health surveillance by identifying local variation of disease prevalence.

Planning and Implementing Immunization Billing Programs at State and Local Health Departments: Barriers and Possible Solutions.

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Corriero, Rosemary; Redmon, Ginger

Before participating in a project funded by the Centers for Disease Control and Prevention, most state and local health departments (LHDs) were not seeking reimbursement or being fully reimbursed by insurance plans for the cost of immunization services (including vaccine costs and administration fees) they provided to insured patients. Centers for Disease Control and Prevention's Billables Project was designed to enable state and LHDs to bill public and private insurance plans for immunization services provided to insured patients. Identify and describe key barriers state and LHDs may encounter while planning and implementing a billing program, as well as possible solutions for overcoming those barriers. This study used reports from Billables Project participants to explore barriers they encountered when planning and implementing a billing program and steps taken to address those barriers. Thirty-eight state immunization programs. Based on project participants' reports, barriers were noted in 7 categories: (1) funding and costs, (2) staff, (3) health department characteristics, (4) third-party payers and insurance plans, (5) software, (6) patient insurance status, and (7) other barriers. Possible solutions for overcoming those barriers included hiring or seeking external help, creating billing guides and training modules, streamlining workflows, and modifying existing software systems. Overcoming barriers during planning and implementation of a billing program can be challenging for state and LHDs, but the experiences and suggestions of past Billables Project participants can help guide future billing program efforts.

Restructuring a State Nutrition Education and Obesity Prevention Program: Implications of a Local Health Department Model for SNAP-Ed.

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Wu, Helen W; Backman, Desiree; Kizer, Kenneth W

The US Department of Agriculture Supplemental Nutrition Assistance Program-Education (SNAP-Ed) funds state programs to improve nutrition and physical activity in low-income populations through its Nutrition Education and Obesity Prevention grants. States vary in how they manage and structure these programs. California substantially restructured its program in 2012 to universally position local health departments (LHDs) as the programmatic lead in all jurisdictions. This study sought to determine whether California's reorganization aligned with desirable attributes of decentralized public management. This study conducted 40 in person, semistructured interviews with 57 local, state, and federal SNAP-Ed stakeholders between October 2014 and March 2015. Local respondents represented 15 counties in all 7 of California's SNAP-Ed regions. We identified 3 common themes that outlined advantages or disadvantages of local public management, and we further defined subthemes within: (1) coordination and communication (within local jurisdictions, across regions, between local and state), (2) efficiency (administrative, fiscal, program), and (3) quality (innovation, skills). We conducted qualitative content analysis to evaluate how respondents characterized the California experience for each theme, identifying positive and negative experiences. California's LHD model offers some distinct advantages, but the model does not exhibit all the advantages of decentralized public management. Strategic planning, partnerships, subcontracting, and fiscal oversight are closer to communities than previously. However, administrative burden remains high and LHDs are limited in their ability to customize programs on the basis of community needs because of state and federal constraints. California's use of a universal LHD model for SNAP-Ed is novel. Recent federal SNAP-Ed changes present an opportunity for other states to consider this structure. Employing small-scale approaches initially (eg

Perception of Workforce Skills Needed Among Public Health Professionals in Local Health Departments: Staff Versus Top Executives.

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Ye, Jiali; Leep, Carolyn; Robin, Nathalie; Newman, Sarah

2015-01-01

To examine how top executives and staff from local health departments (LHDs) perceive the importance of various types of workforce skills, and to assess the differences in the perception of the importance of these workforce skills between these 2 groups and among LHDs serving different-sized jurisdictions. Data for this study were drawn from the 2014 Public Health Workforce Interests and Needs Survey (PH WINS) and the 2015 Forces of Change survey. While PH WINS collected data from LHD staff, the Forces of Change survey was administered to LHD top executives. Ratings of perceived importance of workforce skills from LHD staff and top executives were compared. Overall, LHD workers at all levels believe that core competencies are important for their jobs. The perceived importance of these skills differed somewhat across supervisory level (nonsupervisory staff vs supervisory staff vs top executives). Communication was rated as one of the most important skills by all groups. For top executives, ensuring that programs are managed within budget constraints was the most important skill for their employees. However, this skill was rated much lower among staff. Policy development skills were rated to be of lowest importance by LHD leaders and staff. LHD leaders and staff agree on the relative importance of some competencies, although they also show some clear differences in the relative importance that they place on other competencies. It is essential to strengthen the communication between public health leaders and staff regarding the importance of workforce skills. More investigation is needed to assess whether and how gaps in staff competencies are addressed in the workforce development strategies.

Assessing Capacity for Sustainability of Effective Programs and Policies in Local Health Departments.

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Tabak, Rachel G; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C

2016-01-01

Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Case study interviews from June to July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Six geographically diverse LHD's (selected from 3 of high and 3 of low capacity) : 35 LHD practitioners. Thematic reports explored the 8 domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training when compared with low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High- and low-capacity LHDs described strategic planning, but high

Assessing capacity for sustainability of effective programs and policies in local health departments

Science.gov (United States)

Tabak, Rachel G.; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C.

2015-01-01

Context Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Objective Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Design Case study interviews from June-July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Setting Six geographically diverse LHD’s (selected from three high- and three low-capacity) Participants 35 LHD practitioners Main Outcome Measures Thematic reports explored the eight domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. Results High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training compared to low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High

Leading by example: a local health department-community collaboration to incorporate physical activity into organizational practice.

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Yancey, Antronette K; Lewis, Lavonna B; Sloane, David C; Guinyard, Joyce Jones; Diamant, Allison L; Nascimento, Lori M; McCarthy, William J

2004-01-01

A multisectoral model promoting sociocultural environmental change to increase physical activity levels among African Americans in Los Angeles County, California, was developed and implemented. This model represents a true collaboration between a local health department and a community lead agency. Community organizations serving targeted areas of the county participated in one or more interventions incorporating physical activity into routine organizational practice, which centered around modeling the behaviors promoted ("walking the talk"). In the current study, level of organizational support for physical activity integration was assessed, as reflected in the extent of organizational commitment associated with each intervention. Individual-level data, characterizing the sociodemography, health status, and health behaviors of organization staff, members, and clients, are presented to document the average risk burden in the targeted population. Nearly half of the more than 200 participating organizations actively embraced incorporating physical activity into their regular work routines, with more than 25 percent committed at the highest level of involvement. Broad capacity and support for organizational integration of physical activity was demonstrated, with the observed level of commitment varying by organization type. Similar to the successful evolution of tobacco control, some of the responsibility ("cost") for physical activity adoption and maintenance can and should be shifted from the individual to organizational entities, such as workplaces.

Hepatitis A Cases Among Food Handlers: A Local Health Department Response-New York City, 2013.

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Ridpath, Alison; Reddy, Vasudha; Layton, Marcelle; Misener, Mark; Scaccia, Allison; Starr, David; Stavinsky, Faina; Varma, Jay K; Waechter, HaeNa; Zucker, Jane R; Balter, Sharon

During 2013, the New York City Department of Health and Mental Hygiene (DOHMH) received reports of 6 hepatitis A cases among food handlers. We describe our decision-making process for public notification, type of postexposure prophylaxis (PEP) offered, and lessons learned. For 3 cases, public notification was issued and DOHMH offered only hepatitis A vaccine as PEP. Subsequent outbreaks resulted from 1 case for which no public notification was issued or PEP offered, and 1 for which public notification was issued and PEP was offered too late. DOHMH continues to use environmental assessments to guide public notification decisions and offer only hepatitis A vaccine as PEP after public notification but recognizes the need to evaluate each situation individually. The PEP strategy employed by DOHMH should be considered because hepatitis A vaccine is immunogenic in all age groups, can be obtained by local jurisdictions more quickly, and is logistically easier to administer in mass clinics than immunoglobulin.

Openness to change: experiential and demographic components of change in in Local Health Department leaders

Directory of Open Access Journals (Sweden)

Emmanuel D Jadhav

2015-09-01

Full Text Available Background: During the 2008-10 economic recession, Kentucky local health department (LHD leaders utilized innovative strategies to maintain their programs. A characteristic of innovative strategy is leader openness to change. Leader demographical research in for-profit organizations has yielded valuable insight into leader openness to change. For LHD leaders the nature of the association between leader demographic and organizational characteristics on leader openness to change is unknown. The objectives of this study are to identify variation in openness to change by leaders’ demographic and organizational characteristics and to characterize the underlying relationships. Material and Methods: The study utilized Spearman rank correlations test to determine relationships between leader openness to change (ACQ and leader and LHD characteristics. To identify differences in the distribution of ACQ scores, Wilcoxon-Mann-Whitney and Kruskal Wallis non-parametric tests were used, and to adjust for potential confounding linear regression analysis was performed.Data: LHD leaders in the Commonwealth of Kentucky were the unit of analysis. Expenditure and revenue data were available from the state health department. National census data was utilized for county level population estimates. A cross-sectional survey was performed of KY LHD leaders’ observable attributes relating to age, gender, race, educational background, leadership experience and openness to change. Results: Leaders had relatively high openness to change scores. Spearman correlations between leader ACQ and departmental 2012-13 revenue and expenditures were statistically significant, as were the differences observed in ACQ by gender and the educational level of the leader. Differences in ACQ score by education level and agency revenue were significant even after adjusting for potential confounders. The analyses imply there are underlying relationships between leader and LHD characteristics

Comparing types of local public health agencies in North Carolina.

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Markiewicz, Milissa; Moore, Jill; Foster, Johanna H; Berner, Maureen; Matthews, Gene; Wall, Aimee

2013-01-01

Some states are considering restructuring local public health agencies (LPHAs) in hopes of achieving long-term efficiencies. North Carolina's experience operating different types of LPHAs, such as county health departments, district health departments, public health authorities, and consolidated human services agencies, can provide valuable information to policy makers in other states who are examining how best to organize their local public health system. To identify stakeholders' perceptions of the benefits and challenges associated with different types of LPHAs in North Carolina and to compare LPHA types on selected financial, workforce, and service delivery measures. Focus groups and key informant interviews were conducted to identify stakeholders' perceptions of different LPHA types. To compare LPHA types on finance, workforce, and service delivery measures, descriptive statistical analyses were performed on publicly available quantitative data. North Carolina. Current and former state and local public health practitioners, county commissioners, county managers, assistant managers, state legislators, and others. In addition to identifying stakeholders' perceptions of LPHA types, proportion of total expenditures by funding source, expenditures per capita by funding source, full-time equivalents per 1000 population, and percentage of 127 tracked services offered were calculated. Stakeholders reported benefits and challenges of all LPHA types. LPHA types differ with regard to source of funding, with county health departments and consolidated human services agencies receiving a greater percentage of their funding from county appropriations than districts and authorities, which receive a comparatively larger percentage from other revenues. Types of LPHAs are not entirely distinct from one another, and LPHAs of the same type can vary greatly from one another. However, stakeholders noted differences between LPHA types-particularly with regard to district health

The epidemiology and surveillance response to pandemic influenza A (H1N1) among local health departments in the San Francisco Bay Area.

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Enanoria, Wayne T A; Crawley, Adam W; Tseng, Winston; Furnish, Jasmine; Balido, Jeannie; Aragón, Tomás J

2013-03-27

Public health surveillance and epidemiologic investigations are critical public health functions for identifying threats to the health of a community. Very little is known about how these functions are conducted at the local level. The purpose of the Epidemiology Networks in Action (EpiNet) Study was to describe the epidemiology and surveillance response to the 2009 pandemic influenza A (H1N1) by city and county health departments in the San Francisco Bay Area in California. The study also documented lessons learned from the response in order to strengthen future public health preparedness and response planning efforts in the region. In order to characterize the epidemiology and surveillance response, we conducted key informant interviews with public health professionals from twelve local health departments in the San Francisco Bay Area. In order to contextualize aspects of organizational response and performance, we recruited two types of key informants: public health professionals who were involved with the epidemiology and surveillance response for each jurisdiction, as well as the health officer or his/her designee responsible for H1N1 response activities. Information about the organization, data sources for situation awareness, decision-making, and issues related to surge capacity, continuity of operations, and sustainability were collected during the key informant interviews. Content and interpretive analyses were conducted using ATLAS.ti software. The study found that disease investigations were important in the first months of the pandemic, often requiring additional staff support and sometimes forcing other public health activities to be put on hold. We also found that while the Incident Command System (ICS) was used by all participating agencies to manage the response, the manner in which it was implemented and utilized varied. Each local health department (LHD) in the study collected epidemiologic data from a variety of sources, but only case reports

Implementation and evaluation of health passport communication tools in emergency departments.

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Heifetz, Marina; Lunsky, Yona

2018-01-01

People with IDD (intellectual or developmental disabilities) and their families consistently report dissatisfaction with their emergency department experience. Clear care plans and communication tools may not only improve the quality of patient care, but also can prevent unnecessary visits and reduce the likelihood of return visits. To evaluate communication tools to be used by people with IDD in psychiatric and general emergency departments in three different regions of Ontario. Health passport communication tools were locally tailored and implemented in each of the three regions. A total of 28 questionnaires and 18 interviews with stakeholders (e.g., hospital staff, community agency representatives, families) were completed across the regions to obtain feedback on the implementation of health passports with people with IDD. Participants felt that the health passport tools provided helpful information, improved communication between patients with IDD and hospital staff, and were user friendly. Continued efforts are needed to work with communities on maintenance of this tool, ensuring all hospital staff are utilizing the information. These findings emphasize the merits of health passport tools being implemented in the health system to support communication between patients with IDD and health care practitioners and the importance of tailoring tools to local settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

Interoperability of Information Systems Managed and Used by the Local Health Departments.

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Shah, Gulzar H; Leider, Jonathon P; Luo, Huabin; Kaur, Ravneet

2016-01-01

In the post-Affordable Care Act era marked by interorganizational collaborations and availability of large amounts of electronic data from other community partners, it is imperative to assess the interoperability of information systems used by the local health departments (LHDs). To describe the level of interoperability of LHD information systems and identify factors associated with lack of interoperability. This mixed-methods research uses data from the 2015 Informatics Capacity and Needs Assessment Survey, with a target population of all LHDs in the United States. A representative sample of 650 LHDs was drawn using a stratified random sampling design. A total of 324 completed responses were received (50% response rate). Qualitative data were used from a key informant interview study of LHD informatics staff from across the United States. Qualitative data were independently coded by 2 researchers and analyzed thematically. Survey data were cleaned, bivariate comparisons were conducted, and a multivariable logistic regression was run to characterize factors associated with interoperability. For 30% of LHDs, no systems were interoperable, and 38% of LHD respondents indicated some of the systems were interoperable. Significant determinants of interoperability included LHDs having leadership support (adjusted odds ratio [AOR] = 3.54), control of information technology budget allocation (AOR = 2.48), control of data systems (AOR = 2.31), having a strategic plan for information systems (AOR = 1.92), and existence of business process analysis and redesign (AOR = 1.49). Interoperability of all systems may be an informatics goal, but only a small proportion of LHDs reported having interoperable systems, pointing to a substantial need among LHDs nationwide.

Characteristics of Kentucky local health departments that influence public health communication during times of crisis: information dissemination associated with H1N1 novel influenza.

Science.gov (United States)

Howard, Alex F; Bush, Heather M; Shapiro, Robert M; Dearinger, Angela

2012-01-01

The purpose of this study was to investigate the association of selected characteristics of local health departments (LHDs) in Kentucky with the receipt of information by external stakeholders, specifically physicians and pharmacists, during the initial H1N1 outbreak of 2009. This study utilized a cross-sectional survey to gather characteristic information from local health departments. In addition, cross sectional surveys of physicians and pharmacists were used to determine information receipt. All 54 LHDs in Kentucky were surveyed; however, only those physicians belonging to the Kentucky Family Physician Association or the Kentucky Ambulatory Network were surveyed. Also, pharmacists included in this survey were members of the Kentucky Pharmacist Association. Descriptive data analyses, including chi-square test of independence, were conducted, and generalized estimating equations were used to calculate odds ratios to depict associations related to information exchange in this study. Response rates for the study were as follows: LHDs 65% (35/54), physicians 18.5% (96/518), and pharmacists 21.1% (211/1000). Of the 35 participating LHDs the most common characteristic identified was the presence of a public information officer (PIO) and a pandemic influenza plan, 76% and 64%, respectively. Despite these factors, 72% of external stakeholders did not receive any information regarding H1N1 from the LHD. Generalized estimating equations also indicated that stakeholders in jurisdictions lacking a PIO had 6 (95% confidence interval, 1.3-26.95) greater odds of not receiving information from the LHD. External stakeholders in jurisdictions without a pandemic influenza plan had 3.38 (95% confidence interval, 0.80-1.17) increased odds of not receiving information but this association was not statistically significant. Observations from this study indicate a need to improve information exchange between LHDs and their external stakeholders, specifically physicians and pharmacists

Tax levy financing for local public health: fiscal allocation, effort, and capacity.

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Riley, William J; Gearin, Kimberly J; Parrotta, Carmen D; Briggs, Jill; Gyllstrom, M Elizabeth

2013-12-01

Local health departments (LHDs) rely on a wide variety of funding sources, and the level of financing is associated with both LHD performance in essential public health services and population health outcomes. Although it has been shown that funding sources vary across LHDs, there is no evidence regarding the relationship between fiscal allocation (local tax levy); fiscal effort (tax capacity); and fiscal capacity (community wealth). The purpose of this study is to analyze local tax levy support for LHD funding. Three research questions are addressed: (1) What are tax levy trends in LHD fiscal allocation? (2) What is the role of tax levy in overall LHD financing? and (3) How do local community fiscal capacity and fiscal effort relate to LHD tax levy fiscal allocation? This study focuses on 74 LHDs eligible for local tax levy funding in Minnesota. Funding and expenditure data for 5 years (2006 to 2010) were compiled from four governmental databases, including the Minnesota Department of Health, the State Auditor, the State Demographer, and the Metropolitan Council. Trends in various funding sources and expenditures are described for the time frame of interest. Data were analyzed in 2012. During the 2006-2010 time period, total average LHD per capita expenditures increased 13%, from $50.98 to $57.63. Although the overall tax levy increase in Minnesota was 25%, the local tax levy for public health increased 5.6% during the same period. There is a direct relationship between fiscal effort and LHD expenditures. Local funding reflects LHD community priorities and the relative importance in comparison to funding other local programs with tax dollars. In Minnesota, local tax levy support for local public health services is not keeping pace with local tax support for other local government services. These results raise important questions about the relationship between tax levy resource effort, resource allocation, and fiscal capacity as they relate to public health

Measuring the authority of local public health directors in the context of organizational structure: an exploratory, multimodal approach.

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Miner Gearin, Kimberly J; Thrash, Allison M Rick; Frauendienst, Renee; Myhre, Julie; Gyllstrom, M Elizabeth; Riley, William J; Schroeder, Janelle

2012-11-01

Studies have reported a relationship between the organization of public health services and variability in public health practice at the local and state levels. A national research agenda has prioritized practice-based research to understand pathways that lead to this variation and examine the impact of these differences on outcomes. To measure the extent to which Minnesota local health directors report having key authorities and examine the relationship between organizational structure and authority of local health directors. : Multimodal. Minnesota local health departments. Directors of Minnesota local health departments. Director authorities. Most Minnesota local health directors reported having 6 key authorities related to budget preparation and modification and interaction with local elected officials (n = 51, 71%). Twelve directors (16%) reported that they have 4 or fewer of the 6 authorities. The authority most commonly reported as lacking was the authority to initiate communication with locally elected officials (n = 15, 21%). The percentage of directors who reported having all 6 authorities was higher among those in stand-alone departments (82%) than those in combined organizations (50%). This descriptive study illustrates that emerging practice-based research networks can successfully collaborate on small-scale research projects with immediate application for systems development. Study findings are being used by local public health officials to help articulate their role, aid in succession planning, and inform elected officials, who need to consider the public health implications of potential changes to local public health governance and organization. More studies are needed to refine measurement of authority and structure.

Development of a Survey to Assess Local Health Department Organizational Processes and Infrastructure for Supporting Obesity Prevention.

Science.gov (United States)

Xiao, Ting; Stamatakis, Katherine A; McVay, Allese B

Local health departments (LHDs) have an important function in controlling the growing epidemic of obesity in the United States. Data are needed to gain insight into the existence of routine functions and structures of LHDs that support and sustain obesity prevention efforts. The purpose of this study was to develop and examine the reliability of measures to assess foundational LHD organizational processes and functions specific to obesity prevention. Survey measures were developed using a stratified, random sample of US LHDs to assess supportive organizational processes and infrastructure for obesity prevention representing different domains. Data were analyzed using weighted κ and intraclass correlation coefficient for assessing test-retest reliability. Most items and summary indices in the majority of survey domains had moderate/substantial or almost perfect reliability. The overall findings support this survey instrument to be a reliable measurement tool for a large number of processes and functions that comprise obesity prevention-related capacity in LHDs.

Evaluating the Implementation of a Twitter-Based Foodborne Illness Reporting Tool in the City of St. Louis Department of Health

Directory of Open Access Journals (Sweden)

Jenine K. Harris

2018-04-01

Full Text Available Foodborne illness is a serious and preventable public health problem affecting 1 in 6 Americans with cost estimates over $50 billion annually. Local health departments license and inspect restaurants to ensure food safety and respond to reports of suspected foodborne illness. The City of St. Louis Department of Health adopted the HealthMap Foodborne Dashboard (Dashboard, a tool that monitors Twitter for tweets about food poisoning in a geographic area and allows the health department to respond. We evaluated the implementation by interviewing employees of the City of St. Louis Department of Health involved in food safety. We interviewed epidemiologists, environmental health specialists, health services specialists, food inspectors, and public information officers. Participants viewed engaging innovation participants and executing the innovation as challenges while they felt the Dashboard had relative advantage over existing reporting methods and was not complex once in place. This study is the first to examine practitioner perceptions of the implementation of a new technology in a local health department. Similar implementation projects should focus more on process by developing clear and comprehensive plans to educate and involve stakeholders prior to implementation.

Targeted health department expenditures benefit birth outcomes at the county level.

Science.gov (United States)

Bekemeier, Betty; Yang, Youngran; Dunbar, Matthew D; Pantazis, Athena; Grembowski, David E

2014-06-01

Public health leaders lack evidence for making decisions about the optimal allocation of resources across local health department (LHD) services, even as limited funding has forced cuts to public health services while local needs grow. A lack of data has also limited examination of the outcomes of targeted LHD investments in specific service areas. This study used unique, detailed LHD expenditure data gathered from state health departments to examine the influence of maternal and child health (MCH) service investments by LHDs on health outcomes. A multivariate panel time-series design was used in 2013 to estimate ecologic relationships between 2000-2010 LHD expenditures on MCH and county-level rates of low birth weight and infant mortality. The unit of analysis was 102 LHD jurisdictions in Washington and Florida. Results indicate that LHD expenditures on MCH services have a beneficial relationship with county-level low birth weight rates, particularly in counties with high concentrations of poverty. This relationship is stronger for more targeted expenditure categories, with expenditures in each of the three specific examined MCH service areas demonstrating the strongest effects. Findings indicate that specific LHD investments in MCH have an important effect on related health outcomes for populations in poverty and likely help reduce the costly burden of poor birth outcomes for families and communities. These findings underscore the importance of monitoring the impact of these evolving investments and ensuring that targeted, beneficial investments are not lost but expanded upon across care delivery systems. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Tax-Exempt Hospitals' Investments in Community Health and Local Public Health Spending: Patterns and Relationships.

Science.gov (United States)

Singh, Simone R; Young, Gary J

2017-12-01

To investigate whether tax-exempt hospitals' investments in community health are associated with patterns of governmental public health spending focusing specifically on the relationship between hospitals' community benefit expenditures and the spending patterns of local health departments (LHDs). We combined data on tax-exempt hospitals' community benefit spending with data on spending by the corresponding LHD that served the county in which a hospital was located. Data were available for 2 years, 2009 and 2013. Generalized linear regressions were estimated with indicators of hospital community benefit spending as the dependent variable and LHD spending as the key independent variable. Hospital community benefit spending was unrelated to how much local public health agencies spent, per capita, on public health in their communities. Patterns of local public health spending do not appear to impact the investments of tax-exempt hospitals in community health activities. Opportunities may, however, exist for a more active engagement between the public and private sector to ensure that the expenditures of all stakeholders involved in community health improvement efforts complement one another. © Health Research and Educational Trust.

Use of twitter among local health departments: an analysis of information sharing, engagement, and action.

Science.gov (United States)

Neiger, Brad L; Thackeray, Rosemary; Burton, Scott H; Thackeray, Callie R; Reese, Jennifer H

2013-08-19

Social media offers unprecedented opportunities for public health to engage audiences in conversations and collaboration that could potentially lead to improved health conditions. While there is some evidence that local health departments (LHDs) are using social media and Twitter in particular, little is known about how Twitter is used by LHDs and how they use it to engage followers versus disseminating one-way information. To examine how LHDs use Twitter to share information, engage with followers, and promote action, as well as to discover differences in Twitter use among LHDs by size of population served. The Twitter accounts for 210 LHDs were stratified into three groups based on size of population served (n=69 for less than 100,000; n=89 for 100,000-499,999; n=52 for 500,000 or greater). A sample of 1000 tweets was obtained for each stratum and coded as being either about the organization or about personal-health topics. Subcategories for organization included information, engagement, and action. Subcategories for personal health included information and action. Of all LHD tweets (n=3000), 56.1% (1682/3000) related to personal health compared with 39.5% (1186/3000) that were about the organization. Of the personal-health tweets, 58.5% (984/1682) involved factual information and 41.4% (697/1682) encouraged action. Of the organization-related tweets, 51.9% (615/1186) represented one-way communication about the organization and its events and services, 35.0% (416/1186) tried to engage followers in conversation, and 13.3% (158/1186) encouraged action to benefit the organization (eg, attend events). Compared with large LHDs, small LHDs were more likely to post tweets about their organization (Cramer's V=0.06) but were less likely to acknowledge events and accomplishments of other organizations (χ²=12.83, P=.02, Cramer's V=0.18). Small LHDs were also less likely to post personal health-related tweets (Cramer's V=0.08) and were less likely to post tweets containing

Managing health physics departmental data via a local area network

International Nuclear Information System (INIS)

Weber, P.J.; Castronovo, F.P. Jr.

1993-01-01

The authors describe the multiuser data management system that can be accessed simultaneously by all department members, in use at the Dept of Health Physics, Brigham and Women's Hospital, U.S.A., which makes use of the Local Area Network. (UK)

Introduction of new technologies and decision making processes: a framework to adapt a Local Health Technology Decision Support Program for other local settings

Directory of Open Access Journals (Sweden)

Poulin P

2013-11-01

Full Text Available Paule Poulin,1 Lea Austen,1 Catherine M Scott,2 Michelle Poulin,1 Nadine Gall,2 Judy Seidel,3 René Lafrenière1 1Department of Surgery, 2Knowledge Management, 3Public Health Innovation and Decision Support, Alberta Health Services, Calgary, AB, Canada Purpose: Introducing new health technologies, including medical devices, into a local setting in a safe, effective, and transparent manner is a complex process, involving many disciplines and players within an organization. Decision making should be systematic, consistent, and transparent. It should involve translating and integrating scientific evidence, such as health technology assessment (HTA reports, with context-sensitive evidence to develop recommendations on whether and under what conditions a new technology will be introduced. However, the development of a program to support such decision making can require considerable time and resources. An alternative is to adapt a preexisting program to the new setting. Materials and methods: We describe a framework for adapting the Local HTA Decision Support Program, originally developed by the Department of Surgery and Surgical Services (Calgary, AB, Canada, for use by other departments. The framework consists of six steps: 1 development of a program review and adaptation manual, 2 education and readiness assessment of interested departments, 3 evaluation of the program by individual departments, 4 joint evaluation via retreats, 5 synthesis of feedback and program revision, and 6 evaluation of the adaptation process. Results: Nine departments revised the Local HTA Decision Support Program and expressed strong satisfaction with the adaptation process. Key elements for success were identified. Conclusion: Adaptation of a preexisting program may reduce duplication of effort, save resources, raise the health care providers' awareness of HTA, and foster constructive stakeholder engagement, which enhances the legitimacy of evidence

The influence of management and environment on local health department organizational structure and adaptation: a longitudinal network analysis.

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Keeling, Jonathan W; Pryde, Julie A; Merrill, Jacqueline A

2013-01-01

The nation's 2862 local health departments (LHDs) are the primary means for assuring public health services for all populations. The objective of this study is to assess the effect of organizational network analysis on management decisions in LHDs and to demonstrate the technique's ability to detect organizational adaptation over time. We conducted a longitudinal network analysis in a full-service LHD with 113 employees serving about 187,000 persons. Network survey data were collected from employees at 3 times: months 0, 8, and 34. At time 1 the initial analysis was presented to LHD managers as an intervention with information on evidence-based management strategies to address the findings. At times 2 and 3 interviews documented managers' decision making and events in the task environment. Response rates for the 3 network analyses were 90%, 97%, and 83%. Postintervention (time 2) results showed beneficial changes in network measures of communication and integration. Screening and case identification increased for chlamydia and for gonorrhea. Outbreak mitigation was accelerated by cross-divisional teaming. Network measurements at time 3 showed LHD adaptation to H1N1 and budget constraints with increased centralization. Task redundancy increased dramatically after National Incident Management System training. Organizational network analysis supports LHD management with empirical evidence that can be translated into strategic decisions about communication, allocation of resources, and addressing knowledge gaps. Specific population health outcomes were traced directly to management decisions based on network evidence. The technique can help managers improve how LHDs function as organizations and contribute to our understanding of public health systems.

Estimating the cost to U.S. health departments to conduct HIV surveillance.

Science.gov (United States)

Shrestha, Ram K; Sansom, Stephanie L; Laffoon, Benjamin T; Farnham, Paul G; Shouse, R Luke; MacMaster, Karen; Hall, H Irene

2014-01-01

HIV case surveillance is a primary source of information for monitoring HIV burden in the United States and guiding the allocation of prevention and treatment funds. While the number of people living with HIV and the need for surveillance data have increased, little is known about the cost of surveillance. We estimated the economic cost to health departments of conducting high-quality HIV case surveillance. We collected primary data on the unit cost and quantity of resources used to operate the HIV case surveillance program in Michigan, where HIV burden (i.e., the number of HIV cases) is moderate to high (n=14,864 cases). Based on Michigan's data, we projected the expected annual HIV surveillance cost for U.S., state, local, and territorial health departments. We based our cost projection on the variation in the number of new and established cases, area-specific wages, and potential economies of scale. We estimated the annual total HIV surveillance cost to the Michigan health department to be $1,286,524 ($87/case), the annual total cost of new cases to be $108,657 ($133/case), and the annual total cost of established cases to be $1,177,867 ($84/case). Our projected median annual HIV surveillance cost per health department ranged from $210,600 in low-HIV burden sites to $1,835,000 in high-HIV burden sites. Our analysis shows that a systematic approach to costing HIV surveillance at the health department level is feasible. For HIV surveillance, a substantial portion of total surveillance costs is attributable to maintaining established cases.

Introduction of new technologies and decision making processes: a framework to adapt a Local Health Technology Decision Support Program for other local settings.

Science.gov (United States)

Poulin, Paule; Austen, Lea; Scott, Catherine M; Poulin, Michelle; Gall, Nadine; Seidel, Judy; Lafrenière, René

2013-01-01

Introducing new health technologies, including medical devices, into a local setting in a safe, effective, and transparent manner is a complex process, involving many disciplines and players within an organization. Decision making should be systematic, consistent, and transparent. It should involve translating and integrating scientific evidence, such as health technology assessment (HTA) reports, with context-sensitive evidence to develop recommendations on whether and under what conditions a new technology will be introduced. However, the development of a program to support such decision making can require considerable time and resources. An alternative is to adapt a preexisting program to the new setting. We describe a framework for adapting the Local HTA Decision Support Program, originally developed by the Department of Surgery and Surgical Services (Calgary, AB, Canada), for use by other departments. The framework consists of six steps: 1) development of a program review and adaptation manual, 2) education and readiness assessment of interested departments, 3) evaluation of the program by individual departments, 4) joint evaluation via retreats, 5) synthesis of feedback and program revision, and 6) evaluation of the adaptation process. Nine departments revised the Local HTA Decision Support Program and expressed strong satisfaction with the adaptation process. Key elements for success were identified. Adaptation of a preexisting program may reduce duplication of effort, save resources, raise the health care providers' awareness of HTA, and foster constructive stakeholder engagement, which enhances the legitimacy of evidence-informed recommendations for introducing new health technologies. We encourage others to use this framework for program adaptation and to report their experiences.

Capital dynamics and local health systems: searching for a comprehensive analysis of the health sector

Directory of Open Access Journals (Sweden)

Maria de Fátima Siliansky de Andreazzi

2006-01-01

Full Text Available The article presents a proposal of a methodology aimed to analyze the health care sector according to the dynamics of capital accumulation. That approach could be summed up to more traditional approaches founded in the Public Health field, based in a political perspective. The proposal departs from concepts and methods of Industrial Organization, already used for health care markets, in the European and Latin-American (CEPAL contexts. We aggregated economic and historical variables to these approaches, which delimitate possibilities and impose constraints to the strategies of the local agents. The objective of the paper is to give methodological support to public managers at state and local level, whose role as the single commander in their territories is prescribed by the present health policy in Brazil. That includes all the fields related to private sector regulation in health: from planning the supply to quality control of providers.

Evolution in obesity and chronic disease prevention practice in California public health departments, 2010.

Science.gov (United States)

Schwarte, Liz; Ngo, Samantha; Banthia, Rajni; Flores, George; Prentice, Bob; Boyle, Maria; Samuels, Sarah E

2014-11-13

Local health departments (LHDs) are dedicating resources and attention to preventing obesity and associated chronic diseases, thus expanding their work beyond traditional public health activities such as surveillance. This study investigated practices of local health departments in California to prevent obesity and chronic disease. We conducted a web-based survey in 2010 with leaders in California's LHDs to obtain diverse perspectives on LHDs' practices to prevent obesity and chronic disease. The departmental response rate for the 2010 survey was 87% (53 of California's 61 LHDs). Although staff for preventing obesity and chronic disease decreased at 59% of LHDs and stayed the same at 26% of LHDs since 2006, LHDs still contributed the same (12%) or a higher (62%) level of effort in these areas. Factors contributing to internal changes to address obesity and chronic disease prevention included momentum in the field of obesity prevention, opportunities to learn from other health departments, participation in obesity and chronic disease prevention initiatives, and flexible funding streams for chronic disease prevention. LHDs that received foundation funding or had a lead person or organizational unit coordinating or taking the lead on activities related to obesity and chronic disease prevention were more likely than other LHDs to engage in some activities related to obesity prevention. California LHDs are increasing the intensity and breadth of obesity and chronic disease prevention. Findings provide a benchmark from which further changes in the activities and funding sources of LHD chronic disease prevention practice may be measured.

Saving Lives and Saving Money: The Role of North Carolina Health Departments in Medicaid Managed Care.

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Bridger, Colleen M; Smith, Steven E; Saunders, Stacie Turpin

2017-01-01

A new Medicaid system is emerging in North Carolina in which accountable care organizations will aim to improve both the quality and value of health care. We explore how local health departments can apply their expertise in population health to help achieve these goals. ©2017 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Effective communication of public health guidance to emergency department clinicians in the setting of emerging incidents: a qualitative study and framework.

Science.gov (United States)

Khan, Yasmin; Sanford, Sarah; Sider, Doug; Moore, Kieran; Garber, Gary; de Villa, Eileen; Schwartz, Brian

2017-04-28

Evidence to inform communication between emergency department clinicians and public health agencies is limited. In the context of diverse, emerging public health incidents, communication is urgent, as emergency department clinicians must implement recommendations to protect themselves and the public. The objectives of this study were to: explore current practices, barriers and facilitators at the local level for communicating public health guidance to emergency department clinicians in emerging public health incidents; and develop a framework that promotes effective communication of public health guidance to clinicians during emerging incidents. A qualitative study was conducted using semi-structured interviews with 26 key informants from emergency departments and public health agencies in Ontario, Canada. Data were analyzed inductively and the analytic approach was guided by concepts of complexity theory. Emergent themes corresponded to challenges and strategies for effective communication of public health guidance. Important challenges related to the coordination of communication across institutions and jurisdictions, and differences in work environments across sectors. Strategies for effective communication were identified as the development of partnerships and collaboration, attention to specific methods of communication used, and the importance of roles and relationship-building prior to an emerging public health incident. Following descriptive analysis, a framework was developed that consists of the following elements: 1) Anticipate; 2) Invest in building relationships and networks; 3) Establish liaison roles and redundancy; 4) Active communication; 5) Consider and respond to the target audience; 6) Leverage networks for coordination; and 7) Acknowledge and address uncertainty. The qualities inherent in local relationships cut across framework elements. This research indicates that relationships are central to effective communication between public health

Pennsylvania Department of Transportation's Local Technical Assistance Program (LTAP).

Science.gov (United States)

2010-11-01

The Pennsylvania Department of Transportations (PennDOT) Local Technical Assistance Program : (LTAP) was awarded to the Pennsylvania State Association of Township Supervisors (PSATS), with the : contract start date of December 1, 2005. PSATS led t...

A multistate examination of partnership activity among local public health systems using the National Public Health Performance Standards.

Science.gov (United States)

Barnes, Priscilla A; Curtis, Amy B; Hall-Downey, Laura; Moonesinghe, Ramal

2012-01-01

This study examines whether partnership-related measures in the second version of the National Public Health Performance Standards (NPHPS) are useful in evaluating level of activity as well as identifying latent constructs that exist among local public health systems (LPHSs). In a sample of 110 LPHSs, descriptive analysis was conducted to determine frequency and percentage of 18 partnership-related NPHPS measures. Principal components factor analysis was conducted to identify unobserved characteristics that promote effective partnerships among LPHSs. Results revealed that 13 of the 18 measures were most frequently reported at the minimal-moderate level (conducted 1%-49% of the time). Coordination of personal health and social services to optimize access (74.6%) was the most frequently reported measure at minimal-moderate levels. Optimal levels (conducted >75% of the time) were reported most frequently in 2 activities: participation in emergency preparedness coalitions and local health departments ensuring service provision by working with state health departments (67% and 61% of respondents, respectively) and the least optimally reported activity was review partnership effectiveness (4% of respondents). Factor analysis revealed categories of partnership-related measures in 4 domains: resources and activities contributing to relationship building, evaluating community leadership activities, research, and state and local linkages to support public health activities. System-oriented public health assessments may have questions that serve as proxy measures to examine levels of interorganizational partnerships. Several measures from the NPHPS were useful in establishing a national baseline of minimal and optimal activity levels as well as identifying factors to enhance the delivery of the 10 essential public health services among organizations and individuals in public health systems.

State practitioner insights into local public health challenges and opportunities in obesity prevention: a qualitative study.

Science.gov (United States)

Stamatakis, Katherine A; Lewis, Moira; Khoong, Elaine C; Lasee, Claire

2014-03-13

The extent of obesity prevention activities conducted by local health departments (LHDs) varies widely. The purpose of this qualitative study was to characterize how state obesity prevention program directors perceived the role of LHDs in obesity prevention and factors that impact LHDs' success in obesity prevention. From June 2011 through August 2011, we conducted 28 semistructured interviews with directors of federally funded obesity prevention programs at 22 state and regional health departments. Interviews were transcribed verbatim, coded, and analyzed to identify recurring themes and key quotations. Main themes focused on the roles of LHDs in local policy and environmental change and on the barriers and facilitators to LHD success. The role LHDs play in obesity prevention varied across states but generally reflected governance structure (decentralized vs centralized). Barriers to local prevention efforts included competing priorities, lack of local capacity, siloed public health structures, and a lack of local engagement in policy and environmental change. Structures and processes that facilitated prevention were having state support (eg, resources, technical assistance), dedicated staff, strong communication networks, and a robust community health assessment and planning process. These findings provide insight into successful strategies state and local practitioners are using to implement innovative (and evidence-informed) community-based interventions. The change in the nature of obesity prevention requires a rethinking of the state-local relationship, especially in centralized states.

Collaboration between local health and local government agencies for health improvement.

Science.gov (United States)

Hayes, Sara L; Mann, Mala K; Morgan, Fiona M; Kelly, Mark J; Weightman, Alison L

2012-10-17

In many countries, national, regional and local inter- and intra-agency collaborations have been introduced to improve health outcomes. Evidence is needed on the effectiveness of locally developed partnerships which target changes in health outcomes and behaviours. To evaluate the effects of interagency collaboration between local health and local government agencies on health outcomes in any population or age group. We searched the Cochrane Public Health Group Specialised Register, AMED, ASSIA, CENTRAL, CINAHL, DoPHER, EMBASE, ERIC, HMIC, IBSS, MEDLINE, MEDLINE In-Process, OpenGrey, PsycINFO, Rehabdata, Social Care Online, Social Services Abstracts, Sociological Abstracts, TRoPHI and Web of Science from 1966 through to January 2012. 'Snowballing' methods were used, including expert contact, citation tracking, website searching and reference list follow-up. Randomized controlled trials (RCTs), controlled clinical trials (CCTs), controlled before-and-after studies (CBAs) and interrupted time series (ITS) where the study reported individual health outcomes arising from interagency collaboration between health and local government agencies compared to standard care. Studies were selected independently in duplicate, with no restriction on population subgroup or disease. Two authors independently conducted data extraction and assessed risk of bias for each study. Sixteen studies were identified (28,212 participants). Only two were considered to be at low risk of bias. Eleven studies contributed data to the meta-analyses but a narrative synthesis was undertaken for all 16 studies. Six studies examined mental health initiatives, of which one showed health benefit, four showed modest improvement in one or more of the outcomes measured but no clear overall health gain, and one showed no evidence of health gain. Four studies considered lifestyle improvements, of which one showed some limited short-term improvements, two failed to show health gains for the intervention

Tackling Health Inequalities Locally

DEFF Research Database (Denmark)

Diderichsen, Finn; Scheele, Christian Elling; Little, Ingvild Gundersen

of this study. It is based on three sources: 1. Interviews with policymakers (administrators and politicians) within healthcare administrations, childhood/education, and labour market administrations from September 2014 to March 2015*. 2. Textual analysis of available policy documents from regions...... of translating small inequalities in wealth into small inequalities in health. Denmark, Norway and Sweden all have legislation that indifferent ways offers local governments key roles in public health. This is partly due to local governments’ responsibility for many policy areas of great relevance to health...... state model, including its health policy, as an area of Nordic collaboration (104). However, realising the principle of health (equity) in all policiesis no simple matter. The national authorities and local government federations in Denmark, Norway and Sweden have therefore initiated various activities...

Enhancing evidence-based diabetes and chronic disease control among local health departments: a multi-phase dissemination study with a stepped-wedge cluster randomized trial component.

Science.gov (United States)

Parks, Renee G; Tabak, Rachel G; Allen, Peg; Baker, Elizabeth A; Stamatakis, Katherine A; Poehler, Allison R; Yan, Yan; Chin, Marshall H; Harris, Jenine K; Dobbins, Maureen; Brownson, Ross C

2017-10-18

The rates of diabetes and prediabetes in the USA are growing, significantly impacting the quality and length of life of those diagnosed and financially burdening society. Premature death and disability can be prevented through implementation of evidence-based programs and policies (EBPPs). Local health departments (LHDs) are uniquely positioned to implement diabetes control EBPPs because of their knowledge of, and focus on, community-level needs, contexts, and resources. There is a significant gap, however, between known diabetes control EBPPs and actual diabetes control activities conducted by LHDs. The purpose of this study is to determine how best to support the use of evidence-based public health for diabetes (and related chronic diseases) control among local-level public health practitioners. This paper describes the methods for a two-phase study with a stepped-wedge cluster randomized trial that will evaluate dissemination strategies to increase the uptake of public health knowledge and EBPPs for diabetes control among LHDs. Phase 1 includes development of measures to assess practitioner views on and organizational supports for evidence-based public health, data collection using a national online survey of LHD chronic disease practitioners, and a needs assessment of factors influencing the uptake of diabetes control EBPPs among LHDs within one state in the USA. Phase 2 involves conducting a stepped-wedge cluster randomized trial to assess effectiveness of dissemination strategies with local-level practitioners at LHDs to enhance capacity and organizational support for evidence-based diabetes prevention and control. Twelve LHDs will be selected and randomly assigned to one of the three groups that cross over from usual practice to receive the intervention (dissemination) strategies at 8-month intervals; the intervention duration for groups ranges from 8 to 24 months. Intervention (dissemination) strategies may include multi-day in-person workshops, electronic

The interplay between policy guidelines and local dynamics in shaping the scope of networks: the experience of the Italian Departments of Mental Health.

Science.gov (United States)

Compagni, Amelia; Gerzeli, Simone; Bergamaschi, Mara

2011-02-01

In the mental health field, the creation of networks that can guarantee the smooth coordination of services and organizations across sectors is a priority in the policy agenda of several countries. In Italy, Departments of Mental Health (DMHs) have been designated responsible for the system of specialist mental health services, and also mandated as the conveners and leaders of interorganizational and cross-sectoral networks, by a system-wide reform. This study aims to understand how mental health networks have been assembled in this context and the factors and motivations that have shaped their scope. By combining an analysis of policies with a survey of DMH directors, we have determined that DMHs have preferentially formed collaborative relationships with social service providers (local governments) and the voluntary sector. In contrast, relationships with substance abuse and addiction services and primary care providers were weak and stifled by a lack of trust and by conflict about respective contributions to mental care. We explore the reasons for this selectivity in interorganizational relationships and propose that a lack of targeted incentives in policy guidelines, on the one hand, and the existence of a mandated network leadership, on the other, have led to a rather narrow range of collaborations.

[Engagement as motivational driver. Processes of change in an Italian department of mental health].

Science.gov (United States)

Fuschillo, Carmine; Orazzo, Catello; Orazzo, Gabriele Gennaro; Capriola, Elena; Palumbo, Rocco; Grimaldi, Manlio

2017-01-01

The health care reforms of last years have deeply affected the National Health System, resulting in the need for a change in organizational processes and a more efficient and dynamic change management. An effective change management is not possible without a deep involvement (engagement) of professionals, which is itself a key requisite for motivation. This study aims to examine the main instruments of engagement management, as a tool of change according to a modern reorganization approach. We examine the results of this process in the Mental Health Department of the Local Health Company Naples 3 South in recent years, starting with the analysis of its main weaknesses.

Changes in public health preparedness services provided to local health departments by regional offices in North Carolina: a comparison of two cross-sectional studies.

Science.gov (United States)

Donovan, Catherine V; Markiewicz, Milissa; Horney, Jennifer A

2014-05-28

In 2011, seven decentralized Public Health Regional Surveillance Teams (PHRSTs) were restructured into four centralized Public Health Preparedness and Response (PHP&R) regional offices to realign preparedness priorities and essential services with appropriate infrastructure; field-based staff was reduced, saving approximately $1 million. The objective of this study was to understand the impact that restructuring had on services provided to local health departments (LHDs) throughout North Carolina. A survey to document services that regional offices provide to LHDs in North Carolina was administered by the North Carolina Preparedness and Emergency Response Research Center in 2013. The results were compared to a similar survey from 2009, which identified services provided by regional teams prior to restructuring. Of 69 types of assistance, 14 (20%) were received by 50% or more LHDs in 2012. Compared to 2009, there was a significant decrease in the proportion of LHDs receiving 67% (n = 47) of services. The size of the region served by regional offices was shown to inversely impact the proportion of LHDs receiving services for 25% of services. There was a slight significant decline in perceived quality of the services provided by regional teams in 2012 as comparison to 2009. Following a system-wide review of preparedness in North Carolina, the state's regional teams were reorganized to refine their focus to planning, exercises, and training. Some services, most notably under the functions of epidemiology and surveillance and public health event response, are now provided by other state offices. However, the study results indicate that several services that are still under the domain of the regional offices were received by fewer LHDs in 2012 than 2009. This decrease may be due to the larger number of counties now served by the four regional offices.

78 FR 60283 - Guidance for Temporary Reassignment of State and Local Personnel During a Public Health Emergency

Science.gov (United States)

2013-10-01

... Personnel During a Public Health Emergency AGENCY: Department of Health and Human Services, Office of the... and Local Personnel during a Public Health Emergency.'' Section 201 of the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (PAHPRA), Public Law 113-5, amends section 319 of the Public Health...

School-Located Influenza Vaccination Clinics: Local Health Department Perspectives

Science.gov (United States)

Ransom, James

2009-01-01

Universal childhood influenza vaccination presents challenges and opportunities for health care and public health systems to vaccinate the children who fall under the new recommendation. Advisory Committee on Immunization Practices (ACIP) recommendations and guidelines are helpful, but they do not provide strategies on how to deliver immunization…

Public health and English local government: historical perspectives on the impact of 'returning home'.

Science.gov (United States)

Gorsky, Martin; Lock, Karen; Hogarth, Sue

2014-12-01

This article uses history to stimulate reflection on the present opportunities and challenges for public health practice in English local government. Its motivation is the paradox that despite Department of Health policy-makers' allusions to 'a long and proud history' and 'returning public health home' there has been no serious discussion of that past local government experience and what we might learn from it. The article begins with a short resumé of the achievements of Victorian public health in its municipal location, and then considers the extensive responsibilities that it developed for environmental, preventive and health services by the mid-twentieth century. The main section discusses the early NHS, explaining why historians see the era as one of decline for the speciality of public health, leading to the reform of 1974, which saw the removal from local government and the abolition of the Medical Officer of Health role. Our discussion focuses on challenges faced before 1974 which raise organizational and political issues relevant to local councils today as they embed new public health teams. These include the themes of leadership, funding, integrated service delivery, communication and above all the need for a coherent vision and rationale for public health action in local authorities. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health.

77 FR 5012 - Environmental Protection Agency, Department of Health and Human Services and Department of...

Science.gov (United States)

2012-02-01

..., Department of Health and Human Services and Department of Agriculture; Memorandum of Understanding Regarding... Memorandum of Understanding (MOU). The MOU will support and encourage cooperation and communication between... Department of Human Services (HHS) and the U.S. Department of Agriculture (USDA). HHS's Centers for Disease...

Returns on Investment in California County Departments of Public Health.

Science.gov (United States)

Brown, Timothy T

2016-08-01

To estimate the average return on investment for the overall activities of county departments of public health in California. I gathered the elements necessary to estimate the average return on investment for county departments of public health in California during the period 2001 to 2008-2009. These came from peer-reviewed journal articles published as part of a larger project to develop a method for determining return on investment for public health by using a health economics framework. I combined these elements by using the standard formula for computing return on investment, and performed a sensitivity analysis. Then I compared the return on investment for county departments of public health with the returns on investment generated for various aspects of medical care. The estimated return on investment from $1 invested in county departments of public health in California ranges from $67.07 to $88.21. The very large estimated return on investment for California county departments of public health relative to the return on investment for selected aspects of medical care suggests that public health is a wise investment.

Sex education for local tourism/hospitality employees: addressing a local health need.

Science.gov (United States)

Bauer, Irmgard L

2009-11-01

Health concerns arising from sexual relationships between tourists and locals usually focus on the travelling public. The local sex partners' health, and their impact on their communities' health, seem far less acknowledged. This paper describes a local health education session which implemented recommendations based on a study in Cuzco/Peru on tourists' and locals' views, knowledge, attitudes and experiences relating to sexual relationships between them. On location, fifteen discotheque employees received a health education session at the establishment's owner's request. Concluding from the positive experience, it is argued that researchers should, where possible, respond to requests to deliver ad hoc health education sessions while on location to address an identified local health need.

Local health and social care responses to implementing the national cold weather plan.

Science.gov (United States)

Heffernan, C; Jones, L; Ritchie, B; Erens, B; Chalabi, Zaid; Mays, N

2017-09-18

The Cold Weather Plan (CWP) for England was launched by the Department of Health in 2011 to prevent avoidable harm to health by cold weather by enabling individuals to prepare and respond appropriately. This study sought the views of local decision makers involved in the implementation of the CWP in the winter of 2012/13 to establish the effects of the CWP on local planning. It was part of a multi-component independent evaluation of the CWP. Ten LA areas were purposively sampled which varied in level of deprivation and urbanism. Fifty-two semi-structured interviews were held with health and social care managers involved in local planning between November 2012 and May 2013. Thematic analysis revealed that the CWP was considered a useful framework to formalize working arrangements between agencies though local leadership varied across localities. There were difficulties in engaging general practitioners, differences in defining vulnerable individuals and a lack of performance monitoring mechanisms. The CWP was welcomed by local health and social care managers, and improved proactive winter preparedness. Areas for improvement include better integration with general practice, and targeting resources at socially isolated individuals in cold homes with specific interventions aimed at reducing social isolation and building community resilience. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Assessing the Knowledge, Skills, and Abilities of Public Health Professionals in Big City Governmental Health Departments.

Science.gov (United States)

McGinty, Meghan D; Castrucci, Brian C; Rios, Debra M

2017-12-13

To identify essential knowledge, skills, and abilities (KSAs) for and characterize gaps in KSAs of professionals working in large, urban health departments. A survey was disseminated to potentially eligible supervisors within 26 of 28 health departments in the largest, most urban jurisdictions in the country. A supervisor was eligible to participate if he or she supervised at least 1 staff member whose highest level of education was a master's degree. A total of 645 eligible supervisors participated in the workforce survey for a response rate of 27.1% and cooperation rate of 55.2%. Supervisors were asked to rate the importance of KSAs to their masters-level staffs' work and indicate their staffs' proficiency. Fifty-eight percent of supervisors reported supervising staff with a master of public health/master of science in public health degree. More than 30% of supervisors indicated that all of the 30 KSAs were essential. Four of the top 10 KSAs rated as essential by supervisors pertained to the ability to communicate. The top skills gaps perceived by supervisors were professional staffs' ability to apply quality improvement concepts to their work (38.0%), understanding of the political system (37.7%), and ability to anticipate changes (33.8%). Public health practitioners receive training in methods, theories, and evidence-based approaches, yet further investment in the workforce is necessary to advance population health. A focus should be placed developing strategic skills rather than advancing narrow specialties. Findings from this research can guide the creation and implementation of training curricula and professional development programs offered within local health departments or targeted to their staff, as well as satisfaction of accreditation requirements. By focusing on building strategic skills, we can ensure a public health workforce that is equipped with the KSAs necessary to practice Public Health 3.0 and leaders who are able to serve as their communities

Returns on Investment in California County Departments of Public Health

Science.gov (United States)

2016-01-01

Objectives. To estimate the average return on investment for the overall activities of county departments of public health in California. Methods. I gathered the elements necessary to estimate the average return on investment for county departments of public health in California during the period 2001 to 2008–2009. These came from peer-reviewed journal articles published as part of a larger project to develop a method for determining return on investment for public health by using a health economics framework. I combined these elements by using the standard formula for computing return on investment, and performed a sensitivity analysis. Then I compared the return on investment for county departments of public health with the returns on investment generated for various aspects of medical care. Results. The estimated return on investment from $1 invested in county departments of public health in California ranges from $67.07 to $88.21. Conclusions. The very large estimated return on investment for California county departments of public health relative to the return on investment for selected aspects of medical care suggests that public health is a wise investment. PMID:27310339

Enhancing Michigan's local public health accreditation program through participation in the multistate learning collaborative.

Science.gov (United States)

Kushion, Mary L; Tews, Debra Scamarcia; Parker, Melody D

2007-01-01

This article presents Michigan's efforts and accomplishments as a result of its involvement with the Multi-State Learning Collaborative (MLC) project. The article gives a brief overview of Michigan's accreditation program. It outlines the two goals and six objectives associated with Michigan's MLC project, and describes the structure it used to implement the project plan. It further explains and illustrates the outcomes achieved from successfully meeting the goals and objectives. The article gives a sample of a proposed voluntary component for continuous quality improvement that local health departments can implement utilizing the Shewhart Cycle of "Plan, Do, Check, and Act" and National Association of City and County Health Officials' Operational Definition of a Functional Health Department.

Tweeting for and against public health policy: response to the Chicago Department of Public Health's electronic cigarette Twitter campaign.

Science.gov (United States)

Harris, Jenine K; Moreland-Russell, Sarah; Choucair, Bechara; Mansour, Raed; Staub, Mackenzie; Simmons, Kendall

2014-10-16

In January 2014, the Chicago City Council scheduled a vote on local regulation of electronic cigarettes as tobacco products. One week prior to the vote, the Chicago Department of Public Health (CDPH) released a series of messages about electronic cigarettes (e-cigarettes) through its Twitter account. Shortly after the messages, or tweets, were released, the department's Twitter account became the target of a "Twitter bomb" by Twitter users sending more than 600 tweets in one week against the proposed regulation. The purpose of our study was to examine the messages and tweet patterns in the social media response to the CDPH e-cigarette campaign. We collected all tweets mentioning the CDPH in the week between the e-cigarette campaign and the vote on the new local e-cigarette policy. We conducted a content analysis of the tweets, used descriptive statistics to examine characteristics of involved Twitter users, and used network visualization and descriptive statistics to identify Twitter users prominent in the conversation. Of the 683 tweets mentioning CDPH during the week, 609 (89.2%) were anti-policy. More than half of anti-policy tweets were about use of electronic cigarettes for cessation as a healthier alternative to combustible cigarettes (358/609, 58.8%). Just over one-third of anti-policy tweets asserted that the health department was lying or disseminating propaganda (224/609, 36.8%). Approximately 14% (96/683, 14.1%) of the tweets used an account or included elements consistent with "astroturfing"-a strategy employed to promote a false sense of consensus around an idea. Few Twitter users were from the Chicago area; Twitter users from Chicago were significantly more likely than expected to tweet in support of the policy. Our findings may assist public health organizations to anticipate, recognize, and respond to coordinated social media campaigns.

Health sciences libraries' subscriptions to journals: expectations of general practice departments and collection-based analysis.

Science.gov (United States)

Barreau, David; Bouton, Céline; Renard, Vincent; Fournier, Jean-Pascal

2018-04-01

The aims of this study were to (i) assess the expectations of general practice departments regarding health sciences libraries' subscriptions to journals and (ii) describe the current general practice journal collections of health sciences libraries. A cross-sectional survey was distributed electronically to the thirty-five university general practice departments in France. General practice departments were asked to list ten journals to which they expected access via the subscriptions of their health sciences libraries. A ranked reference list of journals was then developed. Access to these journals was assessed through a survey sent to all health sciences libraries in France. Adequacy ratios (access/need) were calculated for each journal. All general practice departments completed the survey. The total reference list included 44 journals. This list was heterogeneous in terms of indexation/impact factor, language of publication, and scope (e.g., patient care, research, or medical education). Among the first 10 journals listed, La Revue Prescrire (96.6%), La Revue du Praticien-Médecine Générale (90.9%), the British Medical Journal (85.0%), Pédagogie Médicale (70.0%), Exercer (69.7%), and the Cochrane Database of Systematic Reviews (62.5%) had the highest adequacy ratios, whereas Family Practice (4.2%), the British Journal of General Practice (16.7%), Médecine (29.4%), and the European Journal of General Practice (33.3%) had the lowest adequacy ratios. General practice departments have heterogeneous expectations in terms of health sciences libraries' subscriptions to journals. It is important for librarians to understand the heterogeneity of these expectations, as well as local priorities, so that journal access meets users' needs.

Health contribution to local government planning

International Nuclear Information System (INIS)

France, Cheryl

2004-01-01

When local government considers future land-use plans, the local health authorities are not always included as a key partner. In Cambridgeshire, England, the former Cambridgeshire Health Authority formed a partnership with local government to address this issue. The relationship that developed and the subsequent health impact review provided an opportunity to influence strategic policy and ensure that health objectives are taken into account. Through partnership working, lessons were learned about how to incorporate health issues into a strategic land-use planning document to the overall benefit of the community

The structure and organization of local and state public health agencies in the U.S.: a systematic review.

Science.gov (United States)

Hyde, Justeen K; Shortell, Stephen M

2012-05-01

This systematic review provides a synthesis of the growing field of public health systems research related to the structure and organization of state and local governmental public health agencies. It includes an overview of research examining the influence of organizational characteristics on public health performance and health status and a summary of the strengths and gaps of the literature to date. Data were retrieved through an iterative process, beginning with key word searches in three publication databases (PubMed, JSTOR, Web of Science). Gray literature was searched through the use of Google Scholar™. Targeted searches on websites and key authors were also performed. Documents underwent an initial and secondary screening; they were retained if they contained information about local or state public health structure, organization, governance, and financing. 77 articles met the study criteria. Public health services are delivered by a mix of local, state, and tribal governmental and nongovernmental agencies and delivered through centralized (28%); decentralized (37%); or combined authority (35%). The majority of studies focused on organizational characteristics that are associated with public health performance based on the 10 Essential Public Health Services framework. Population size of jurisdiction served (>50,000); structure of authority (decentralized and mixed); per capita spending at the local level; some partnerships (academic, health services); and leadership of agency directors have been found to be related to public health performance. Fewer studies examined the relationship between organizational characteristics and health outcomes. Improvements in health outcomes are associated with an increase in local health department expenditures, FTEs per capita, and location of health department within local networks. Public health systems in the U.S. face a number of critical challenges, including limited organizational capacity and financial resources

STRUCTURAL AND HIDDEN BARRIERS TO A LOCAL PRIMARY HEALTH CARE INFRASTRUCTURE: AUTONOMY, DECISIONS ABOUT PRIMARY HEALTH CARE, AND THE CENTRALITY AND SIGNIFICANCE OF POWER.

Science.gov (United States)

Freed, Christopher R; Hansberry, Shantisha T; Arrieta, Martha I

2013-09-01

To examine a local primary health care infrastructure and the reality of primary health care from the perspective of residents of a small, urban community in the southern United States. Data derive from 13 semi-structured focus groups, plus three semi-structured interviews, and were analyzed inductively consistent with a grounded theory approach. Structural barriers to the local primary health care infrastructure include transportation, clinic and appointment wait time, and co-payments and health insurance. Hidden barriers consist of knowledge about local health care services, non-physician gatekeepers, and fear of medical care. Community residents have used home remedies and the emergency department at the local academic medical center to manage these structural and hidden barriers. Findings might not generalize to primary health care infrastructures in other communities, respondent perspectives can be biased, and the data are subject to various interpretations and conceptual and thematic frameworks. Nevertheless, the structural and hidden barriers to the local primary health care infrastructure have considerably diminished the autonomy community residents have been able to exercise over their decisions about primary health care, ultimately suggesting that efforts concerned with increasing the access of medically underserved groups to primary health care in local communities should recognize the centrality and significance of power. This study addresses a gap in the sociological literature regarding the impact of specific barriers to primary health care among medically underserved groups.

Chaplaincy and mental health in the department of Veterans affairs and department of defense.

Science.gov (United States)

Nieuwsma, Jason A; Rhodes, Jeffrey E; Jackson, George L; Cantrell, William C; Lane, Marian E; Bates, Mark J; Dekraai, Mark B; Bulling, Denise J; Ethridge, Keith; Drescher, Kent D; Fitchett, George; Tenhula, Wendy N; Milstein, Glen; Bray, Robert M; Meador, Keith G

2013-01-01

Chaplains play important roles in caring for Veterans and Service members with mental health problems. As part of the Department of Veterans Affairs (VA) and Department of Defense (DoD) Integrated Mental Health Strategy, we used a sequential approach to examining intersections between chaplaincy and mental health by gathering and building upon: 1) input from key subject matter experts; 2) quantitative data from the VA / DoD Chaplain Survey (N = 2,163; response rate of 75% in VA and 60% in DoD); and 3) qualitative data from site visits to 33 VA and DoD facilities. Findings indicate that chaplains are extensively involved in caring for individuals with mental health problems, yet integration between mental health and chaplaincy is frequently limited due to difficulties between the disciplines in establishing familiarity and trust. We present recommendations for improving integration of services, and we suggest key domains for future research.

Building a regional health equity movement: the grantmaking model of a local health department.

Science.gov (United States)

Baril, Nashira; Patterson, Meghan; Boen, Courtney; Gowler, Rebekah; Norman, Nancy

2011-01-01

The Boston Public Health Commission's Center for Health Equity and Social Justice provides grant funding, training, and technical assistance to 15 organizations and coalitions across New England to develop, implement, and evaluate community-based policy and systems change strategies that address social determinants of health and reduce racial and ethnic health inequities. This article describes Boston Public Health Commission's health equity framework, theory of change regarding the elimination of racial and ethnic health inequities, and current grantmaking model. To conclude, the authors evaluate the grant model and offer lessons learned from providing multiyear regional grants to promote health equity.

[Health inequality gap in inmigrant versus local children in Chile].

Science.gov (United States)

Cabieses, Baltica; Chepo, Macarena; Oyarte, Marcela; Markkula, Niina; Bustos, Patricia; Pedrero, Víctor; Delgado, Iris

2017-12-01

Children and young international migrants face different health challenges compa red with the local population, particularly if they live in insecure environments or adverse social conditions. This study seeks to identify gaps in health outcomes of children between immigrant and local population in Chile. This study analyses data from three sources: (i) Born in Chile: Electronic records of antenatal visits from all municipal antenatal clinics of Recoleta in 2012; (ii) Growing up in Chile: Population survey "National Socioeconomic Characterization" (CASEN) from 2013 and (iii) Getting sick in Chile: Data of all hospital discharges in 2012, provided by the department of statistics and health information (DEIS) of the Ministry of Health. (I) Born in Chile: Im migrants more frequently have psychosocial risk (62.3% vs 50.1% in Chileans) and enter later into the program (63.1% vs 33.4% enter later than 14 weeks of pregnancy). All birth outcomes were better among immigrants (e.g. caesarean sections rates: 24.2% immigrants vs % Chileans). (ii) Growing up in Chile: A higher proportion of migrant children is outside the school system and lives in multidi mensional poverty (40% immigrants vs 23.2% Chileans). (iii) Getting sick in Chile: Injuries and other external causes were more frequent cause of hospitalisation among migrants (23.6%) than the local population (16.7%) aged between 7 and 14 years. Addressing the needs of the children in Chile, regardless of their immigration status, is an ethical, legal and moral imperative.

PUBLIC EXPENDITURE ON HEALTH IN LOCAL BUDGETS

Directory of Open Access Journals (Sweden)

Cristinel ICHIM

2017-06-01

Full Text Available This paper entitled "Public expenditure on health in local budgets" aims analysing and deepening major spending categories that public authorities finance at local level, namely health expenditure. In the first part of the article we have specified the content and role of this category of expenditure in local budgets and also made some feedback on decentralization in health. In the second part of the work, based on data available in Statistical Yearbook of Romania, we have carried out an analysis of the dynamics of health spending from local budgets to emphasize their place and role in the health care expenses. The research carried out follows that the evolution and structure of health expenditure financed from local budgets is determined, along with the legislative framework in the field, by several variables that differ from one territorial administrative unit to another: the existence of sanitary units, their type, the involving of local public authorities in their development and modernization, the number and the social structure of the population. The research shows that over the period 1993-2015, the dynamics of the share of health spending in total expenditures of local budgets is sinusoidal, with a minimum threshold in 2000 of only 0.3%.

A utilização das informações de custos na gestão da saúde pública: um estudo preliminar em secretarias municipais de saúde do estado de Santa Catarina The use of costs information in public health: a preliminary study in local health departments in the state of Santa Catarina

Directory of Open Access Journals (Sweden)

André Graf de Almeida

2009-06-01

Full Text Available Este artigo analisa o uso das informações de custos pelos gestores de 20 grandes secretarias municipais da saúde do estado de Santa Catarina. Para isso, foi avaliado o perfil dos gestores entrevistados; foi verificada a existência ou não de sistemas de custos implantados nessas secretarias; foi feita uma avaliação da percepção desses gestores sobre a utilização das informações de custos no processo de tomada de decisão e foram identificadas quais informações de custos são utilizadas atualmente na gestão desses órgãos. Os entrevistados foram os ocupantes de cargos administrativos nas secretarias municipais da saúde pesquisadas. Conseguiu-se avaliar o uso das informações de custos na gestão de 18 secretarias municipais da saúde do estado de Santa Catarina. Os resultados indicam que apenas duas secretarias municipais da saúde possuem esse processo um pouco mais avançado; nas demais, o que se verifica é que existem algumas tentativas de se obter informações mais detalhadas sobre custos. Entretanto, na opinião dos entrevistados, as informações de custos são bastante importantes na gestão das secretarias.This article analyzes the use of costs information in decision-making by managers of the 20 local health departments in the state of Santa Catarina, Brazil. Public managers profiles were assessed so as to verify whether they had the schooling and experience needed to produce ethical information on certain issues. The existence of costs systems in such departments was assessed through the managers' perceptions of the use of costs information in the decision-making process, and which information is actually used. The methodology used was guided interviews, and the subjects were public employees withholding managing positions in local health departments. The goals of the study were reached as 18 local health departments in the state of Santa Catarina were assessed on their use of costs information. Results show that in

Local wisdom and health promotion

DEFF Research Database (Denmark)

Demaio, Alessandro Rhyll

2011-01-01

The respectful, appropriate use of local wisdom (LW) in health promotion increases penetration and longevity of positive behavior change. Collaborations based on mutual respect, flexibility and trust between health program organizers, traditional and local practitioners, and the communities being...... served are the goal for public health physicians in our modern, globalized world. This meta-analysis reviewed literature from the past 18 years drawn from a wide range of sources. This investigations proposes a grassroots, material shift toward regarding health promotion interventions as partnerships...... when planning, executing, and evaluating health promotion projects. This holistic approach would be based on the premise that LW is equal to expert opinion. This article endorses the integration of LW at every stage of the health promotion process concluding that it is through empowerment...

Engaging youth in food activism in New York City: lessons learned from a youth organization, health department, and university partnership.

Science.gov (United States)

Tsui, Emma; Bylander, Kim; Cho, Milyoung; Maybank, Aletha; Freudenberg, Nicholas

2012-10-01

Research indicates that insufficient emphasis on community collaboration and partnership can thwart innovative community-driven work on the social determinants of health by local health departments. Appreciating the importance of enhancing community participation, the New York City Department of Health and Mental Hygiene (DOHMH) helped lead the development of the Health Equity Project (HEP), an intervention aimed at increasing the capacity of urban youth to identify and take action to reduce food-related health disparities. DOHMH partnered with the City University of New York School of Public Health and several local youth organizations to design and implement the intervention. HEP was conducted with 373 young people in 17 cohorts at 14 unique sites: six in Brooklyn, six in the Bronx, and two in Harlem. Partnered youth organizations hosted three stages of work: interactive workshops on neighborhood health disparities, food environments, and health outcomes; food-focused research projects conducted by youth; and small-scale action projects designed to change local food environments. Through these activities, HEP appears to have been successful in introducing youth to the social, economic, and political factors that shape food environments and to the influence of food on health outcomes. The intervention was also somewhat successful in providing youth with community-based participatory research skills and engaging them in documenting and then acting to change their neighborhood food environments. In the short term, we are unable to assess how successful HEP has been in building young leaders who will continue to engage in this kind of activism, but we suspect that more extended interactions would be needed to achieve this more ambitious goal. Experiences at these sites suggest that youth organizations with a demonstrated capacity to engage youth in community service or activism and a commitment to improving food or other health-promoting community resources make the

Local house prices and mental health.

Science.gov (United States)

Joshi, Nayan Krishna

2016-03-01

This paper examines the impact of local (county-level) house prices on individual self-reported mental health using individual level data from the United States Behavioral Risk Factor Surveillance System between 2005 and 2011. Exploiting a fixed-effects model that relies on within-county variations, relative to the corresponding changes in other counties, I find that while individuals are likely to experience worse self-reported mental health when local house prices decline, this association is most pronounced for individuals who are least likely to be homeowners. This finding is not consistent with a prediction from a pure wealth mechanism but rather with the hypothesis that house prices act as an economic barometer. I also demonstrate that the association between self-reported mental health and local house prices is not driven by unemployment or foreclosure. The primary result-that lower local house prices have adverse impact on self-reported mental health of homeowners and renters-is consistent with studies using data from the United Kingdom.

[The role of the public health personnel in the Prevention Department (in the Hygiene Services and Public Health Care and Hygiene of Food and Nutrition): proposal for the future of public health care].

Science.gov (United States)

Brusaferro, Silvio; Marcolongo, Adriano; Schiava, Flavio; Bggio, Luca; Betta, Alberto; Buzzo, Armando; Cinquetti, Sandro; Coin, Paulo; Dal Fior, Tina; De Battisti, Fabio; De Marchi, Chiara; De Noni, Lucia; Donatoni, Luigi; Ferraresso, Anna; Gallo, Giovanni; Gallo, Lorenza; Gallo, Tolinda; Gottardello, Lorena; Menegon, Tiziana; Minuzzo, Michele; Paussi, Gianna; Pinna, Clara; Poli, Albino; Rossato, Luigi; Sbrogliò, Luca; Simeoni, Josef; Speccini, Manuela; Stoppato, Ugo; Superbi, Piero; Tardivo, Stefano; Urdich, Alessandro; Valsecchi, Massimo; Zamparo, Manuela

2008-01-01

A global and local discussion on Public Health relevance is taking place, including the future role and organization of its services. Noteworthy becomes the role played by Public Health Specialists. This work presents the results of a workshop, carried out following the Guilbert methodology, whose aim was to define Public Health Doctors functions and their related activities. The programme involved 30 professionals from Triveneto area (North Eastern Italy), working in Prevention Departments at National Health Service and Universities. The key-functions identified were: 1) Health status assessment and identification of community risk factors, 2) Health Promotion, 3) Prevention, 4) Protection, 5) Planning, 6) Communication, 7) Professional Training, 8) Alliances and resources for complex Public Health programs, 9) Crisis management in Public Health, 10) Research. For each function activities were identified, meaning concerning areas and contents that must be warranted by professionals. This experience allowed to share existing attitudes and experiences present in Triveneto area, and it can stand as a feasible instrument for different settings. Nevertheless, it appears mandatory explaining at each level in the society role and functions of Prevention Departments.

An integrated program to train local health care providers to meet post-disaster mental health needs Programa integrado para entrenar a proveedores de servicios sanitarios locales a satisfacer las necesidades de salud mental después de un desastre

OpenAIRE

Stan Kutcher; Sonia Chehil; Thorne Roberts

2005-01-01

This paper describes a post-disaster mental health training program developed by the International Section of the Department of Psychiatry at Dalhousie University (Halifax, Canada) and delivered in Grenada after Hurricane Ivan struck the country in September 2004. This train-the-trainer program used an integrated community health model to help local health care providers develop the necessary skills for the identification and evidenced-based treatment of mental disorders occurring after a nat...

Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

Data.gov (United States)

Department of Veterans Affairs — Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a health care benefit program designed for the dependents of certain Veterans....

Health consequences of road accidents: insights from local health authority registries.

Science.gov (United States)

Bertoncello, C; Furlan, P; Baldovin, T; Marcolongo, A; Casale, P; Cocchio, S; Buja, A; Baldo, V

2013-01-01

Road accidents are a major public health problem that affect all age groups but their impact is most striking among the young. The aim of this study is to quantify the burden of road traffic injuries, their mortality and direct in-patient economic costs and to identify the age classes at highest risk for severe road traffic injuries, through analysis of data collected by information systems of an Italian Local Health Authority. The study was conducted in a Local Health Authority of Veneto Region. Injured people were selected from Emergency Department (2006-2010). Data were linked to the Hospital Information System for hospital admissions and to the Mortality Registry to check 30-day mortality. The direct costs associated to hospitalizations were estimated through Diagnosis Related Group reimbursement rates. Multivariate analysis was performed using hospitalization and mortality as the dependent variables and gender, age, day of week when accident occurred as the independent variables. Traffic injury, hospitalization and mortality incidence rates were calculated by gender and age per 100,000 residents per year. The road traffic injuries were 9,192, decreasing from 2,112 in 2006 to 1,980 in 2010. Among injured persons 55.3% were male (68.1% among 15-19 age class); 41.7% young people aged 15-34 years (43.9% among male, 39.0% among female). Total hospitalisation rate was 5.9%. Overall mortality rate was 0.3% (0.9% among aged 65 or older). The cost of hospital admission was euro 2,742,505 (hospitalization mean cost euro 5,097). Risk of hospitalization and death was higher in male, in elderly and during week end. Young people aged 15-19 had the highest incidence of visits (2,258.4 per 100,000) and high hospitalisation weekend and mortality rates (respectively 101.5 and 8.5). Analysis at local level, using current data sources, permits to estimate the burden of injuries caused by road-traffic, to describe the characteristics of injured persons and finally to estimate

Integrated Care Programme—Department of Health, UK

OpenAIRE

Dewji, Mo; Passmore, Julie; Wardell, John

2010-01-01

Introduction Integration is seen as a key building block within the strategic plan for improving the health and well-being of the population of England. The Integrated Care Pilot programme is a three-year academically assessed research programme sponsored by the Department of Health, England, which aims to explore and gather evidence to support different approaches to integration. Aims With 16 pilot sites across England the objectives of the programme are based upon a Government commitment to...

Cost of a roller skating rink to the local accident and emergency department.

Science.gov (United States)

Nayeem, N; Shires, S E; Porter, J E

1990-01-01

A 14 month retrospective study was undertaken to determine the cost implications of the opening of a roller skating rink to the local hospital accident and emergency department (A and E). A total of 398 patients attended following injury at the roller skating rink, of whom 384 were included in the study. The estimated cost of their injuries was determined by the hospital accounts department. The average cost per patient attending the A and E department following roller skating injury was about 100 pounds. The total cost to the A and E department of all injuries sustained at the rink over this period was 38,412 pounds. The cost implications of opening a roller skating rink for the A and E department are considerable. If proposals for self-budgeting are applied, A and E departments will have to seek additional funding if such leisure facilities are opened in their vicinity. PMID:2097020

Local health department epidemiologic capacity: a stratified cross-sectional assessment describing the quantity, education, training, and perceived competencies of epidemiologic staff.

Science.gov (United States)

O'Keefe, Kaitlin A; Shafir, Shira C; Shoaf, Kimberley I

2013-01-01

Local health departments (LHDs) must have sufficient numbers of staff functioning in an epidemiologic role with proper education, training, and skills to protect the health of communities they serve. This pilot study was designed to describe the composition, training, and competency level of LHD staff and examine the hypothesis that potential disparities exist between LHDs serving different sized populations. Cross-sectional surveys were conducted with directors and epidemiologic staff from a sample of 100 LHDs serving jurisdictions of varied sizes. Questionnaires included inquiries regarding staff composition, education, training, and measures of competency modeled on previously conducted studies by the Council of State and Territorial Epidemiologists. Number of epidemiologic staff, academic degree distribution, epidemiologic training, and both director and staff confidence in task competencies were calculated for each LHD size strata. Disparities in measurements were observed in LHDs serving different sized populations. LHDs serving small populations reported a smaller average number of epidemiologic staff than those serving larger jurisdictions. As size of population served increased, percentages of staff and directors holding bachelors' and masters' degrees increased, while those holding RN degrees decreased. A higher degree of perceived competency of staff in most task categories was reported in LHDs serving larger populations. LHDs serving smaller populations reported fewer epidemiologic staff, therefore might benefit from additional resources. Differences observed in staff education, training, and competencies suggest that enhanced epidemiologic training might be particularly needed in LHDs serving smaller populations. RESULTS can be used as a baseline for future research aimed at identifying areas where training and personnel resources might be particularly needed to increase the capabilities of LHDs.

Public Health Response Systems In-Action: Learning from Local Health Departments’ Experiences with Acute and Emergency Incidents

Science.gov (United States)

Hunter, Jennifer C.; Yang, Jane E.; Crawley, Adam W.; Biesiadecki, Laura; Aragón, Tomás J.

2013-01-01

As part of their core mission, public health agencies attend to a wide range of disease and health threats, including those that require routine, acute, and emergency responses. While each incident is unique, the number and type of response activities are finite; therefore, through comparative analysis, we can learn about commonalities in the response patterns that could improve predictions and expectations regarding the resources and capabilities required to respond to future acute events. In this study, we interviewed representatives from more than 120 local health departments regarding their recent experiences with real-world acute public health incidents, such as infectious disease outbreaks, severe weather events, chemical spills, and bioterrorism threats. We collected highly structured data on key aspects of the incident and the public health response, particularly focusing on the public health activities initiated and community partners engaged in the response efforts. As a result, we are able to make comparisons across event types, create response profiles, and identify functional and structural response patterns that have import for future public health preparedness and response. Our study contributes to clarifying the complexity of public health response systems and our analysis reveals the ways in which these systems are adaptive to the character of the threat, resulting in differential activation of functions and partners based on the type of incident. Continued and rigorous examination of the experiences of health departments throughout the nation will refine our very understanding of what the public health response system is, will enable the identification of organizational and event inputs to performance, and will allow for the construction of rich, relevant, and practical models of response operations that can be employed to strengthen public health systems. PMID:24236137

Local self governance in health - a study of it's functioning in Odisha, India.

Science.gov (United States)

Panda, Bhuputra; Zodpey, Sanjay P; Thakur, Harshad P

2016-10-31

Local decision making is linked to several service quality improvement parameters. Rogi Kalyan Samitis (RKS) at peripheral decision making health units (DMHU) are composite bodies that are mandated to ensure accountability and transparency in governance, improve quality of services, and facilitate local responsiveness. There is scant literature on the nature of functioning of these institutions in Odisha. This study aimed to assess the perception of RKS members about their roles, involvement and practices with respect to local decision making and management of DMHUs; it further examined perceptual and functional differences between priority and non-priority district set-ups; and identified predictors of involvement of RKS members in local governance of health units. As members of RKS, health service providers, officials in administrative/managerial role, elected representatives, and officials from other departments (including independent members) constituted our study sample. A total of 112 respondents were interviewed across 6 districts, through a multi-stage stratified random sampling; we used a semi-structured interview schedule that comprised mainly of close-ended and some open-ended questions. Descriptive and inferential statistics were used to compare 3 priority (PD) and 3 non-priority districts (NPD), categorized on the basis of Infant Mortality Rate (IMR) estimates of 2011 as proxy of population health. Governance, human resource management, financial management and quality improvement functions were studied in detail. Opinion about various individual and organizational factors in local self-governance and predictors of involvement were identified. The socio-demographic profile and composition of respondents were comparable between PD and NPD. Majority of respondents were 'satisfied' with their current roles in the governance of local health institutions. About one-fourth opined that the amount of funds allocated to RKS under National Health Mission (NHM

Physical Trauma among Refugees: Comparison between Refugees and Local Population Who Were Admitted to Emergency Department-Experience of a State Hospital in Syrian Border District.

Science.gov (United States)

Duzkoylu, Yigit; Basceken, Salim Ilksen; Kesilmez, Emrullah Cem

2017-01-01

Hundreds of thousands of people have fled to Turkey since the civil war started in Syria in 2011. Refugees and local residents have been facing various challenges such as sociocultural and economic ones and access to health services. Trauma exposure is one of the most important and underestimated health problems of refugees settling in camps. We aimed to evaluate refugee admissions to emergency department because of trauma in means of demographics of patients and mechanism of trauma and compare the results with the local population. Retrospective evaluation of results and comparison with the results of local population. We determined that the ratio of emergency admission of refugee patients because of trauma was significantly higher than the local population for most types of trauma. Further studies with more refugee participants are needed to fully understand the underlying reasons for this high ratio to protect refugees as well as for planning to take caution to attenuate the burden on healthcare systems.

The Impact of Emotional Intelligence on Conditions of Trust Among Leaders at the Kentucky Department for Public Health

Directory of Open Access Journals (Sweden)

Jennifer Redmond Knight

2015-03-01

Full Text Available There has been limited leadership research on emotional intelligence and trust in governmental public health settings. The purpose of this study was to identify and seek to understand the relationship between trust and elements of emotional intelligence, including stress management, at the Kentucky Department for Public Health. The Kentucky Department for Public Health (KDPH serves as Kentucky’s state governmental health department. KDPH is led by a Commissioner and composed of seven primary divisions and 25 branches within those divisions. The study was a non-randomized cross-sectional study utilizing electronic surveys that evaluated conditions of trust among staff members and emotional intelligence among supervisors. Pearson correlation coefficients and corresponding p-values are presented to provide the association between emotional intelligence scales and the conditions of trust. Significant positive correlations were observed between supervisors' stress management and the staff members' trust or perception of supervisors' loyalty(r=0.6, p=0.01, integrity(r=0.5, p=0.03, receptivity(r=0.6, p=0.02, promise fulfillment(r=0.6, p=0.02 and availability (r=0.5, p=0.07. This research lays the foundation for emotional intelligence and trust research and leadership training in other governmental public health settings, such as local, other state, national or international organizations. This original research provides metrics to assess the public health workforce with attention to organizational management and leadership constructs. The survey tools could be used in other governmental public health settings in order to develop tailored training opportunities related to emotional intelligence and trust organizations.

Localization and upregulation of survivin in cancer health disparities: a clinical perspective

Directory of Open Access Journals (Sweden)

Khan S

2015-07-01

Full Text Available Salma Khan,1,2 Heather Ferguson Bennit,1,2 Malyn May Asuncion Valenzuela,1,2 David Turay,1,3 Carlos J Diaz Osterman,1,2 Ron B Moyron,1,2 Grace E Esebanmen,1,2 Arjun Ashok,1,2 Nathan R Wall1,2 1Department of Biochemistry, 2Center for Health Disparities and Molecular Medicine, 3Department of Anatomy, Loma Linda University School of Medicine, Loma Linda, CA, USA Abstract: Survivin is one of the most important members of the inhibitors of apoptosis protein family, as it is expressed in most human cancers but is absent in normal, differentiated tissues. Lending to its importance, survivin has proven associations with apoptosis and cell cycle control, and has more recently been shown to modulate the tumor microenvironment and immune evasion as a result of its extracellular localization. Upregulation of survivin has been found in many cancers including breast, prostate, pancreatic, and hematological malignancies, and it may prove to be associated with the advanced presentation, poorer prognosis, and lower survival rates observed in ethnically diverse populations. Keywords: survivin, cancer, exosomes, health disparity

Building a sustainable Academic Health Department: the South Carolina model.

Science.gov (United States)

Smith, Lillian Upton; Waddell, Lisa; Kyle, Joseph; Hand, Gregory A

2014-01-01

Given the limited resources available to public health, it is critical that university programs complement the development needs of agencies. Unfortunately, academic and practice public health entities have long been challenged in building sustainable collaborations that support practice-based research, teaching, and service. The academic health department concept offers a promising solution. In South Carolina, the partners started their academic health department program with a small grant that expanded into a dynamic infrastructure that supports innovative professional exchange and development programs. This article provides a background and describes the key elements of the South Carolina model: joint leadership, a multicomponent memorandum of agreement, and a shared professional development mission. The combination of these elements allows the partners to leverage resources and deftly respond to challenges and opportunities, ultimately fostering the sustainability of the collaboration.

Role of a state health department in an underground nuclear experiment

Energy Technology Data Exchange (ETDEWEB)

Gerusky, T M [Department of Health, Harrisburg, PA (United States)

1969-07-01

When Project Ketch was first announced to Pennsylvania state officials, the Department of Health, under its legal responsibility to protect the health of the citizens of the state, was quick to realize that a thorough, independent review of the proposal was indeed necessary. Although the project was terminated by the sponsoring company before on-site preliminary evaluation work was begun, it is believed that the Department's approach was sound and practical. This study and the planned joint effort of the state and the Bureau of Radiological health will be discussed in detail. (author)

Role of a state health department in an underground nuclear experiment

International Nuclear Information System (INIS)

Gerusky, T.M.

1969-01-01

When Project Ketch was first announced to Pennsylvania state officials, the Department of Health, under its legal responsibility to protect the health of the citizens of the state, was quick to realize that a thorough, independent review of the proposal was indeed necessary. Although the project was terminated by the sponsoring company before on-site preliminary evaluation work was begun, it is believed that the Department's approach was sound and practical. This study and the planned joint effort of the state and the Bureau of Radiological health will be discussed in detail. (author)

What Makes the Bangladesh Local Government Engineering Department (LGED) So Effective?

OpenAIRE

Fujita, Yasuo

2011-01-01

The Local Government Engineering Department (LGED) is renowned for its superior effectiveness compared with other public organizations in Bangladesh. Using the management and organizational theory framework, this paper attempts to answer the following two related questions: (i) why is LGED so effective, and (ii) has there been complementarity between LGED’s own strengths and the capacity development support of its donors. LGED’s business domain has been conducive to its effectiveness and to t...

[Local health systems. Moral rationality of community decisions].

Science.gov (United States)

Tealdi, J C

1990-01-01

The author examines the points of convergence between local health systems and bioethics in three basic areas: structural or institutional, methodological or justificatory, and regulatory or normative. Comparisons are drawn between the decentralization of the health system posed by local health systems and deconcentration of the power vested in multidisciplinary ethics committees; the strategy of social participation and the movement in the United States of community decision-making in the area of health; and the basic concepts of primary health care and the principle of justice. The theories of Pellegrino and Thomasma on the philosophic bases for medical practice provide the framework of this comparative analysis. The article concludes with a call for a local health systems-bioethical nexus in which this discipline can provide the basis for infusing an ethical component into participatory planning and community decision-making.

Local self governance in health - a study of it’s functioning in Odisha, India

Directory of Open Access Journals (Sweden)

Bhuputra Panda

2016-10-01

Full Text Available Abstract Background Local decision making is linked to several service quality improvement parameters. Rogi Kalyan Samitis (RKS at peripheral decision making health units (DMHU are composite bodies that are mandated to ensure accountability and transparency in governance, improve quality of services, and facilitate local responsiveness. There is scant literature on the nature of functioning of these institutions in Odisha. This study aimed to assess the perception of RKS members about their roles, involvement and practices with respect to local decision making and management of DMHUs; it further examined perceptual and functional differences between priority and non-priority district set-ups; and identified predictors of involvement of RKS members in local governance of health units. Methods As members of RKS, health service providers, officials in administrative/managerial role, elected representatives, and officials from other departments (including independent members constituted our study sample. A total of 112 respondents were interviewed across 6 districts, through a multi-stage stratified random sampling; we used a semi-structured interview schedule that comprised mainly of close-ended and some open-ended questions. Descriptive and inferential statistics were used to compare 3 priority (PD and 3 non-priority districts (NPD, categorized on the basis of Infant Mortality Rate (IMR estimates of 2011 as proxy of population health. Governance, human resource management, financial management and quality improvement functions were studied in detail. Opinion about various individual and organizational factors in local self-governance and predictors of involvement were identified. Results The socio-demographic profile and composition of respondents were comparable between PD and NPD. Majority of respondents were ‘satisfied’ with their current roles in the governance of local health institutions. About one-fourth opined that the amount of funds

Local enactments of national health promotion policies

DEFF Research Database (Denmark)

Wimmelmann, Camilla Lawaetz

2017-01-01

organisational levels. Visiting, observing and interviewing 15 policy workers from 10 municipalities during a two-year period, this study investigated what happened to a Danish national health promotion policy as it was put into practice and managed in the Danish municipalities. The analysis reveals...... the concrete enactments and their locally experienced effects, our understanding of national public health policies risks becoming detached from praxis and unproductive. Public health policy-makers must pay methodological and analytical attention to the policies' multimodality and their concrete locally......Governments of welfare states are firmly committed to public health, resulting in a substantial number of public health policies. Given the multi-level structure of most welfare systems, the influence of a public health policy is related to its ability to spread geographically and move across...

Terrorism preparedness in state health departments--United States, 2001-2003.

Science.gov (United States)

2003-10-31

The anthrax attacks in fall 2001 highlighted the role of infectious disease (ID) epidemiologists in terrorism preparedness and response. Beginning in 2002, state health departments (SHDs) received approximately 1 billion dollars in new federal funding to prepare for and respond to terrorism, infectious disease outbreaks, and other public health threats and emergencies. This funding is being used in part to improve epidemiologic and surveillance capabilities. To determine how states have used a portion of their new funding to increase ID epidemiology capacity, the Iowa Department of Public Health's Center for Acute Disease Epidemiology and the Iowa State University Department of Microbiology conducted two surveys of U.S. state epidemiologists during September 2000-August 2001 and October 2002-June 2003. This report summarizes the results of these surveys, which determined that although the number of SHD epidemiology workers assigned to ID and terrorism preparedness increased by 132%, concerns remained regarding the ability of SHDs to hire qualified personnel. These findings underscore the need to develop additional and more diverse training venues for current and future ID epidemiologists.

Homeland security and public health: role of the Department of Veterans Affairs, the US Department of Homeland Security, and implications for the public health community.

Science.gov (United States)

Koenig, Kristi L

2003-01-01

The terrorist attacks of 11 September 2001 led to the largest US Government transformation since the formation of the Department of Defense following World War II. More than 22 different agencies, in whole or in part, and >170,000 employees were reorganized to form a new Cabinet-level Department of Homeland Security (DHS), with the primary mission to protect the American homeland. Legislation enacted in November 2002 transferred the entire Federal Emergency Management Agency and several Department of Health and Human Services (HHS) assets to DHS, including the Office of Emergency Response, and oversight for the National Disaster Medical System, Strategic National Stockpile, and Metropolitan Medical Response System. This created a potential separation of "health" and "medical" assets between the DHS and HHS. A subsequent presidential directive mandated the development of a National Incident Management System and an all-hazard National Response Plan. While no Department of Veterans Affairs (VA) assets were targeted for transfer, the VA remains the largest integrated healthcare system in the nation with important support roles in homeland security that complement its primary mission to provide care to veterans. The Emergency Management Strategic Healthcare Group (EMSHG) within the VA's medical component, the Veteran Health Administration (VHA), is the executive agent for the VA's Fourth Mission, emergency management. In addition to providing comprehensive emergency management services to the VA, the EMSHG coordinates medical back-up to the Department of Defense, and assists the public via the National Disaster Medical System and the National Response Plan. This article describes the VA's role in homeland security and disasters, and provides an overview of the ongoing organizational and operational changes introduced by the formation of the new DHS. Challenges and opportunities for public health are highlighted.

Analysis of judicial demands in health at the Regional Health Department XII

Directory of Open Access Journals (Sweden)

Leticia Florido Povinske Domingues

2017-08-01

Full Text Available The management of lawsuits in health represents a challenge for most Brazilian municipalities. Many papers described in the literature characterized properly the problem as well as discussed the repercussions on the Unified Health System.In this context, the objective of this study was to analyze the situation of health judicial processes at the twelfth Regional Department in Registro, São Paulo´s state, evaluating the profile of the users who claim in court the couverage of treatment´s costs as well as examination, procedure or medication. For this, we analyzed data on lawsuits in the health field at the twelfth Regional Department in Registro (SP from january 2009 to october 2015.The variables studied were gender, age, municipality of origin of the lawsuit, the mentioned disease, the medical prescription origin, specialty of the prescriber, type of lawsuit triggered, year of the lawsuit, entity judicially triggered and requested items. It was analyzed thirty-eight lawsuits against the twelfth Regional Department, it was observed the prevalence of the female gender, age group above 51 years and originating from the municipality of Registro (SP.The most of the judicial actions are for care given at the Unified Health System, by prescribers of specialty in Clinical Medicine and diagnosed with Diabetes Mellitus. The processes were characterized in the majority by judicial actions called Ordinary Rite, against the State. On the analyzed cases, 92% requested only medications and of these 11% supplements like vitamins and enteral diets.The number of patients who have been served through legal actions in the last three years reached 47% of the total cases registered during the period of the seven years analyzed and the approximate cost was R$ 1,340,000.00.This study contributes to the diagnosis of the processes related to the health judicialization in the region studied. The results showed a predominance of processes which comes from of patients

State funding for local public health: observations from six case studies.

Science.gov (United States)

Potter, Margaret A; Fitzpatrick, Tiffany

2007-01-01

The purpose of this study is to describe state funding of local public health within the context of state public health system types. These types are based on administrative relationships, legal structures, and relative proportion of state funding in local public health budgets. We selected six states representing various types and geographic regions. A case study for each state summarized available information and was validated by state public health officials. An analysis of the case studies reveals that the variability of state public health systems--even within a given type--is matched by variability in approaches to funding local public health. Nevertheless, some meaningful associations appear. For example, higher proportions of state funding occur along with higher levels of state oversight and the existence of local service mandates in state law. These associations suggest topics for future research on public health financing in relation to local accountability, local input to state priority-setting, mandated local services, and the absence of state funds for public health services in some local jurisdictions.

Linking public relations processes and organizational effectiveness at a state health department.

Science.gov (United States)

Wise, Kurt

2003-01-01

This qualitative case study explored a state health department's relationships with strategic constituencies from a public relations perspective. The relationships were explored within the theoretical framework of the Excellence Theory, the dominant paradigm in public research. Findings indicate application of the Excellence Theory has the potential to increase organizational effectiveness at public health entities. With respect to the case investigated, findings indicate that the state health department could increase its organizational effectiveness through the adoption of recommendations based on the Excellence Theory.

49 CFR 17.7 - How does the Secretary communicate with state and local officials concerning the Department's...

Science.gov (United States)

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false How does the Secretary communicate with state and local officials concerning the Department's programs and activities? 17.7 Section 17.7 Transportation Office of the Secretary of Transportation INTERGOVERNMENTAL REVIEW OF DEPARTMENT OF TRANSPORTATION...

W-320 Department of Health documentation

International Nuclear Information System (INIS)

Bailey, J.W.

1998-01-01

The purpose of this document is to gather information required to show that Project W-320 is in compliance with Washington State Department of Health requirements as specified in Radioactive Air Emissions Notice of Construction Project W-320, Tank 241-C-106 Sluicing, DOE/RL-95-45. Specifically, that W-320 is in compliance with ASME N509-1989 (Nuclear Power Plant Air-Cleaning Units and Components) and ASME N5 10-1989 (Testing of Nuclear Air Treatment Systems) for the 296-C-006 exhaust system

W-320 Department of Health documentation

Energy Technology Data Exchange (ETDEWEB)

Bailey, J.W.

1998-08-07

The purpose of this document is to gather information required to show that Project W-320 is in compliance with Washington State Department of Health requirements as specified in Radioactive Air Emissions Notice of Construction Project W-320, Tank 241-C-106 Sluicing, DOE/RL-95-45. Specifically, that W-320 is in compliance with ASME N509-1989 (Nuclear Power Plant Air-Cleaning Units and Components) and ASME N5 10-1989 (Testing of Nuclear Air Treatment Systems) for the 296-C-006 exhaust system.

Adoption and use of social media among public health departments

OpenAIRE

Thackeray, Rosemary; Neiger, Brad L; Smith, Amanda K; Van Wagenen, Sarah B

2012-01-01

Abstract Background Effective communication is a critical function within any public health system. Social media has enhanced communication between individuals and organizations and has the potential to augment public health communication. However, there is a lack of reported data on social media adoption within public health settings. The purposes of this study were to assess: 1) the extent to which state public health departments (SHDs) are using social media; 2) which social media applicat...

Assessing the Department of Defense’s Approach to Reducing Mental Health Stigma

Science.gov (United States)

2016-01-18

C O R P O R A T I O N RESE ARCH BR IEF Assessing the Department of Defense’s Approach to Reducing Mental Health Stigma When facing mental health ...problems, many service members choose not to seek needed help because of the stigma associated with mental health dis- orders and treatment. Not seeking...mem- bers. The stigma of seeking mental health treatment in the military persists despite the efforts of both the U.S. Depart- ment of Defense (DoD

Experience of wireless local area network in a radiation oncology department.

Science.gov (United States)

Mandal, Abhijit; Asthana, Anupam Kumar; Aggarwal, Lalit Mohan

2010-01-01

The aim of this work is to develop a wireless local area network (LAN) between different types of users (Radiation Oncologists, Radiological Physicists, Radiation Technologists, etc) for efficient patient data management and to made easy the availability of information (chair side) to improve the quality of patient care in Radiation Oncology department. We have used mobile workstations (Laptops) and stationary workstations, all equipped with wireless-fidelity (Wi-Fi) access. Wireless standard 802.11g (as recommended by Institute of Electrical and Electronic Engineers (IEEE, Piscataway, NJ) has been used. The wireless networking was configured with the Service Set Identifier (SSID), Media Access Control (MAC) address filtering, and Wired Equivalent Privacy (WEP) network securities. We are successfully using this wireless network in sharing the indigenously developed patient information management software. The proper selection of the hardware and the software combined with a secure wireless LAN setup will lead to a more efficient and productive radiation oncology department.

Violence toward health care workers in emergency departments in Denizli, Turkey.

Science.gov (United States)

Boz, Bora; Acar, Kemalettin; Ergin, Ahmet; Erdur, Bulent; Kurtulus, Ayse; Turkcuer, Ibrahim; Ergin, Nesrin

2006-01-01

This study sought to determine the frequency and types of violence that occurred during the previous year against health care workers in emergency departments in Denizli, Turkey, and to discern the views of workers on the prevention of such aggressive behavior. This study was conducted from March 1 to April 15, 2003, and included a group of 79 health care workers from the emergency departments of 3 hospitals in Denizli, namely, the Hospital of Pamukkale University Medical Faculty, the City Hospital of Denizli, and the Hospital of the Social Insurance Foundation. Data were collected from a self-administered questionnaire. In all, 88.6% of participants had been subjected to or had witnessed verbal violence, and 49.4% of them had been subjected to or had witnessed physical violence during the previous year. The most frequent reason (31.4%) for violence was abuse of alcohol and drugs by perpetrators. The second most frequent reason (24.7%) was the long waiting times typical of emergency departments. The most common type of violence was loud shouting; swearing, threatening, and hitting were the next most frequent violent behaviors. In all, 36.1% of subjects who had experienced violence reported that they developed psychological problems after the incident. Most participants commented on the insufficiency of currently available security systems within emergency departments and on the need for further training about violence. All health care personnel within emergency departments should be aware of the risk of violence and should be prepared for unpredictable conditions and events; in addition, security systems should be updated so that violence within emergency departments can be prevented.

[The contributions of local authorities to regional public health policy].

Science.gov (United States)

de Maria, Florence; Grémy, Isabelle

2009-01-01

Local authorities in France are key players in shaping public health policy by their action on the determinants of health and through their actions aimed at specific population groups. Since the public health act of 9 August 2004 establishing the first regional public health plans, their level of involvement and role continues to grow as coordinators, funders and project managers within the greater Paris metropolitan region. Their active participation in regional policy to improve population health and reduce inequalities in health has led to a better organization of the public health programs implemented (in terms of visibility, dialogue, coordination, transparency, and better awareness of context and integration of local issues). Their participation is also a source of innovation resulting in the proposal and use of new approaches (such as the development of health surveillance and observation for advising the local decision-making process). Within the current context of the "Hospitals, patients, health and territories" bill, which entrusts the governance of regional health policy to a specific agency, the role given to local authorities in this new organizational structure must be clearly defined to take into account all of their existing and potential contributions to public health policy.

Can voter-approved tax levies provide fiscal advantages and stability for local public health agencies?

Science.gov (United States)

Schmalzried, Hans D; Fallon, L Fleming

2013-01-01

Major funding cuts have occurred throughout the United States public health system during the past several years. Funding for local public health agency (LPHA) services and programs is obtained through a patchwork of sources that vary both within and among states. Even though local city and county sources provide a significant proportion of funding for LPHAs, information available in the literature about these revenues is sparse and is not clearly described. This study focused on a single specific revenue stream included in the local sources (local city and county) category: funds voted on directly by the public. The primary purpose of this study was to examine whether this type of funding source provided fiscal advantages for LPHAs. Specifically, we wanted to see how sensitive levy votes were to changing general economic conditions. A questionnaire to collect LPHA levy data was developed, approved, and mailed to county boards of elections in Ohio (n = 88). Elections officials were asked to provide voting results for all LPHA levy ballot attempts since 1994 regardless of outcome. In the study period (1994 through 2011), 250 LPHA property tax levies were placed on election ballots in Ohio. LPHAs were successful in 155 (62.0%) and unsuccessful in 95 (38.0%) attempts. Over the 18-year period, the most noteworthy outcome was a 94.6% pass rate for renewal levies. Our study demonstrated that voter-approved tax levies provide some fiscal advantages for LPHAs: higher per capita revenues than those who have to rely on other sources of income and predictable revenue streams. This translates into more funds being available for public health programs and services. Property tax levies allow citizens to make direct investments in their local health departments.

Health promotion activities in annual reports of local governments: 'Health for All' targets as a tool for content analysis.

Science.gov (United States)

Andersson, Camilla M; Bjärås, Gunilla E M; Tillgren, Per; Ostenson, Claes-Göran

2003-09-01

This article presents an instrument to study the annual reporting of health promotion activities in local governments within the three intervention municipalities of the Stockholm Diabetes Prevention Program (SDPP). The content of health promotion activities are described and the strengths, weaknesses and relevance of the method to health promotion discussed. A content analysis of local governmental reports from 1995-2000 in three Swedish municipalities. A matrix with WHO's 38 'Health for All' (HFA) targets from 1991 was used when coding the local health promotion activities. There are many public health initiatives within the local governmental structure even if they are not always addressed as health promotion. The main focuses in the local governmental reports were environmental issues, unemployment, social care and welfare. Local governmental reports were found to be a useful source of information that could provide knowledge about the priorities and organizational capacities for health promotion within local authorities. Additionally the HFA targets were an effective tool to identify and categorize systematically local health promotion activities in the annual reports of local governments. Identifying local health promotion initiatives by local authorities may ease the development of a health perspective and joint actions within the existing political and administrative structure. This paper provides a complementary method of attaining and structuring information about the local community for developments in health promotion.

Working for the public health: politics, localism and epistemologies of practice.

Science.gov (United States)

Phillips, Gemma; Green, Judith

2015-05-01

The recent move of public health back to English local government has reignited debates about the role of a medicalised public health profession. The explicit policy rationale for the move was that local government is the arena in which the social determinants of health can be addressed, and that public health specialists could provide neutral evidence to support action on these. However, if a discourse of 'evidence-based' policy is in principle (if not practice) relatively unproblematic within the health arena, within the more overtly politicised local government space, rather different policy imperatives come to the fore. Responding to calls for research on evidence in practice, this article draws on ethnographic data of local authorities in the first year of the reorganised public health function. Focusing on alcohol policy, we explore how decisions that affect public health are rationalised and enacted through discourses of localism, empiricism and holism. These frame policy outcomes as inevitably plural and contingent: a framing which sits uneasily with normative discourses of evidence-based policy. We argue that locating public health in local government necessitates a refocusing of how evidence for public health is conceptualised, to incorporate multiple, and political, understandings of health and wellbeing. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Wildfire risk reduction in the United States: Leadership staff perceptions of local fire department roles and responsibilities

Science.gov (United States)

Rachel S. Madsen; Hylton J. G. Haynes; Sarah M. McCaffrey

2018-01-01

As wildland fires have had increasing negative impacts on a range of human values, in many parts of the United States (U.S.) and around the world, collaborative risk reduction efforts among agencies, homeowners, and fire departments are needed to improve wildfire safety and mitigate risk. Using interview data from 46 senior officers from local fire departments around...

48 CFR 1371.113 - Department of Labor occupational safety and health standards for ship repair.

Science.gov (United States)

2010-10-01

... occupational safety and health standards for ship repair. 1371.113 Section 1371.113 Federal Acquisition... CONSTRUCTION AND SHIP REPAIR Provisions and Clauses 1371.113 Department of Labor occupational safety and health standards for ship repair. Insert clause 1352.271-82, Department of Labor Occupational Safety and Health...

Partners in Public Health: Public Health Collaborations With Schools of Pharmacy, 2015.

Science.gov (United States)

DiPietro Mager, Natalie A; Ochs, Leslie; Ranelli, Paul L; Kahaleh, Abby A; Lahoz, Monina R; Patel, Radha V; Garza, Oscar W; Isaacs, Diana; Clark, Suzanne

To collect data on public health collaborations with schools of pharmacy, we sent a short electronic survey to accredited and preaccredited pharmacy programs in 2015. We categorized public health collaborations as working or partnering with local and/or state public health departments, local and/or state public health organizations, academic schools or programs of public health, and other public health collaborations. Of 134 schools, 65 responded (49% response rate). Forty-six (71%) responding institutions indicated collaborations with local and/or state public health departments, 34 (52%) with schools or programs of public health, and 24 (37%) with local and/or state public health organizations. Common themes of collaborations included educational programs, community outreach, research, and teaching in areas such as tobacco control, emergency preparedness, chronic disease, drug abuse, immunizations, and medication therapy management. Interdisciplinary public health collaborations with schools of pharmacy provide additional resources for ensuring the health of communities and expose student pharmacists to opportunities to use their training and abilities to affect public health. Examples of these partnerships may stimulate additional ideas for possible collaborations between public health organizations and schools of pharmacy.

Resource allocation in public health practice: a national survey of local public health officials.

Science.gov (United States)

Baum, Nancy M; DesRoches, Catherine; Campbell, Eric G; Goold, Susan Dorr

2011-01-01

The purpose of this study was to gain an empirical understanding of the types of allocation decisions local health officials (LHOs) make and the factors that influence those allocation decisions. We conducted a national survey of LHOs in the United States in 2008 to 2009. The sample was stratified by the size of the population served by the department. We merged our data with data from the 2008 National Association of County and City Health Officials Profile survey. Descriptive statistics were generated using weighted data. Our final sample size was 608 respondents, with an average of 10 years experience. The LHOs reported little shifting of resources among population groups but greater capacity to redirect staffing time. Less than half of LHOs reported using economic analyses or conducting needs assessments when setting priorities. Having sole provider status in a community strongly influenced LHOs' allocation decisions. In addition, the effectiveness of activities, previous budget allocations, and input from boards of health were influential factors in allocation decisions. Public expectations were moderately to very influential, but direct public input had a low impact on allocation decisions. Survey findings provide a clearer understanding of how LHOs fulfill their obligations as stewards of public health resources and ensure effective activities and access to needed services. It may be useful to assess the value of more structured allocation methods (eg, decision frameworks) in the allocation process. Expanding opportunities for public engagement in priority setting may also be valuable for difficult allocation decisions.

The Oregon Public Health Policy Institute: Building Competencies for Public Health Practice

Science.gov (United States)

Yoon, Jangho; Bernell, Stephanie; Tynan, Michael; Alvarado, Carla Sarai; Eversole, Tom; Mosbaek, Craig; Beathard, Candice

2015-01-01

The Oregon Public Health Policy Institute (PHPI) was designed to enhance public health policy competencies among state and local health department staff. The Oregon Health Authority funded the College of Public Health and Human Sciences at Oregon State University to develop the PHPI curriculum in 2012 and offer it to participants from 4 state public health programs and 5 local health departments in 2013. The curriculum interspersed short instructional sessions on policy development, implementation, and evaluation with longer hands-on team exercises in which participants applied these skills to policy topics their teams had selected. Panel discussions provided insights from legislators and senior Oregon health experts. Participants reported statistically significant increases in public health policy competencies and high satisfaction with PHPI overall. PMID:26066925

A health impact assessment of a proposed bill to decrease speed limits on local roads in Massachusetts (U.S.A.).

Science.gov (United States)

James, Peter; Ito, Kate; Banay, Rachel F; Buonocore, Jonathan J; Wood, Benjamin; Arcaya, Mariana C

2014-10-02

Decreasing traffic speeds increases the amount of time drivers have to react to road hazards, potentially averting collisions, and makes crashes that do happen less severe. Boston's regional planning agency, the Metropolitan Area Planning Council (MAPC), in partnership with the Massachusetts Department of Public Health (MDPH), conducted a Health Impact Assessment (HIA) that examined the potential health impacts of a proposed bill in the state legislature to lower the default speed limits on local roads from 30 miles per hour (mph) to 25 mph. The aim was to reduce vehicle speeds on local roads to a limit that is safer for pedestrians, cyclists, and children. The passage of this proposed legislation could have had far-reaching and potentially important public health impacts. Lower default speed limits may prevent around 18 fatalities and 1200 serious injuries to motorists, cyclists and pedestrians each year, as well as promote active transportation by making local roads feel more hospitable to cyclists and pedestrians. While a lower speed limit would increase congestion and slightly worsen air quality, the benefits outweigh the costs from both a health and economic perspective and would save the state approximately $62 million annually from prevented fatalities and injuries.

Tests to evaluate public health disease reporting systems in local public health agencies

National Research Council Canada - National Science Library

Dausey, David J

2005-01-01

... to evaluate the ability to receive and respond to case reports 24 hours a day, 7 days a week. We refined these tests by beta-testing them at 20 metropolitan area local public health agencies across the country over the course of 10 months. The contents of this manual will be of interest to public health professionals at the state and local l...

Delivering on a gendered definition of health needs in local ...

African Journals Online (AJOL)

Delivering on a gendered definition of health needs in local government budgeting: ... of financial grants channelled annually from central to local governments. ... does not reflect the broad community-wide understanding of health needs.

Patronage or Partnership: Local Capacity Building in Humanitarian ...

International Development Research Centre (IDRC) Digital Library (Canada)

Much has been written about the need to build local capacities in emergency and ... In reality, strengthening local capacity is easier said than done, and there are ... Fund—managed by the Department of Health and Social Care (DHSC)—are ...

[What determines the market shares of the health funds in Israeli localities?].

Science.gov (United States)

Shmueli, Amir; Engelcin-Nissan, Esti

2011-08-01

Four health funds operate nationally in Israel, but their local market shares vary dramatically across localities. To identify the main localities' characteristics which affect the size of the market shares of the various health funds. A total of 60 Localities with more than 20,000 inhabitants were chosen. The following Localities' characteristics were retrieved for the year 2004: the market shares of the four health funds, average income, standardized mortality ratio (SMR), periphery index, the age structure, the distance from the nearest general hospital, the share of Arab population, and size. Four market share equations were estimated using SURE (seemingly unrelated regressions estimation), allowing for inter-equation correlations. The results show that the market shares of the different health funds are affected by different factors. Clalit Health Services' (CHS) share increases with the distance from Tel Aviv and SMR, and decreases with the level of mean income and the distance from the nearest CHS hospital. Leumit's market share increases only with the distance from a CHS's hospital. The market share of Maccabi Healthcare Services is higher in central localities, Jewish localities, small cities and further away from a non-CHS hospital. Meuhedet's market share is higher in big cities, rich and healthy localities, and in Localities which are further away from CHS's hospitals. These findings indicate that the presence of the health funds in different Localities varies according to the Localities' characteristics. There appears to be a market segmentation and "specialization" of certain health funds in specific populations, and of the other health funds in the rest of the population.

500 Cities: Local Data for Better Health

Data.gov (United States)

U.S. Department of Health & Human Services — This is the complete dataset for the 500 Cities project. This dataset includes 2013, 2014 model-based small area estimates for 27 measures of chronic disease related...

Health Physics Department. Annual progress report 1 January - 31 December 1988

International Nuclear Information System (INIS)

1989-06-01

The report describes the work of the Health Physics Department at Risoe during 1988. The activities cover dosimetry, instrumentation, radioecology, risk by nuclear activities and nuclear emergency preparedness. Lists of staff and publications are included. The emphasis in the report has been placed on basic research and contractual work. However, service functions do constitute a substantial work load for the department. (author)

Health Physics Department annual progress report 1 January - 31 December 1986

International Nuclear Information System (INIS)

1987-05-01

The report describes the work of the Healths Physsics Department at Risoe during 1986. The activities cover dosimetry, instrumentation, radioecology, risk by nuclear activities and nuclear emergency preparedness. Lists of staff and publications are included. The emphasis in the report has been placed on scientific and contractual work. However, service functions do constitute a substantial work load for the department. (author)

Health Physics Department. Annual progress report 1 January - 31 December 1987

International Nuclear Information System (INIS)

1988-08-01

The report describes the work of the Health Physics Department at Risoe during 1987. The activities cover dosimetry, instrumentation, radioecology, risk by nuclear activities and nuclear emergency preparedness. Lists of staff and publications are included. The main emphasis in the report has been placed on scientific and contractual work. However, service functions do constitute a substantial work load for the department. (author)

Assessing the use of computers in industrial occupational health departments.

Science.gov (United States)

Owen, J P

1995-04-01

Computers are widely used in business and industry and the benefits of computerizing occupational health (OH) departments have been advocated by several authors. The requirements for successful computerization of an OH department are reviewed. Having identified the theoretical benefits, the real picture in industry is assessed by surveying 52 firms with over 1000 employees in a large urban area. Only 15 (29%) of the companies reported having any OH service, of which six used computers in the OH department, reflecting the business priorities of most of the companies. The types of software systems used and their main use are examined, along with perceived benefits or disadvantages. With the decreasing costs of computers and increasingly 'user-friendly' software, there is a real cost benefit to be gained from using computers in OH departments, although the concept may have to be 'sold' to management.

Assessing electronic health record systems in emergency departments: Using a decision analytic Bayesian model.

Science.gov (United States)

Ben-Assuli, Ofir; Leshno, Moshe

2016-09-01

In the last decade, health providers have implemented information systems to improve accuracy in medical diagnosis and decision-making. This article evaluates the impact of an electronic health record on emergency department physicians' diagnosis and admission decisions. A decision analytic approach using a decision tree was constructed to model the admission decision process to assess the added value of medical information retrieved from the electronic health record. Using a Bayesian statistical model, this method was evaluated on two coronary artery disease scenarios. The results show that the cases of coronary artery disease were better diagnosed when the electronic health record was consulted and led to more informed admission decisions. Furthermore, the value of medical information required for a specific admission decision in emergency departments could be quantified. The findings support the notion that physicians and patient healthcare can benefit from implementing electronic health record systems in emergency departments. © The Author(s) 2015.

Use of fees to fund local public health services in Western Massachusetts.

Science.gov (United States)

Shila Waritu, A; Bulzacchelli, Maria T; Begay, Michael E

2015-01-01

Recent budget cuts have forced many local health departments (LHDs) to cut staff and services. Setting fees that cover the cost of service provision is one option for continuing to fund certain activities. To describe the use of fees by LHDs in Western Massachusetts and determine whether fees charged cover the cost of providing selected services. A cross-sectional descriptive analysis was used to identify the types of services for which fees are charged and the fee amounts charged. A comparative cost analysis was conducted to compare fees charged with estimated costs of service provision. Fifty-nine LHDs in Western Massachusetts. Number of towns charging fees for selected types of services; minimum, maximum, and mean fee amounts; estimated cost of service provision; number of towns experiencing a surplus or deficit for each service; and average size of deficits experienced. Enormous variation exists both in the types of services for which fees are charged and fee amounts charged. Fees set by most health departments did not cover the cost of service provision. Some fees were set as much as $600 below estimated costs. These results suggest that considerations other than costs of service provision factor into the setting of fees by LHDs in Western Massachusetts. Given their limited and often uncertain funding, LHDs could benefit from examining their fee schedules to ensure that the fee amounts charged cover the costs of providing the services. Cost estimates should include at least the health agent's wage and time spent performing inspections and completing paperwork, travel expenses, and cost of necessary materials.

76 FR 44592 - Cooperative Agreement With the World Health Organization Department of Food Safety and Zoonoses...

Science.gov (United States)

2011-07-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0010] Cooperative Agreement With the World Health Organization Department of Food Safety and Zoonoses in Support of... agreement with the World Health Organization. The document published stating that the total funding...

[Gender influence on health related quality of life among resident physicians working in an emergency department].

Science.gov (United States)

Fernández-Prada, María; González-Cabrera, Joaquín; Torres G, Francisco; Iribar-Ibabe, Concepción; María Peinado, José

2014-02-01

The high emotional burden of physicians working in emergency departments may affect their quality of life perception. To evaluate health related quality of life among resident physicians performing shifts at an emergency department. Seventy one physicians aged 26,3 ± 1,7 years (47 women), working as residents in an emergency department, answered the short version of the Short-Form Health Survey Questionnaire (SF-36®). This questionnaire analyses eight domains: physical function, body pain, general health, vitality, social function, emotional role and mental health. Women had a significantly worse perception than a reference population in four dimensions of the SF-36, especially mental health and social functioning. Men had scores similar to the reference population. Among women, vitality is the best predictor of mental health and social functioning. Women working as residents in an emergency department have a worse perception of their quality of life than men performing the same job.

Managing costs, managing benefits: employer decisions in local health care markets.

Science.gov (United States)

Christianson, Jon B; Trude, Sally

2003-02-01

To better understand employer health benefit decision making, how employer health benefits strategies evolve over time, and the impact of employer decisions on local health care systems. Data were collected as part of the Community Tracking Study (CTS), a longitudinal analysis of health system change in 12 randomly selected communities. This is an observational study with data collection over a six-year period. The study used semistructured interviews with local respondents, combined with monitoring of local media, to track changes in health care systems over time and their impact on community residents. Interviewing began in 1996 and was carried out at two-year intervals, with a total of approximately 2,200 interviews. The interviews provided a variety of perspectives on employer decision making concerning health benefits; these perspectives were triangulated to reach conclusions. The tight labor market during the study period was the dominant consideration in employer decision making regarding health benefits. Employers, in managing employee compensation, made independent decisions in pursuit of individual goals, but these decisions were shaped by similar labor market conditions. As a result, within and across our study sites, employer decisions in aggregate had an important impact on local health care systems, although employers' more highly visible public efforts to bring about health system change often met with disappointing results. General economic conditions in the 1990s had an important impact on the configuration of local health systems through their effect on employer decision making regarding health benefits offered to employees, and the responses of health plans and providers to those decisions.

We Develop Welfare Together - Locally

DEFF Research Database (Denmark)

Flindt, Helle; Carlsbæk, Poul Hornshøj

information: Poul Carlsbæk:  Master of Science (MSc) in Political Science  Senior lecturer at Department of Management and Administration and head responsible for the interprofessional course We Develop Welfare Together – Locally.  Has taught adults at the Diploma programme in Public Administration for 26...... years  Former Information Manager in municipalities and Senior Executive Consultant in a Danish consultant firm and in a IT-firm's innovative department  Volunteer in e.g. DJØF (association for layers and economists) and DN (society for nature conservation) Helle Flindt:  Occupational Therapist.......  Master in Medical Anthropology  Senior lecturer at Department of physiotherapy and Occupational Therapy  Lecturer at the the interprofessional course We Develop Welfare Together – Locally. 'Equality in Health' depend on both interprofessional collaboration regarding the individual citizen...

Public health promotion of "local food": Constituting the self-governing citizen-consumer.

Science.gov (United States)

Derkatch, Colleen; Spoel, Philippa

2017-03-01

This article explores how the recent and growing promotion of local foods by public health units in Ontario, Canada, rhetorically interpellates the "good" health citizen as someone who not only takes responsibility for personal health but, through the consumption and support of "local food," also accepts and fulfills her responsibilities to care for the local economy, the community's well-being, and the natural environment. Drawing on Charland's concept of constitutive rhetoric, we analyze a selection of public health unit documents about local food to develop a textured account of the complex, multifaceted forms of health citizenship they constitute. Our analysis reveals that, despite their appeals to environmental sustainability and community well-being, these materials primarily characterize the ideal health citizen as an informed consumer who supports the interests of the neoliberal state through individualized lifestyle behaviors, consuming goods produced and distributed through private enterprise. By exhorting individuals to "buy local," public health discourse therefore frames responsible health citizenship principally in consumerist terms that constrain the range of available options for citizens to engage in meaningful action vis-à-vis their food systems.

Violence in the Emergency Department.

Science.gov (United States)

Stowell, Keith R; Hughes, Nolan P; Rozel, John S

2016-12-01

Violence is common in the emergency department (ED). The ED setting has numerous environmental risk factors for violence, including poor staffing, lack of privacy, overcrowding, and ready availability of nonsecured equipment that can be used as weapons. Strategies can be taken to mitigate the risk of violence toward health care workers, including staff training, changes to the ED layout, appropriate use of security, and policy-level changes. Health care providers in the ED should be familiar with local case law and standards related to the duty to warn third parties when a violent threat is made by a patient. Copyright © 2016 Elsevier Inc. All rights reserved.

New Approaches for Moving Upstream: How State and Local Health Departments Can Transform Practice to Reduce Health Inequalities

Science.gov (United States)

Freudenberg, Nicholas; Franzosa, Emily; Chisholm, Janice; Libman, Kimberly

2015-01-01

Growing evidence shows that unequal distribution of wealth and power across race, class, and gender produces the differences in living conditions that are "upstream" drivers of health inequalities. Health educators and other public health professionals, however, still develop interventions that focus mainly on "downstream"…

Reducing health care costs - potential and limitations of local ...

African Journals Online (AJOL)

Reducing health care costs - potential and limitations of local authority health services. ... both the quality and the cost-effectiveness of health care would be improved. ... LAs offer an appropriate structure for effective community control over the ...

Health physics department annual progress report 1 January - 31 December 1983

International Nuclear Information System (INIS)

1984-08-01

The report describes the work of the Health Physics Department at Risoe during 1983. The activities cover dosimetry, instrumentation, radioecology, risk by nuclear activities and nuclear emergency preparedness. Lists of staff and publications are included. A great deal of the work in the department is of minor interest to people outside Risoe as it represents service functions. Therefore, the main emphasis in the report has been placed on scientific and contractual work. (author)

Local area unemployment, individual health and workforce exit: ONS Longitudinal Study.

Science.gov (United States)

Murray, Emily T; Head, Jenny; Shelton, Nicola; Hagger-Johnson, Gareth; Stansfeld, Stephen; Zaninotto, Paola; Stafford, Mai

2016-06-01

In many developed countries, associations have been documented between higher levels of area unemployment and workforce exit, mainly for disability pension receipt. Health of individuals is assumed to be the primary driver of this relationship, but no study has examined whether health explains or modifies this relationship. We used data from 98 756 Office for National Statistics Longitudinal Study members who were aged 40-69 and working in 2001, to assess whether their odds of identifying as sick/disabled or retired in 2011 differed by local authority area unemployment in 2001, change in local area unemployment from 2001 to 2011 and individual reported health in 2001 (self-rated and limiting long-term illness). Higher local area unemployment and worse self-rated health measures in 2001 were independently related to likelihood of identifying as sick-disabled or retired, compared to being in work, 10 years later, after adjusting for socio-demographic covariates. Associations for local area unemployment were stronger for likelihood of identification as sick/disabled compared to retired in 2011. Associations for changes in local area unemployment from 2001 to 2011 were only apparent for likelihood of identifying as retired. For respondents that identified as sick/disabled in 2011, effects of local area unemployment in 2001 were stronger for respondents who had better self-rated health in 2001. Strategies to retain older workers may be most effective if targeted toward areas of high unemployment. For persons in ill health, local area unemployment interventions alone will not be as efficient in reducing their exit from the workforce. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association.

Public Health Surveillance: A Local Health Department Perspective

Science.gov (United States)

2002-04-03

vomiting – Diarrhea (+/-bloody) • Rash and fever – Vesicular – Petechial • Neurologic – cranial nerve palsies, HA, fever , confusion • Septic Shock...Francisella tularensis (tularemia) • Viral hemorrhagic fever Agents of Concern: CDC Category B • Coxiella burnetti (Q fever ) • Brucella species...Concern: CDC Category C • Nipah virus • hantaviruses • tickborne hemorrhagic fever viruses • yellow fever • multidrug-resistant tuberculosis

A national survey on health department capacity for community engagement in emergency preparedness.

Science.gov (United States)

Schoch-Spana, Monica; Selck, Frederic W; Goldberg, Lisa A

2015-01-01

Limited systematic knowledge exists about how public health practitioners and policy makers can best strengthen community engagement in public health emergency preparedness ("CE-PHEP"), a top priority for US national health security. To investigate local health department (LHD) adoption of federally recommended participatory approaches to PHEP and to identify LHD organizational characteristics associated with more intense CE-PHEP. National survey in 2012 of LHDs using a self-administered Web-based questionnaire regarding LHD practices and resources for CE-PHEP ("The Community Engagement for Public Health Emergency Preparedness Survey"). Differences in survey responses were examined, and a multivariate analysis was used to test whether LHD organizational characteristics were associated with differences in CE-PHEP intensity. A randomized sample of 754 LHDs drawn from the 2565 LHDs that had been invited to participate in the 2010 National Profile of LHDs. Sample selection was stratified by the size of population served and geographic location. Emergency preparedness coordinators reporting on their respective LHDs. CE-PHEP intensity as measured with a scoring system that rated specific CE-PHEP practices by LHD according to the relative degrees of public participation and community capacity they represented. Survey response rate was 61%. The most common reported CE-PHEP activity was disseminating personal preparedness materials (90%); the least common was convening public forums on PHEP planning (22%). LHD characteristics most strongly associated with more intense CE-PHEP were having a formal CE-PHEP policy, allocating funds for CE-PHEP, having strong support from community-based organizations, and employing a coordinator with prior CE experience. Promising ways to engage community partners more fully in the PHEP enterprise are institutionalizing CE-PHEP objectives, employing sufficient and skilled staff, leveraging current community-based organization support, and

Can We Improve Training for Health Professionals to Sustain Local Health Development?

Science.gov (United States)

King, Stephen

2016-01-01

Can we improve training for health professionals? We explore specific variables that need to be accounted for to achieve sustainable local health development through training. A problem-based approach with appreciation of the need for making changes is suggested as the only authentic basis for training. PMID:28090174

Effect of a Targeted Women's Health Intervention in an Inner-City Emergency Department

Directory of Open Access Journals (Sweden)

Debra Houry

2011-01-01

Full Text Available Objective. To evaluate the effect of an Emergency Department (ED based, educational intervention for at-risk health behaviors. Methods. A randomized trial over a one-year period. African American women, aged 21–55, presenting to the ED waiting room were eligible. Each participant took a computer-based survey on health risk behaviors. Participants who screened positive on any of four validated scales (for IPV, nicotine, alcohol, or drug dependence were randomized to standard information about community resources (control or to targeted educational handouts based upon their screening results (intervention. Participants were surveyed at 3 months regarding contacts with community resources and harm-reduction actions. Results. 610 women were initially surveyed; 326 screened positive (13.7% for IPV, 40.1% for nicotine addiction, 26.6% for alcohol abuse, and 14.4% for drug abuse. 157 women were randomized to intervention and 169 to control. Among women who completed follow-up (=71, women in the Intervention Group were significantly more likely to have contacted local resources (37% versus 9%, =0.04 and were more likely to have taken risk-reducing action (97% versus 79%, =0.04. Conclusion. Targeted, brief educational interventions may be an effective method for targeting risk behaviors among vulnerable ED populations.

Plutonium working group report on environmental, safety and health vulnerabilities associated with the Department's plutonium storage. Volume I: Summary

International Nuclear Information System (INIS)

1994-11-01

At the conclusion of the Cold War, the Department of Energy (DOE) stopped plutonium processing for nuclear weapons production. Facilities used for that purpose now hold significant quantities of plutonium in various forms. Unless properly stored and handled, plutonium can present environment, safety and health (ES ampersand H) hazards. Improperly stored plutonium poses a variety of hazards. When containers or packaging fail to fully protect plutonium metal from exposure to air, oxidation can occur and cause packaging failures and personnel contamination. Contamination can also result when plutonium solutions leak from bottles, tanks or piping. Plutonium in the form of scrap or residues generated by weapons production are often very corrosive, chemically reactive and difficult to contain. Buildings and equipment that are aging, poorly maintained or of obsolete design contribute to the overall problem. Inadvertent accumulations of plutonium of any form in sufficient quantities within facilities can result in nuclear criticality events that could emit large amounts of radiation locally. Contamination events and precursors of criticality events are causing safety and health concerns for workers at the Department's plutonium facilities. Contamination events also potentially threaten the public and the surrounding environment

COMMUNITY HEALTH & PRIMARY HEALTH CARE

African Journals Online (AJOL)

2Primary Health Care Department, Ikpoba Okha Local Government Area, Benin City, ... selected from each of the ten wards in the LGA using multistage sampling technique. ..... Knowledge of HIV/AIDS Insurance Companies in Lagos State.

Tests to evaluate public health disease reporting systems in local public health agencies (electronic resource)

National Research Council Canada - National Science Library

Ricci, Karen; Lurie, Nicole; Stoto, Michael A; Wasserman, Jeffrey; Dausey, David J; Meade, Barbara; Diamond, Alexis; Molander, Roger C

2005-01-01

... to evaluate the ability to receive and respond to case reports 24 hours a day, 7 days a week. We refined these tests by beta-testing them at 20 metropolitan area local public health agencies across the country over the course of 10 months. The contents of this manual will be of interest to public health professionals at the state and local l...

42 CFR 54.11 - Effects on State and local funds.

Science.gov (United States)

2010-10-01

... AND/OR PROJECTS FOR ASSISTANCE IN TRANSITION FROM HOMELESSNESS GRANTS § 54.11 Effects on State and... 42 Public Health 1 2010-10-01 2010-10-01 false Effects on State and local funds. 54.11 Section 54.11 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS CHARITABLE...

Building Sustainable Local Capacity for Global Health Research in West Africa.

Science.gov (United States)

Sam-Agudu, Nadia A; Paintsil, Elijah; Aliyu, Muktar H; Kwara, Awewura; Ogunsola, Folasade; Afrane, Yaw A; Onoka, Chima; Awandare, Gordon A; Amponsah, Gladys; Cornelius, Llewellyn J; Mendy, Gabou; Sturke, Rachel; Ghansah, Anita; Siberry, George K; Ezeanolue, Echezona E

Global health research in resource-limited countries has been largely sponsored and led by foreign institutions. Thus, these countries' training capacity and productivity in global health research is limited. Local participation at all levels of global health knowledge generation promotes equitable access to evidence-based solutions. Additionally, leadership inclusive of competent local professionals promotes best outcomes for local contextualization and implementation of successful global health solutions. Among the sub-Saharan African regions, West Africa in particular lags in research infrastructure, productivity, and impact in global health research. In this paper, experts discuss strategies for scaling up West Africa's participation in global health evidence generation using examples from Ghana and Nigeria. We conducted an online and professional network search to identify grants awarded for global health research and research education in Ghana and Nigeria. Principal investigators, global health educators, and representatives of funding institutions were invited to add their knowledge and expertise with regard to strengthening research capacity in West Africa. While there has been some progress in obtaining foreign funding, foreign institutions still dominate local research. Local research funding opportunities in the 2 countries were found to be insufficient, disjointed, poorly sustained, and inadequately publicized, indicating weak infrastructure. As a result, research training programs produce graduates who ultimately fail to launch independent investigator careers because of lack of mentoring and poor infrastructural support. Research funding and training opportunities in Ghana and Nigeria remain inadequate. We recommend systems-level changes in mentoring, collaboration, and funding to drive the global health research agenda in these countries. Additionally, research training programs should be evaluated not only by numbers of individuals graduated but

The U.S. department of energy health and mortality study

International Nuclear Information System (INIS)

Fry, S.A.; Lushbaugh, C.C.; Shy, C.M.; Cragle, D.L.; Checkoway, H.; Blum, S.; Carpenter, A.V.; Dupree, E.A.; Frome, E.L.; Groer, P.G.; Wilson, J.

1985-01-01

Epidemiological studies to evaluate health and mortality among persons employed at some time since 1942 by the U.S. Department of Energy and its predecessors are being carried out by investigators at the Oak Ridge Associated Universities (ORAU) together with others at Hanford and the Los Alamos National Laboratory. The ORAU is responsible for examining relationships between occupational exposure to ionizing radiations from external and/or internal sources and subsequent health and mortality. The health effects of chemical toxicants, especially uranium and other toxic metals are also being investigated. Approximately one third of the estimated total DOE worker population of 600,000 are included in this study. Some results of the study are tabulated. 13 refs

Participatory health impact assessment for the development of local government regulation on hazard control

International Nuclear Information System (INIS)

Inmuong, Uraiwan; Rithmak, Panee; Srisookwatana, Soomol; Traithin, Nathathai; Maisuporn, Pornpun

2011-01-01

The Thai Public Health Act 1992 required the Thai local governments to issue respective regulations to take control of any possible health-hazard related activities, both from commercial and noncommercial sources. Since 1999, there has been centrally decentralized of power to a new form of local government establishment, namely Sub-district Administrative Organization (SAO). The SAO is asmall-scale local governing structure while its legitimate function is for community services, including control of health impact related activities. Most elected SAO administrators and officers are new and less experience with any of public health code of practice, particularly on health-hazard control. This action research attempted to introduce and apply a participatory health impact assessment (HIA) tool for the development of SAO health-hazard control regulation. The study sites were at Ban Meang and Kok See SAOs, Khon Kaen Province, Thailand, while all intervention activities conducted during May 2005-April 2006. A set of cooperative activities between researchers and community representatives were planned and organized by; surveying and identifying place and service base locally causing local environmental health problems, organizing community participatory workshops for drafting and proposing the health-hazard control regulation, and appropriate practices for health-hazard controlling measures. This action research eventually could successfully enable the SAO administrators and officers understanding of local environmental-related health problem, as well as development of imposed health-hazard control regulation for local community.

National public health policy in a local context--implementation in two Swedish municipalities.

Science.gov (United States)

Jansson, Elisabeth; Fosse, Elisabeth; Tillgren, Per

2011-12-01

In 2003 the wide-ranging Swedish National Public Health Policy (SNPHP), with a focus on health determinants, was adopted by the Swedish parliament. In the context of multilevel governance, SNPHP implementation is dependent on self-governed municipalities and counties. The aim of the study is, from a municipal perspective, to investigate public-health policies in two municipalities. Content analysis of documents and interviews provided a foundation for an explorative case study. The SNPHP at national level is overriding but politically controversial. At local level, a health-determinants perspective was detectable in the policies implemented, but none regarding to health equality. At local level, the SNPHP is not regarded as implementable; rather, limited parts have, to varying degrees, been reconciled with local public-health goals, according to municipal needs and conditions. A success-promoting factor in the two municipalities was the presence of committed and knowledgeable actors/implementers. Also, the municipality with a more centrally controlled and stable party-political leadership succeeded better in implementing structural and intersectoral community-wide policies for coordinated local health promotion. The contents of national and local public-health policies differ, and municipalities that have implemented their own local health policies do not seem to regard the SNPHP as justifiable or adoptable. If the SNPHP overall aim regarding equal health is to be achieved homogeneously in Swedish municipalities, its contents and purpose need clearer management and negotiation, so that implementation of the national policy locally is understandable and motivated. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Strengthening capacity for local evidence to inform local responders to HIV in a remote Solomon Island health service

Directory of Open Access Journals (Sweden)

David MacLaren

2015-04-01

Full Text Available Background: Documenting specific knowledge and attitudes about HIV in the culturally diverse nation of Solomon Islands is essential to inform locally targeted public health responses. As part of a large capacity-strengthening project at Atoifi Adventist Hospital in East Kwaio, Solomon Islands, researchers, using a ‘learn-by-doing’ process, worked with participants in public health research methods. Methods: Overall, 43 people attended research capacity building workshops in 2011; eight joined the HIV study group. A cross-sectional survey including semi-structured interviews on HIV was conducted by the group. In February 2014, a hospital administrator was interviewed about how the 2011 study informed local HIV responses. Results: Of the 53 survey participants, 64% self-assessed as having little or no HIV knowledge, but 90% knew HIV could be transmitted between men and women during sex. Less than 50% knew HIV could be transmitted between two men having sex, 45% thought HIV could be transmitted by mosquitoes and 55% agreed condoms help protect from HIV. Most participants reported negative attitudes towards people with HIV. Three years later the health administrator reported ad hoc responses to HIV because of low HIV prevalence, increasing noncommunicable diseases, staff turnover and resource shortages. Discussion: This HIV study was used to strengthen research skills in local health professionals and community members in Solomon Islands. It showed that community members require accurate information about HIV transmission and that entrenched stigma is an issue. Although results provided local evidence for local response, ongoing health system challenges and little local HIV transmission meant HIV services remain rudimentary.

Pre-travel health seeking practices of Umrah pilgrims departing from Assiut International Airport, Egypt.

Science.gov (United States)

Aziz, Mirette M; Abd El-Megeed, Hosnia S; Abd Ellatif, Mennat Allah M

2018-04-22

to assess the health seeking practices and their determinants among Umrah pilgrims departing from Assiut international Airport. We interviewed 300 pilgrims departing from Assiut International Airport while they were in the departure lounge, using a semi-structured questionnaire. Only 60%, 46.3% and 46.3% of Umrah pilgrims believed in importance of pre-travel vaccination, seeking health information, and health examination, respectively. The most frequently practiced pre-travel health related behaviour was getting vaccinated (56.3%), as compared to much lower frequencies of seeking health information (24%) or having a clinical health examination (26.7%). Private clinics, internet and the tourism companies were the main sources of health information of the pilgrims. Positive attitude of pilgrims about health seeking practices, the perception of health risk of travelling to Hajj/Umrah and having a chronic disease were the predictors of pre-travel health practices. Raising awareness among Hajj/Umrah pilgrims about the importance of seeking professional pre-travel health advice and communicating the risk of exposure to travel-related diseases to pilgrims could be important strategies to improve the uptake of preventive measures. Training of general practitioners in the public health sector about the travel health information would promote the travel health services. Copyright © 2018. Published by Elsevier Ltd.

Analysing local-level responses to migration and urban health in Hillbrow: the Johannesburg Migrant Health Forum

Directory of Open Access Journals (Sweden)

Jo Vearey

2017-07-01

Full Text Available Abstract Johannesburg is home to a diverse migrant population and a range of urban health challenges. Locally informed and implemented responses to migration and health that are sensitive to the particular needs of diverse migrant groups are urgently required. In the absence of a coordinated response to migration and health in the city, the Johannesburg Migrant Health Forum (MHF – an unfunded informal working group of civil society actors – was established in 2008. We assess the impact, contributions and challenges of the MHF on the development of local-level responses to migration and urban health in Johannesburg to date. In this Commentary, we draw on data from participant observation in MHF meetings and activities, a review of core MHF documents, and semi-structured interviews conducted with 15 MHF members. The MHF is contributing to the development of local-level migration and health responses in Johannesburg in three key ways: (1 tracking poor quality or denial of public services to migrants; (2 diverse organisational membership linking the policy process with community experiences; and (3 improving service delivery to migrant clients through participation of diverse service providers and civil society organisations in the Forum. Our findings indicate that the MHF has a vital role to play in supporting the development of appropriate local responses to migration and health in a context of continued – and increasing – migration, and against the backdrop of rising anti-immigrant sentiments.

The impact of a temporary ice-rink on an emergency department service.

LENUS (Irish Health Repository)

Clarke, Heather J

2012-02-03

BACKGROUND: A temporary ice-rink opened close to Cork city for 6 weeks from 30 November 2003. During this time, a number of patients presented to the local emergency departments with ice-skating-related injuries. We documented these injuries. METHODS: All patients presenting to emergency departments in Cork city with ice-skating-related complaints were included. Information on age and sex, mechanism of injury, diagnosis, follow-up\\/disposition and ambulance service utilization was recorded. RESULTS: One hundred and twenty-five ice-rink-related attendances were reported at Cork emergency departments, representing 1.25% of total attendances. One hundred and twenty-three patients presented with skating-related injuries and two with medical complaints occurring at the ice-rink: 70.8% were female patients and 29.2% were male patients. In the 4-14-year age group, however, 48.5% were girls and 51.5% were boys. Most injuries were directly due to falls; 5.6% were due to skate blades. The commonest site of injury was the upper limb. Fractures and dislocations accounted for 53.9% of injuries, with 20.5% of these requiring orthopaedic admission. Lacerations and digital injuries accounted for 7.1%, with 11% of these required admission for surgery. One minor head injury was reported. 38.1% had soft tissue injuries. Fifteen patients were transported by ambulance. These attendances represented a minimum overall cost of 77,510 euro to the local health service. CONCLUSIONS: A temporary ice-rink had a significant impact on local emergency departments. Currently, there is no specific legislation in Ireland relating to public health and safety in ice-rinks. We recommend consultation with local public bodies before opening such facilities, and appropriate regulation.

Local leadership in public health: the role of the medical officer of health in Britain, 1872–1974

Science.gov (United States)

Gorsky, Martin

2007-01-01

The recent policy focus in British public health on the importance of local action invites consideration of historical precedent. The role and achievements of the medical officer of health (MOH), the local government official charged with public health responsibilities, is discussed. The gradual accretion of duties is traced in the first section: the mid‐Victorian concern with urban sanitation; the preventive strategies adopted after the bacteriological revolution; the extension of personal health services in the early 20th century; and the more diminished role under the National Health Service (NHS), when infectious diseases retreated. The historical verdicts passed on the MOsH are reviewed in the second section. The leading role of the MOsH in the late 19th‐century mortality decline has been reasserted, and although there is some justification in the argument that in the 20th century public health lost its focus, it is important to recall that the extension of personal health services under MOH direction signified a major extension of access to care. Similarly, the charge that MOsH did not redefine their role in the period before their final demise in 1974 is not entirely justified. The emphasis of the NHS on curative rather than preventive medicine, and the economic constraints on local authority health service expansion limited their room for manoeuvre. The history of local leadership in public health may offer some enduring lessons. These include the importance of monitoring local population health, acting as a public interface between medicine and the community, facilitating joined‐up working and confronting vested interests. PMID:17496253

Designing and evaluating a balanced scorecard for a health information management department in a Canadian urban non-teaching hospital.

Science.gov (United States)

Nippak, Pria Md; Veracion, Julius Isidro; Muia, Maria; Ikeda-Douglas, Candace J; Isaac, Winston W

2016-06-01

This report is a description of a balanced scorecard design and evaluation process conducted for the health information management department at an urban non-teaching hospital in Canada. The creation of the health information management balanced scorecard involved planning, development, implementation, and evaluation of the indicators within the balanced scorecard by the health information management department and required 6 months to complete. Following the evaluation, the majority of members of the health information management department agreed that the balanced scorecard is a useful tool in reporting key performance indicators. These findings support the success of the balanced scorecard development within this setting and will help the department to better align with the hospital's corporate strategy that is linked to the provision of efficient management through the evaluation of key performance indicators. Thus, it appears that the planning and selection process used to determine the key indicators within the study can aid in the development of a balanced scorecard for a health information management department. In addition, it is important to include the health information management department staff in all stages of the balanced scorecard development, implementation, and evaluation phases. © The Author(s) 2014.

Attitudes of Students Studying In Health Related Departments towards the Elderly

Directory of Open Access Journals (Sweden)

Sercan Özbek YAZICI

2016-12-01

Full Text Available Negative attitudes towards the elderly may cause decreases in quality health service provided to the elderly. In the study, the aim was to determine attitudes of students studying in health related departments towards the elderly and relationships between the attitudes and various variables were analyzed. In a descriptive study, the sample included nursing, physiotherapy, and elderly care students. Kogan’s attitude towards old people scale (KAOP was used to measure attitudes towards the elderly and Stanley Coopersmith Self Esteem Inventory (SEI was used to assess the level of students’ self-esteem. The KOAP mean attitude score of the students was 125.6 ± 14.38 and the students had slightly positive attitudes towards the elderly. Students who were at the age of 20 or over and who were living in the city showed more positive attitudes. The students of the Elderly Care Department had the lowest mean score and there was a significant difference between mean KAOP scores of students at Nursing and Elderly Care Department. Also, weak positive correlation was found between the KAOP and SEI mean scores of students. The results implies that the students are required to enhance their positive attitudes towards the elderly. Therefore, students should be provided a training program that improves the positive attitudes

A public health perspective

African Journals Online (AJOL)

user

EDITORIAL. Enabling local health departments to save more lives: A public ... promoting health through the organized efforts of society” (1) ... and synergistic with achieving the sustainable development goals because its furtherance brings a ...

Improving local health through community health workers in Cambodia: challenges and solutions.

Science.gov (United States)

Ozano, Kim; Simkhada, Padam; Thann, Khem; Khatri, Rose

2018-01-06

Volunteer community health workers (CHWs) are an important link between the public health system and the community. The 'Community Participation Policy for Health' in Cambodia identifies CHWs as key to local health promotion and as a critical link between district health centres and the community. However, research on the challenges CHWs face and identifying what is required to optimise their performance is limited in the Cambodian context. This research explores the views of CHWs in rural Cambodia, on the challenges they face when implementing health initiatives. Qualitative methodology was used to capture the experiences of CHWs in Kratie and Mondulkiri provinces. Two participatory focus groups with CHWs in Mondulkiri and ten semi-structured interviews in Kratie were conducted. Results from both studies were used to identify common themes. Participants were CHWs, male and female, from rural Khmer and Muslim communities and linked with seven different district health centres. Findings identify that CHWs regularly deliver health promotion to communities. However, systemic, personal and community engagement challenges hinder their ability to function effectively. These include minimal leadership and support from local government, irregular training which focuses on verticalised health programmes, inadequate resources, a lack of professional identity and challenges to achieving behaviour change of community members. In addition, the CHW programme is delivered in a fragmented way that is largely influenced by external aid objectives. When consulted, however, CHWs demonstrate their ability to develop realistic practical solutions to challenges and barriers. The fragmented delivery of the CHW programme in Cambodia means that government ownership is minimal. This, coupled with the lack of defined core training programme or adequate resources, prevents CHWs from reaching their potential. CHWs have positive and realistic ideas on how to improve their role and, subsequently

The role of civil society in strengthening intercultural maternal health care in local health facilities: Puno, Peru

Directory of Open Access Journals (Sweden)

Jeannie Samuel

2016-12-01

Full Text Available Background and objective: Peru's Ministry of Health has made efforts to increase the cultural inclusiveness of maternal health services. In 2005, the Ministry adopted an intercultural birthing policy (IBP that authorizes and encourages the use of culturally acceptable birthing practices in government-run health facilities. However, studies suggest that indigenous women may receive inconsistent benefits from these kinds of policies. This article examines whether a grassroots accountability initiative based on citizen monitoring of local health facilities by indigenous women can help to promote the objectives of the IBP and improve intercultural maternal health care. Design: Findings are drawn from a larger qualitative research study completed in 2015 that included fieldwork done between 2010 and 2011. Semi-structured interviews were conducted with 23 women working as citizen monitors in local health facilities in Puno and 30 key informants, including frontline health workers, health officials, and civil society actors in Puno and Lima, and human rights lawyers from the Defensoría del Pueblo Office in Puno. Results: Monitors confirmed from their own personal experiences in the 1990s and early 2000s that respect for intercultural aspects of maternal health care, including traditional indigenous birthing practices, were not readily accepted in publicly funded health facilities. It was also common for indigenous women to face discrimination when seeking health service provided by the state. Although the government's adoption of the IBP in 2005 was a positive step, considerable efforts are still needed to ensure high-quality, culturally appropriate maternal health care is consistently available in local health facilities. Conclusions: Despite important progress in the past two decades, policies aimed at improving intercultural maternal health care are unevenly implemented in local health facilities. Civil society, in particular indigenous women

The role of civil society in strengthening intercultural maternal health care in local health facilities: Puno, Peru

Science.gov (United States)

Samuel, Jeannie

2016-01-01

Background and objective Peru's Ministry of Health has made efforts to increase the cultural inclusiveness of maternal health services. In 2005, the Ministry adopted an intercultural birthing policy (IBP) that authorizes and encourages the use of culturally acceptable birthing practices in government-run health facilities. However, studies suggest that indigenous women may receive inconsistent benefits from these kinds of policies. This article examines whether a grassroots accountability initiative based on citizen monitoring of local health facilities by indigenous women can help to promote the objectives of the IBP and improve intercultural maternal health care. Design Findings are drawn from a larger qualitative research study completed in 2015 that included fieldwork done between 2010 and 2011. Semi-structured interviews were conducted with 23 women working as citizen monitors in local health facilities in Puno and 30 key informants, including frontline health workers, health officials, and civil society actors in Puno and Lima, and human rights lawyers from the Defensoría del Pueblo Office in Puno. Results Monitors confirmed from their own personal experiences in the 1990s and early 2000s that respect for intercultural aspects of maternal health care, including traditional indigenous birthing practices, were not readily accepted in publicly funded health facilities. It was also common for indigenous women to face discrimination when seeking health service provided by the state. Although the government's adoption of the IBP in 2005 was a positive step, considerable efforts are still needed to ensure high-quality, culturally appropriate maternal health care is consistently available in local health facilities. Conclusions Despite important progress in the past two decades, policies aimed at improving intercultural maternal health care are unevenly implemented in local health facilities. Civil society, in particular indigenous women themselves, can play an

Full-Range Public Health Leadership, Part 1: Quantitative Analysis

Directory of Open Access Journals (Sweden)

Erik L. Carlton

2015-04-01

Full Text Available Background. Workforce and leadership development are central to the future of public health. However, public health has been slow to translate and apply leadership models from other professions and to incorporate local perspectives in understanding public health leadership. Purpose. This study utilized the full-range leadership model in order to examine public health leadership. Specifically, it sought to measure leadership styles among local health department directors and to understand the context of leadership local health departments.Methods. Leadership styles among local health department directors (n=13 were examined using survey methodology. Quantitative analysis methods included descriptive statistics, boxplots, and Pearson bivariate correlations using SPSS v18.0. Findings. Self-reported leadership styles were highly correlated to leadership outcomes at the organizational level. However, they were not related to county health rankings. Results suggest the preeminence of leader behaviors and providing individual consideration to staff as compared to idealized attributes of leaders, intellectual stimulation, or inspirational motivation. Implications. Holistic leadership assessment instruments, such as the Multifactor Leadership Questionnaire (MLQ can be useful in assessing public health leaders approaches and outcomes. Comprehensive, 360-degree reviews may be especially helpful. Further research is needed to examine the effectiveness of public health leadership development models, as well as the extent that public health leadership impacts public health outcomes.

Local health practices and the knowledge of medicinal plants in a Brazilian semi-arid region: environmental benefits to human health.

Science.gov (United States)

Zank, Sofia; Peroni, Nivaldo; de Araújo, Elcida Lima; Hanazaki, Natalia

2015-02-23

The concept of eco-cultural health considers the dynamic interaction between humans and ecosystems, emphasizing the implications of the health of the ecosystem for the health and well-being of human populations. Ethnobotanical studies focusing on folk medicine and medicinal plants can contribute to the field of eco-cultural health if they incorporate the perspective and local knowledge of communities. We investigated the local health practices in three rural communities living within the vicinity of a protected area of sustainable use in a semi-arid region of Brazil. We analyzed the opinions of local health experts on the elements that influence human health and on how the environment contributes to this influence. We also analyzed and compared the local knowledge of medicinal plants, as knowledge of this type is an important factor when considering the interaction between environmental and human health. We performed structured interviews and free-listings with 66 local health experts. We used content analysis to systematize the elements of the influences on human health. We compared the richness of the plants cited among communities and analyzed the differences among the three communities regarding the ways in which the plants were obtained and the environments in which plants were collected. The local experts identified several influences of the environment on human health. These influences can be associated with ecosystem services, such as climatic conditions, water and air quality, recreation and medicinal and food resources. We identified 192 medicinal plant species, most of which were gathered from wild ecosystems. The most important environments for the three communities were the plateau mountain and backyards. The informants had a broad and integrated view of health, perceiving the importance of conserving the environment within the National Forest of Araripe for the health and well-being of the local populations.

Violence in the emergency department: a survey of health care workers.

Science.gov (United States)

Fernandes, C M; Bouthillette, F; Raboud, J M; Bullock, L; Moore, C F; Christenson, J M; Grafstein, E; Rae, S; Ouellet, L; Gillrie, C; Way, M

1999-11-16

Violence in the workplace is an ill-defined and underreported concern for health care workers. The objectives of this study were to examine perceived levels of violence in the emergency department, to obtain health care workers' definitions of violence, to determine the effect of violence on health care workers and to determine coping mechanisms and potential preventive strategies. A retrospective written survey of all 163 emergency department employees working in 1996 at an urban inner-city tertiary care centre in Vancouver. The survey elicited demographic information, personal definition of violence, severity of violence, degree of stress as a result of violence and estimate of the number of encounters with violence in the workplace in 1996. The authors examined the effects of violence on job performance and job satisfaction, and reviewed coping and potential preventive strategies. Of the 163 staff, 106 (65%) completed the survey. A total of 68% (70/103) reported an increased frequency of violence over time, and 60% (64/106) reported an increased severity. Most of the respondents felt that violence included witnessing verbal abuse (76%) and witnessing physical threats or assaults (86%). Sixty respondents (57%) were physically assaulted in 1996. Overall, 51 respondents (48%) reported impaired job performance for the rest of the shift or the rest of the week after an incident of violence. Seventy-seven respondents (73%) were afraid of patients as a result of violence, almost half (49%) hid their identities from patients, and 78 (74%) had reduced job satisfaction. Over one-fourth of the respondents (27/101) took days off because of violence. Of the 18 respondents no longer working in the emergency department, 12 (67%) reported that they had left the job at least partly owing to violence. Twenty-four-hour security and a workshop on violence prevention strategies were felt to be the most useful potential interventions. Physical exercise, sleep and the company of

Local television news coverage of President Clinton's introduction of the Health Security Act.

Science.gov (United States)

Dorfman, L; Schauffler, H H; Wilkerson, J; Feinson, J

1996-04-17

To investigate how local television news reported on health system reform during the week President Clinton presented his health system reform bill. Retrospective content analysis of the 1342-page Health Security Act of 1993, the printed text of President Clinton's speech before Congress on September 22, 1993, and a sample of local television news stories on health system reform broadcast during the week of September 19 through 25, 1993. The state of California. During the week, 316 television news stories on health system reform were aired during the 166 local news broadcasts sampled. Health system reform was the second most frequently reported topic, second to stories on violent crime. News stories on health system reform averaged 1 minute 38 seconds in length, compared with 57 seconds for violent crime. Fifty-seven percent of the local news stories focused on interest group politics. Compared with the content of the Health Security Act, local news broadcasts devoted a significantly greater portion of their stories to financing, eligibility, and preventive services. Local news stories gave significantly less attention to cost-saving mechanisms, long-term care benefits, and changes in Medicare and Medicaid, and less than 2% of stories mentioned quality assurance mechanisms, malpractice reform, or new public health initiatives. Of the 316 televised news stories, 53 reported on the president's speech, covering many of the same topics emphasized in the speech (financing, organization and administration, and eligibility) and de-emphasizing many of the same topics (Medicare and Medicaid, quality assurance, and malpractice reform). Two percent of the president's speech covered partisan politics; 45% of the local news stories on the speech featured challenges from partisan politicians. Although health system reform was the focus of a large number of local television news stories during the week, in-depth explanation was scarce. In general, the news stories provided

[Determining biomedical equipment calibration in health care Institutions in the Risaralda Department of Colombia].

Science.gov (United States)

López-Isaza, Giovanni A; Llamosa-Rincón, Luis E

2008-01-01

Determining quality features related to tracking biomedical equipment calibration patterns and their electrical safety as implemented by Health Care Institutions in the Risaralda department. This was a descriptive study using non-probabilistic sampling and the criterion of a greater equipment inventory and service demand for Clinics, Aesthetic, Radiology and Dentistry Centres and Hospitals. Census; the instrument was applied to 32 health-care institutions distributed throughout the Risaralda departments 14 municipalities between September 2005 and January 2006. Hospitals was the category having a highest number of electro-medical equipment (56%). Pereira (the capital of Risaralda) had 81% of all electro-medical equipment. All the institutions lacked NTC-ISO-IEC-17025 accreditation regarding standards certified by the Superintendence of Industry and Commerce. None of the institutions externally contracted by the institutions being surveyed was accredited. There is a public health risk in the Risaralda department; all health-care institutions lacked NTC-ISO-IEC-17025 accreditation and external institutions (in turn being hired by them for calibrating their equipment) also lacked accreditation. Based on the information obtained from non-calibrated equipment having international patterns, there is a great danger that determining the quality of biomedical equipment calibration patterns may be erroneous. It also places health-care institutions at a competitive disadvantage when compared to other accredited institutions in Colombia or in other countries.

Preparing for climate change: a perspective from local public health officers in California.

Science.gov (United States)

Bedsworth, Louise

2009-04-01

The most recent scientific findings show that even with significant emission reductions, some amount of climate change is likely inevitable. The magnitude of the climate changes will depend on future emissions and climate sensitivity. These changes will have local impacts, and a significant share of coping with these changes will fall on local governmental agencies. Public health is no exception, because local public health agencies are crucial providers of disease prevention, health care, and emergency preparedness services. This article presents the results of a survey of California's local pubic health officers conducted between August and October 2007. The survey gauged health officers' concerns about the public health impacts of climate change, programs in place that could help to mitigate these health effects, and information and resource needs for better coping with a changing climate. The results of this survey show that most public health officers feel that climate change poses a serious threat to public health but that they do not feel well equipped in terms of either resources or information to cope with that threat. Nonetheless, public health agencies currently implement a number of programs that will help these agencies handle some of the challenges posed by a changing climate. Overall, the results suggest that local public health agencies in California are likely in a better position than they perceive to address the threats associated with climate change but that there is a larger role for them to play in climate policy.

Ingredients for Success: Strategies to Support Local Food Use in Health Care Institutions.

Science.gov (United States)

Linton, Emily; Keller, Heather; Duizer, Lisa

2018-06-12

There is growing interest in use of local food within health care institutions such as hospitals and long-term care homes. This study explored stakeholder perspectives on (i) influences on local food use and (ii) strategies that support success and sustainability of use in health care institutions. Fifteen participants who were institutional leaders with experience in implementing or supporting local food use in health care institutions in Ontario were recruited through purposeful and snowball sampling. A semi-structured interview was conducted by telephone and audio-recorded. Qualitative content analysis identified that influences on local food use were: product availability, staff and management engagement, and legislation and resources (e.g., funding, labour). Several strategies were offered for building and sustaining success including: setting goals, requesting local food availability from suppliers, and more clearly identifying local foods in product lists. The influences and potential strategies highlighted in this paper provide a greater understanding for dietitians and food service managers on how local foods can be incorporated into health care institutions.

Health Information Technology Adoption in the Emergency Department.

Science.gov (United States)

Selck, Frederic W; Decker, Sandra L

2016-02-01

To describe the trend in health information technology (IT) systems adoption in hospital emergency departments (EDs) and its effect on ED efficiency and resource use. 2007-2010 National Hospital Ambulatory Medical Care Survey - ED Component. We assessed changes in the percent of visits to EDs with health IT capability and the estimated effect on waiting time to see a provider, visit length, and resource use. The percent of ED visits that took place in an ED with at least a basic health IT or an advanced IT system increased from 25.2 and 3.1 percent in 2007 to 69.1 and 30.6 percent in 2010, respectively (p < .05). Controlling for ED fixed effects, waiting times were reduced by 6.0 minutes in advanced IT-equipped EDs (p < .05), and the number of tests ordered increased by 9 percent (p < .01). In models using a 1-year lag, advanced systems also showed an increase in the number of medications and images ordered per visit. Almost a third of visits now occur in EDs with advanced IT capability. While advanced IT adoption may decrease wait times, resource use during ED visits may also increase depending on how long the system has been in place. We were not able to determine if these changes indicated more appropriate care. © Health Research and Educational Trust.

Rochester’s Lead Law: Evaluation of a Local Environmental Health Policy Innovation

Science.gov (United States)

Ayoob, Maria; Morley, Rebecca

2011-01-01

Background: Significant progress has been made in reducing the incidence of childhood lead poisoning in the United States in the past three decades. However, the prevalence of elevated blood lead in children (≥ 10 μg/dL) remains high in some communities, particularly those with high proportions of pre-1978 housing in poor condition. Increasingly, municipalities are using local policy tools to reduce lead poisoning in high-risk areas, but little is known about the effectiveness of such policies. Objectives: In this article, we evaluated the effectiveness of a comprehensive rental housing–based lead law adopted in Rochester, New York, in 2005. Methods: This policy evaluation integrates analyses of city inspections data, a survey of landlords, landlord focus groups, and health department data on children’s blood lead levels from the first 4 years of implementation of the 2005 law. Results: Implementation has proceeded consistent with projected numbers of inspections with nearly all target units inspected in the first 4 years. Higher than expected inspection passage rates suggest that landlords have reduced lead hazards in rental housing affected by the law. Implementation of the lead law does not appear to have had a significant impact on the housing market. Conclusions: Although many uncertainties remain, our analysis suggests that the lead law has had a positive impact on children’s health. Strong enforcement, support for community-based lead programs, and ongoing intergovernmental coordination will be necessary to maintain lead-safe housing in Rochester. Lessons learned from the Rochester experience may inform future local lead poisoning prevention policies in other communities. PMID:22001644

Urbanization and health in China, thinking at the national, local and individual levels.

Science.gov (United States)

Li, Xinhu; Song, Jinchao; Lin, Tao; Dixon, Jane; Zhang, Guoqin; Ye, Hong

2016-03-08

China has the biggest population in the world, and has been experiencing the largest migration in history, and its rapid urbanization has profound and lasting impacts on local and national public health. Under these conditions, a systems understanding on the correlation among urbanization, environmental change and public health and to devise solutions at national, local and individual levels are in urgent need. In this paper, we provide a comprehensive review of recent studies which have examined the relationship between urbanization, urban environmental changes and human health in China. Based on the review, coupled with a systems understanding, we summarize the challenges and opportunities for promoting the health and wellbeing of the whole nation at national, local, and individual levels. Urbanization and urban expansion result in urban environmental changes, as well as residents' lifestyle change, which can lead independently and synergistically to human health problems. China has undergone an epidemiological transition, shifting from infectious to chronic diseases in a much shorter time frame than many other countries. Environmental risk factors, particularly air and water pollution, are a major contributing source of morbidity and mortality in China. Furthermore, aging population, food support system, and disparity of public service between the migrant worker and local residents are important contributions to China's urban health. At the national level, the central government could improve current environmental policies, food safety laws, and make adjustments to the health care system and to demographic policy. At the local level, local government could incorporate healthy life considerations in urban planning procedures, make improvements to the local food supply, and enforce environmental monitoring and management. At the individual level, urban residents can be exposed to education regarding health behaviour choices while being encouraged to take

Use of Stakeholder Focus Groups to Define the Mission and Scope of a new Department of Population Health.

Science.gov (United States)

Tierney, William M

2018-04-09

The focus and funding of US healthcare is evolving from volume to value-based, and healthcare leaders, managers, payers, and researchers are increasingly focusing on managing populations of patients. Simultaneously, there is increasing interest in getting "upstream" from disease management to promote health and prevent disease. Hence, the term "population health" has both clinical and community-based connotations relevant to the tripartite mission of US medical schools. To seek broad input for the strategic development of the Department of Population Health in a new medical school at a tier 1 research university. Focus groups with facilitated consensus development. Eighty-one persons representing the Dell Medical School and other schools at the University of Texas at Austin, city/county government, community nonprofit organizations, and faculty from other local university schools along with selected national academic leaders. Focus groups with subsequent consensus development of emphases identified premeeting by participants by e-mail exchanges. The resulting departmental strategic plan included scope of work, desired characteristics of leaders, and early impact activities in seven areas of interest: community engagement and health equity, primary care and value-based health, occupational and environment medicine, medical education, health services and community-based research, health informatics and data analysis, and global health. Medical schools should have a primary focus in population, most effectively at the departmental level. Engaging relevant academic and community stakeholders is an effective model for developing this emerging discipline in US medical schools.

500 Cities: Local Data for Better Health, 2016 release

Data.gov (United States)

U.S. Department of Health & Human Services — This is the complete dataset for the 500 Cities project 2016 release. This dataset includes 2013, 2014 model-based small area estimates for 27 measures of chronic...

500 Cities: Local Data for Better Health, 2017 release

Data.gov (United States)

U.S. Department of Health & Human Services — This is the complete dataset for the 500 Cities project 2017 release. This dataset includes 2015, 2014 model-based small area estimates for 27 measures of chronic...

7 CFR 360.400 - Preemption of State and local laws.

Science.gov (United States)

2010-01-01

... local laws. (a) Under section 436 of the Plant Protection Act (7 U.S.C. 7756), a State or political... of the Plant Protection Act, the regulations in this part preempt all State and local laws and... 360.400 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH...

Epidemiological study of snake bite in some local government areas ...

African Journals Online (AJOL)

Envenomation is a common public health problem in many local government areas of Plateau state in Nigeria. Its incidence has increased over the years as reported by the outpatient departments of the General Hospitals in Shendam and Langtang local government areas. In Shendam alone, the increase was from 192 in ...

Program collaboration and service integration activities among HIV programs in 59 U.S. health departments.

Science.gov (United States)

Fitz Harris, Lauren F; Toledo, Lauren; Dunbar, Erica; Aquino, Gustavo A; Nesheim, Steven R

2014-01-01

We identified the level and type of program collaboration and service integration (PCSI) among HIV prevention programs in 59 CDC-funded health department jurisdictions. Annual progress reports (APRs) completed by all 59 health departments funded by CDC for HIV prevention activities were reviewed for collaborative and integrated activities reported by HIV programs for calendar year 2009. We identified associations between PCSI activities and funding, AIDS diagnosis rate, and organizational integration. HIV programs collaborated with other health department programs through data-related activities, provider training, and providing funding for sexually transmitted disease (STD) activities in 24 (41%), 31 (53%), and 16 (27%) jurisdictions, respectively. Of the 59 jurisdictions, 57 (97%) reported integrated HIV and STD testing at the same venue, 39 (66%) reported integrated HIV and tuberculosis testing, and 26 (44%) reported integrated HIV and viral hepatitis testing. Forty-five (76%) jurisdictions reported providing integrated education/outreach activities for HIV and at least one other disease. Twenty-six (44%) jurisdictions reported integrated partner services among HIV and STD programs. Overall, the level of PCSI activities was not associated with HIV funding, AIDS diagnoses, or organizational integration. HIV programs in health departments collaborate primarily with STD programs. Key PCSI activities include integrated testing, integrated education/outreach, and training. Future assessments are needed to evaluate PCSI activities and to identify the level of collaboration and integration among prevention programs.

The political economy of a public health case management program's transition into medical homes.

Science.gov (United States)

Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele

2015-11-01

Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent. Published by Elsevier Ltd.

Information resources used in health risk assessment by the New Jersey Department of Environmental Protection

Energy Technology Data Exchange (ETDEWEB)

Post, G.B.; Baratta, M.; Wolfson, S.; McGeorge, L. [New Jersey Department of Environmental Protection, Trenton (United States)

1990-12-31

The New Jersey Department of Environmental Protection`s responsibilities related to health-based risk assessment are described, including its research projects and its development of health based compound specific standards and guidance levels. The resources used by the agency to support health risk assessment work are outlined.

Department of Defense Birth and Infant Health Registry: select reproductive health outcomes, 2003-2014.

Science.gov (United States)

Bukowinski, Anna T; Conlin, Ava Marie S; Gumbs, Gia R; Khodr, Zeina G; Chang, Richard N; Faix, Dennis J

2017-11-01

Established following a 1998 directive, the Department of Defense Birth and Infant Health Registry (Registry) team conducts surveillance of select reproductive health outcomes among military families. Data are compiled from the Military Health System Data Repository and Defense Manpower Data Center to define the Registry cohort and outcomes of interest. Outcomes are defined using ICD-9/ICD-10 and Current Procedural Terminology codes, and include: pregnancy outcomes (e.g., live births, losses), birth defects, preterm births, and male:female infant sex ratio. This report includes data from 2003-2014 on 1,304,406 infants among military families and 258,332 pregnancies among active duty women. Rates of common adverse infant and pregnancy outcomes were comparable to or lower than those in the general US population. These observations, along with prior Registry analyses, provide reassurance that military service is not independently associated with increased risks for select adverse reproductive health outcomes. The Registry's diverse research portfolio demonstrates its unique capabilities to answer a wide range of questions related to reproductive health. These data provide the military community with information to identify successes and areas for improvement in prevention and care.

Local food policies can help promote local foods and improve health: a case study from the Federated States of Micronesia.

Science.gov (United States)

Englberger, Lois; Lorens, Adelino; Pretrick, Moses; Tara, Mona J; Johnson, Emihner

2011-11-01

The Federated States of Micronesia (FSM) and other countries throughout the Pacific are facing an epidemic of non-communicable disease health problems. These are directly related to the increased consumption of unhealthy imported processed foods, the neglect of traditional food systems, and lifestyle changes, including decreased physical activity. The FSM faces the double burden of malnutrition with both non-communicable diseases and micronutrient deficiencies, including vitamin A deficiency and anemia. To help increase the use of traditional island foods and improve health, the Island Food Community of Pohnpei has initiated a program in the FSM to support and promote local food policies, along with its Go Local awareness campaign. Such local food policies are defined broadly and include individual and family commitments, community group local food policies and policies established by government, including presidential proclamations and increased taxation on soft drinks. The aim of this paper is to describe this work. An inter-agency, community- and research-based, participatory and media approach was used. Partners are both non-governmental and governmental. The use of continuing awareness work along with local food policy establishment and the acknowledgement of the individuals and groups involved are essential. The work is still in the preliminary stage but ad hoc examples show that this approach has had success in increased awareness on health issues and improving dietary intake on both an individual and group basis. This indicates that further use of local food policies could have an instrumental impact in FSM as well as other Pacific Island countries in promoting local foods and improving dietary intake and health, including the control of non-communicable diseases and other dietary-related health problems.

Georgia Health - Go Local: Using Multidisciplinary Partnerships to Promote a Statewide Consumer Health Website.

Science.gov (United States)

Smith, Rita B

2011-01-01

The National Library of Medicine ended its support of the Go Local program in 2010 due to declining usage, but in many ways Georgia's project was a success. From its beginning, Georgia Health - Go Local was a model of successful collaboration among a variety of partners and institutions throughout the state. The high usage statistics for the Go Local website and the support garnered by the project exemplify the positive nature of the collaborations that made the project possible.

Inequalities in health: approaches by health authorities in an English health region.

Science.gov (United States)

McCarron, P; Yates, B

2000-06-01

In 1995 the Department of Health published Variations in health: what can the Department of Health do? This recommended that health authorities should have a comprehensive plan for identifying and tackling variations in health. We investigated how health authorities in the South and West Region were taking forward this work. Semi-structured interviews and reviews of documentation were conducted in all health authorities in the South and West Region of England. All health authorities viewed tackling inequalities in health as important; however, explicit strategies did not exist and Health of the Nation targets were a vehicle for determining priorities of inequalities. Explicit corporate commitment was often weak. Analyses were being conducted to determine the magnitude of local health inequalities and to assist in designing appropriate interventions. The importance of alliance working was highlighted; much work was being done although success was variable. Efforts are being made throughout the South and West region to tackle inequalities in health. Although strategic vision at the corporate level was often lacking, there was evidence of commitment to taking the inequalities agenda forward within public health directorates. Strengthening of primary care and alliance working roles is essential. Recent national strategy documents, forthcoming legislation, and a review of health inequalities recognize the health effects of inequalities and require health authorities to collaborate with local partners to tackle these, and will offer opportunities to improve corporate commitment and alliance working. Uptake and success of these opportunities will have a major influence on progress in tackling health inequalities.

Local Health Integration Networks: Build on their purpose.

Science.gov (United States)

MacLeod, Hugh

2015-11-01

This article provides a high-level overview on the creation of Local Health Integration Networks (LHINs) and illustrates the complexities involved in their implementation. To understand regional structures such as LHINs, one must understand the context in which design and execution takes place. The article ends with a commentary on how Ontario is performing post-LHINs and discusses next steps. © 2015 The Canadian College of Health Leaders.

Towards guideline implementation for integrated local health policies : Evaluation of an experimental implementation strategy in regional health services

NARCIS (Netherlands)

Kuunders, T.J.M.; Cloin, J.C.M.; van Bon, M.J.H.; Paulussen, T.G.W.M.; van Oers, J.A.M.; van de Goor, L.A.M.

2017-01-01

To enhance implementation of a Guideline for integrated local health policy, a draft implementation strategy (DIS) was developed. It was hypothesized that the DIS would be feasible and effective to enhance the use of a Guideline for integrated local health policy. To examine its feasibility and

List of selected publications from Risoe's Health Physics Department 1957-1989

International Nuclear Information System (INIS)

Heikel Vinther, F.

1991-01-01

This list includes scientific and technical papers written by staff members of the former Health Physics Department at Risoe National Laboratory. The first part includes papers in periodicals, proceedings etc. in order of chronology while the second and third part include Riso-R and Riso-M reports respectively arranged according to report numbers. (author)

Health smart cards: differing perceptions of emergency department patients and staff.

Science.gov (United States)

Mohd Rosli, Reizal; Taylor, David McD; Knott, Jonathan C; Das, Atandrila; Dent, Andrew W

2009-02-01

An analytical, cross-sectional survey of 270 emergency department patients and 92 staff undertaken in three tertiary referral hospital emergency departments was completed to compare the perceptions of patients and staff regarding the use of health smart cards containing patient medical records. The study recorded data on a range of health smart card issues including awareness, privacy, confidentiality, security, advantages and disadvantages, and willingness to use. A significantly higher proportion of staff had heard of the card. The perceived disadvantages reported by patients and staff were, overall, significantly different, with the staff reporting more disadvantages. A significantly higher proportion of patients believed that they should choose what information is on the card and who should have access to the information. Patients were more conservative regarding what information should be included, but staff were more conservative regarding who should have access to the information. Significantly fewer staff believed that patients could reliably handle the cards. Overall, however, the cards were considered acceptable and useful, and their introduction would be supported.

Responsibility without legal authority? Tackling alcohol-related health harms through licensing and planning policy in local government.

Science.gov (United States)

Martineau, F P; Graff, H; Mitchell, C; Lock, K

2014-09-01

The power to influence many social determinants of health lies within local government sectors that are outside public health's traditional remit. We analyse the challenges of achieving health gains through local government alcohol control policies, where legal and professional practice frameworks appear to conflict with public health action. Current legislation governing local alcohol control in England and Wales is reviewed and analysed for barriers and opportunities to implement effective population-level health interventions. Case studies of local government alcohol control practices are described. Addressing alcohol-related health harms is constrained by the absence of a specific legal health licensing objective and differences between public health and legal assessments of the relevance of health evidence to a specific place. Local governments can, however, implement health-relevant policies by developing local evidence for alcohol-related health harms; addressing cumulative impact in licensing policy statements and through other non-legislative approaches such as health and non-health sector partnerships. Innovative local initiatives-for example, minimum unit pricing licensing conditions-can serve as test cases for wider national implementation. By combining the powers available to the many local government sectors involved in alcohol control, alcohol-related health and social harms can be tackled through existing local mechanisms. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health.

Management continuity in local health networks

Directory of Open Access Journals (Sweden)

Mylaine Breton

2012-04-01

Full Text Available Introduction: Patients increasingly receive care from multiple providers in a variety of settings. They expect management continuity that crosses boundaries and bridges gaps in the healthcare system. To our knowledge, little research has been done to assess coordination across organizational and professional boundaries from the patients' perspective. Our objective was to assess whether greater local health network integration is associated with management continuity as perceived by patients. Method: We used the data from a research project on the development and validation of a generic and comprehensive continuity measurement instrument that can be applied to a variety of patient conditions and settings. We used the results of a cross-sectional survey conducted in 2009 with 256 patients in two local health networks in Quebec, Canada. We compared four aspects of management continuity between two contrasting network types (highly integrated vs. poorly integrated. Results: The scores obtained in the highly integrated network are better than those of the poorly integrated network on all dimensions of management continuity (coordinator role, role clarity and coordination between clinics, and information gaps between providers except for experience of care plan. Conclusion: Some aspects of care coordination among professionals and organizations are noticed by patients and may be valid indicators to assess care coordination.

Health Services Utilization Patterns Associated with Emergency Department Closure

DEFF Research Database (Denmark)

Hansen, Kristian Schultz; Enemark, Ulrika; Foldspang, Anders

2011-01-01

, 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours...... of substitute health services. By contrast, Morsø women compared to the rest of Viborg county reduced their use of GP services in terms of face-to-face visits (β = -0.08, P = 0.020), telephone consultations (β = -0.11, P = 0.007), home visits (β = -0.48, P = 0.009), and their inpatient hospital utilization (β...... = -0.12, P = 0.022) during the period when emergeny services were only available in the daytime. CONCLUSIONS: Emergency services at neighbouring hospitals (40 kilometres distance) were able to compensate, in part, for the decreased local emergency service provision. Concurrent changes in health care...

A Logic Model for Evaluating the Academic Health Department.

Science.gov (United States)

Erwin, Paul Campbell; McNeely, Clea S; Grubaugh, Julie H; Valentine, Jennifer; Miller, Mark D; Buchanan, Martha

2016-01-01

Academic Health Departments (AHDs) are collaborative partnerships between academic programs and practice settings. While case studies have informed our understanding of the development and activities of AHDs, there has been no formal published evaluation of AHDs, either singularly or collectively. Developing a framework for evaluating AHDs has potential to further aid our understanding of how these relationships may matter. In this article, we present a general theory of change, in the form of a logic model, for how AHDs impact public health at the community level. We then present a specific example of how the logic model has been customized for a specific AHD. Finally, we end with potential research questions on the AHD based on these concepts. We conclude that logic models are valuable tools, which can be used to assess the value and ultimate impact of the AHD.

Local health systems in 21st century: who cares?-An exploratory study on health system governance in Amsterdam.

Science.gov (United States)

Plochg, T; Delnoij, D M J; Hogervorst, W V G; van Dijk, P; Belleman, S; Klazinga, N S

2006-10-01

There is a growing awareness that there should be a public health perspective to health system governance. Its intrinsic population health orientation provides the ultimate ground for determining the health needs and governing collaborative care arrangements within which these needs can be met. Notwithstanding differences across countries, population health concerns are not central to European health reforms. Governments currently withdraw leaving governance roles to care providers and/or financiers. Thereby, incentives that trigger the uptake of a public health perspective are often ignored. In this study we addressed this issue in the city of Amsterdam. Using a qualitative study design, we explored whether there is a public health perspective to the governance practices of the municipality and the major sickness fund in Amsterdam. And if so, what the scope of this perspective is. And if not, why not. Findings indicate that the municipality has a public health perspective to local health system governance, but its scope is limited. The municipality facilitates rather than governs health care provision in Amsterdam. Furthermore, the sickness fund runs major financial risks when adapting a public health perspective. It covers an insured population that partly overlaps the Amsterdam population. Returns on investments in population health are therefore uncertain, as competitors would also profit from the sickness fund's investments. The local health system in Amsterdam is not consistently aligned to the health needs of the Amsterdam population. The Amsterdam case is not unique and general consequences for local health system governance are discussed.

32 CFR 644.336 - Notices to Departments of Interior (DI); Health and Human Resources (HHR); Education; and Housing...

Science.gov (United States)

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Notices to Departments of Interior (DI); Health and Human Resources (HHR); Education; and Housing and Urban Development (HUD). 644.336 Section 644.336... Departments of Interior (DI); Health and Human Resources (HHR); Education; and Housing and Urban Development...

[Satisfaction according to health care insurance systems in an emergency department].

Science.gov (United States)

Dávila, F A; Herrera, J S; Yasnó, D A; Forero, L C; Alvarado, M V

Health satisfaction is a fundamental measure of the quality of health services. This study aims to validate and analyse the results of a quality of care questionnaire to assess the level of satisfaction of patients attended in the emergency department of a high complexity hospital. Observational, cross-sectional study, with a questionnaire designed to assess the quality of service and satisfaction at the end of care in the emergency department. Descriptive statistics of scale were established and presented, as well as determining the construct validity, overall reliability, internal and concurrent validity of an overall against a uni-dimensional scale. A total of 5,961 records were reviewed, most of them (77.3%) reported by patients in the Mandatory Health Plan. High levels of satisfaction overall and by subgroups were found. There were no significant differences between subgroups, with 86.8 for those with Pre-paid Medical Care Plan and 84.4 for mandatory health plan. Cronbach's alpha for the questionnaire was 0.90. The questionnaire proved to be reliable and valid in determining the quality and satisfaction with care. The results showed high levels of satisfaction overall and in the domains. A low consistency between the results of the multidimensional and unidimensional satisfaction scales suggests that there were aspects of satisfaction not investigated on the multidimensional scale. Ecologically-designed before and after studies are required to evaluate the effectiveness of interventions in satisfaction. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

[An experience of collaboration between primary health care and mental health care in La Ribera Department of Health (Valencia, Spain)].

Science.gov (United States)

Morera-Llorca, Miquel; Romeu-Climent, José Enrique; Lera-Calatayud, Guillem; Folch-Marín, Blanca; Palop-Larrea, Vicente; Vidal-Rubio, Sonia

2014-01-01

Despite the high prevalence of mental health problems among patients attending primary care, diagnosis and treatment of these disorders remain inadequate. Sound training of primary care physicians in how to manage mental health problems is needed to reduce the health, economic and social impact associated with these disorders. Among other elements, there is a need for cooperation between primary care physicians and mental health services. Distinct models are available for such collaboration. In 2006, our health department started a collaboration between these two levels of heath care, using a liaison model. Delays until the first specialist visit were reduced and satisfaction among health professionals increased, although these results should be interpreted with caution. Evidence has recently accumulated on the usefulness of the collaborative model, but evaluation of this model and extrapolation of its results are complex. We intend to evaluate our model more thoroughly, similar to other projects in our environment. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

PUBLIC COMMENT ON THE DEPARTMENT OF HEALTH AND HUMAN SERVICES 2018 FEDERAL PHYSICAL ACITIVTY GUIDELINES

Science.gov (United States)

Title: Public Comment on Department of Health and Human Services (DHHS) 2018 Physical Activity Guidelines Author: Wayne E. Cascio, Director, Environmental Public Health Division, US EPA Abstract: In the 2008 Physical Activity Guidelines, the effects of air pollution and advers...

Local connectome phenotypes predict social, health, and cognitive factors

Directory of Open Access Journals (Sweden)

Michael A. Powell

2018-03-01

Full Text Available The unique architecture of the human connectome is defined initially by genetics and subsequently sculpted over time with experience. Thus, similarities in predisposition and experience that lead to similarities in social, biological, and cognitive attributes should also be reflected in the local architecture of white matter fascicles. Here we employ a method known as local connectome fingerprinting that uses diffusion MRI to measure the fiber-wise characteristics of macroscopic white matter pathways throughout the brain. This fingerprinting approach was applied to a large sample (N = 841 of subjects from the Human Connectome Project, revealing a reliable degree of between-subject correlation in the local connectome fingerprints, with a relatively complex, low-dimensional substructure. Using a cross-validated, high-dimensional regression analysis approach, we derived local connectome phenotype (LCP maps that could reliably predict a subset of subject attributes measured, including demographic, health, and cognitive measures. These LCP maps were highly specific to the attribute being predicted but also sensitive to correlations between attributes. Collectively, these results indicate that the local architecture of white matter fascicles reflects a meaningful portion of the variability shared between subjects along several dimensions. The local connectome is the pattern of fiber systems (i.e., number of fibers, orientation, and size within a voxel, and it reflects the proximal characteristics of white matter fascicles distributed throughout the brain. Here we show how variability in the local connectome is correlated in a principled way across individuals. This intersubject correlation is reliable enough that unique phenotype maps can be learned to predict between-subject variability in a range of social, health, and cognitive attributes. This work shows, for the first time, how the local connectome has both the sensitivity and the specificity to

Health Physics Department annual progress report 1 January - 31 December 1984

International Nuclear Information System (INIS)

1985-05-01

The report describes the work of the Health Physics Department at Risoe during 1984. The activities cover dosimetry, instrumentation, radioecology, risk by nuclear activities and nuclear emergency preparedness. Lists of staff and publications are included. The main emphasis in the report has been placed on scientific and contractual work. Of lesser importance, but still quite significant, are the service functions. (author)

Health Physics Department annual progress report 1 January - 31 December 1985

International Nuclear Information System (INIS)

1986-10-01

The report describes the work of the Health Physics Department at Risoe during 1985. The activities cover dosimetry, instrumentation, radioecology, risk by nuclear activities and nuclear emergency preparedness. Lists of staff and publications are included. The main emphasis in the report has been placed on scientific and contractual work. Of lesser importance, but still quite significant, are the service functions. (author)

Adapting to Health Impacts of Climate Change in the Department of Defense.

Science.gov (United States)

Chrétien, Jean-Paul

2016-01-01

The Department of Defense (DoD) recognizes climate change as a threat to its mission and recently issued policy to implement climate change adaptation measures. However, the DoD has not conducted a comprehensive assessment of health-related climate change effects. To catalyze the needed assessment--a first step toward a comprehensive DoD climate change adaptation plan for health--this article discusses the DoD relevance of 3 selected climate change impacts: heat injuries, vector-borne diseases, and extreme weather that could lead to natural disasters. The author uses these examples to propose a comprehensive approach to planning for health-related climate change impacts in the DoD.

48 CFR 1252.217-80 - Department of Labor Safety and Health Regulations for Ship Repairing.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Department of Labor Safety and Health Regulations for Ship Repairing. 1252.217-80 Section 1252.217-80 Federal Acquisition Regulations System DEPARTMENT OF TRANSPORTATION CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 1252.217-80...

Downsizing of a provincial department of health--causes and implications for fiscal policy.

Science.gov (United States)

Blecher, Mark

2002-06-01

To analyse the financial basis for downsizing of a provincial health department and suggest implications for fiscal policy. Analysis of relevant departmental, provincial and national financing and expenditure trends from 1995/96 to 2002/03. Western Cape (WC) Department of Health (DOH). Downsizing involving 9,282 health workers (27.9%) and closure of 3,601 hospital beds (24.4%) over 5 years. Total aggregate provincial transfers (all provinces) remained fairly constant in real terms. The WC's share decreased from 11.8% in 1996/97 to 9.8% in 2002/03. This was offset by the DOH's share of the WC budget increasing from 25.6% to 29.6%, mainly because of an increase in national health conditional grants. The net effect of financing changes was that the DOH's allocation in real terms was similar in 2002/03 and 1995/96, which suggests that financing changes are not the major cause of downsizing. Expenditure analysis revealed a 39.7% real rise in the average cost of health personnel. Substantial interprovincial inequities remain. The major cause of downsizing was wage growth, particularly following the 1996 wage agreement. Disjointed fiscal and wage policy has affected health services. Simultaneous application of policies of fiscal constraint, redistribution and substantial real wage growth has resulted in substantial downsizing with limited inroads into inequities. Inequities will continue to call for further redistribution, reduction in conditional grants and downsizing, much of which could have been avoided if fiscal and wage policy choices had been optimal.

Learning to Promote Health at an Emergency Care Department: Identifying Expansive and Restrictive Conditions

Science.gov (United States)

Gustavsson, Maria; Ekberg, Kerstin

2015-01-01

This article reports on the findings of a planned workplace health promotion intervention, and the aim is to identify conditions that facilitated or restricted the learning to promote health at an emergency care department in a Swedish hospital. The study had a longitudinal design, with interviews before and after the intervention and follow-up…

Determinants of emergency response willingness in the local public health workforce by jurisdictional and scenario patterns: a cross-sectional survey.

Science.gov (United States)

Barnett, Daniel J; Thompson, Carol B; Errett, Nicole A; Semon, Natalie L; Anderson, Marilyn K; Ferrell, Justin L; Freiheit, Jennifer M; Hudson, Robert; Koch, Michelle M; McKee, Mary; Mejia-Echeverry, Alvaro; Spitzer, James; Balicer, Ran D; Links, Jonathan M

2012-03-07

The all-hazards willingness to respond (WTR) of local public health personnel is critical to emergency preparedness. This study applied a threat-and efficacy-centered framework to characterize these workers' scenario and jurisdictional response willingness patterns toward a range of naturally-occurring and terrorism-related emergency scenarios. Eight geographically diverse local health department (LHD) clusters (four urban and four rural) across the U.S. were recruited and administered an online survey about response willingness and related attitudes/beliefs toward four different public health emergency scenarios between April 2009 and June 2010 (66% response rate). Responses were dichotomized and analyzed using generalized linear multilevel mixed model analyses that also account for within-cluster and within-LHD correlations. Comparisons of rural to urban LHD workers showed statistically significant odds ratios (ORs) for WTR context across scenarios ranging from 1.5 to 2.4. When employees over 40 years old were compared to their younger counterparts, the ORs of WTR ranged from 1.27 to 1.58, and when females were compared to males, the ORs of WTR ranged from 0.57 to 0.61. Across the eight clusters, the percentage of workers indicating they would be unwilling to respond regardless of severity ranged from 14-28% for a weather event; 9-27% for pandemic influenza; 30-56% for a radiological 'dirty' bomb event; and 22-48% for an inhalational anthrax bioterrorism event. Efficacy was consistently identified as an important independent predictor of WTR. Response willingness deficits in the local public health workforce pose a threat to all-hazards response capacity and health security. Local public health agencies and their stakeholders may incorporate key findings, including identified scenario-based willingness gaps and the importance of efficacy, as targets of preparedness curriculum development efforts and policies for enhancing response willingness. Reasons for an

Determinants of emergency response willingness in the local public health workforce by jurisdictional and scenario patterns: a cross-sectional survey

Directory of Open Access Journals (Sweden)

Barnett Daniel J

2012-03-01

Full Text Available Abstract Background The all-hazards willingness to respond (WTR of local public health personnel is critical to emergency preparedness. This study applied a threat-and efficacy-centered framework to characterize these workers' scenario and jurisdictional response willingness patterns toward a range of naturally-occurring and terrorism-related emergency scenarios. Methods Eight geographically diverse local health department (LHD clusters (four urban and four rural across the U.S. were recruited and administered an online survey about response willingness and related attitudes/beliefs toward four different public health emergency scenarios between April 2009 and June 2010 (66% response rate. Responses were dichotomized and analyzed using generalized linear multilevel mixed model analyses that also account for within-cluster and within-LHD correlations. Results Comparisons of rural to urban LHD workers showed statistically significant odds ratios (ORs for WTR context across scenarios ranging from 1.5 to 2.4. When employees over 40 years old were compared to their younger counterparts, the ORs of WTR ranged from 1.27 to 1.58, and when females were compared to males, the ORs of WTR ranged from 0.57 to 0.61. Across the eight clusters, the percentage of workers indicating they would be unwilling to respond regardless of severity ranged from 14-28% for a weather event; 9-27% for pandemic influenza; 30-56% for a radiological 'dirty' bomb event; and 22-48% for an inhalational anthrax bioterrorism event. Efficacy was consistently identified as an important independent predictor of WTR. Conclusions Response willingness deficits in the local public health workforce pose a threat to all-hazards response capacity and health security. Local public health agencies and their stakeholders may incorporate key findings, including identified scenario-based willingness gaps and the importance of efficacy, as targets of preparedness curriculum development efforts and

Analysis of National Institutes of Health Funding to Departments of Urology.

Science.gov (United States)

Silvestre, Jason; Agarwal, Divyansh; Lee, David I

2016-05-01

To elucidate the current portfolio of National Institutes of Health (NIH) funding to departments of urology at U.S. medical schools. The NIH Research Portfolio Online Reporting Tools Expenditures and Results was used to generate a comprehensive analysis of NIH research grants awarded to urology departments during 2014. Costs, mechanisms, and institutes were summarized with descriptive statistics. Demographic data were obtained for principal investigators and project abstracts were categorized by research type and area. Fiscal totals were calculated for 2005-2014 and compared with other surgical departments during 2014. One hundred one investigators at 36 urology departments received $55,564,952 in NIH funding during 2014. NIH-funded investigators were predominately male (79%) and PhD scientists (52%). Funding totals did not vary by terminal degree or sex, but increased with higher academic rank (P < .001). The National Cancer Institute (54.7%) and National Institute of Diabetes and Digestive and Kidney Diseases (32.2%) supported the majority of NIH-funded urologic research. The R01 grant accounted for 41.0% of all costs. The top 3 NIH-funded clinical areas were urologic oncology (62.1%), urinary tract infection (8.8%), and neurourology (7.6%). A minority of costs supported clinical research (12.9%). In 2014, urology had the least number of NIH grants relative to general surgery, ophthalmology, obstetrics & gynecology, otolaryngology, and orthopedic surgery. NIH funding to urology departments lags behind awards to departments of other surgical disciplines. Future interventions may be warranted to increase NIH grant procurement in urology. Copyright © 2016 Elsevier Inc. All rights reserved.

A partial solution: a local mental health authority for the UK.

Science.gov (United States)

Hadley, Trevor R.; Goldman, Howard H.

1998-07-01

BACKGROUND: the structural problems of the mental health system in the UK have been analyzed by a number of authors over the past several years as the "reforms" of the health and social service systems have continued (Kavanagh and Knapp, 1995; Mechanic, 1995). In a recent article, Hadley and Goldman (1995) suggest that one possible solution to some of these issues may be the creation of a local mental health authority. Such an authority would consolidate the funding, authority and responsibility in a single entity. We believe this model, which is typical of many local public mental health systems in the US, is at least part of the solution to the current problem of financial and service fragmentation of the current system in the UK. The numerous "reforms" of the health and social service systems (which include the Community Care Act, the development of the Internal Market, GP fundholding and the purchaser-provider split) were not designed for the care of the mentally ill (Han, 1996). These policy changes in the design of health and social services have created a complicated and difficult context in which services must be delivered. Too many agencies play a significant role in the delivery and management of mental health services. Health authorities, social service agencies and GP fundholders are direct and indirect funders of the system while community care trusts, social service agencies and GPs are service providers (Hadley, 1996a). RESULTS AND A PROPOSAL: We believe that the development of local mental health authorities may be part of the solution to the structural and economic problems of the current system in the UK. It is not the answer to limited resources or limited skills, but can create a new structure, which will permit and encourage the cooperation and innovation that is now possible only with unusual effort. Local mental health authorities have a number of crucial characteristics, but, most importantly, they refocus the system on the provision of care

The power of local action in occupational health: the adoption of local exhaust ventilation in the Chicago tuckpointing trade.

Science.gov (United States)

Weinstein, Marc; Susi, Pam; Goldberg, Mark

2016-04-01

Silica is a pervasive and potentially deadly occupational hazard in construction. The occupational risk posed by silica has long been known, but efforts to use engineering controls to minimize dust generation in tuckpointing operations, a masonry restoration specialty, have been slow. The objective of this study is to explore how local innovation in occupational safety and health may emerge, absent the establishment of national standards. This study uses a case study to explore the adoption of local exhaust ventilation in tuckpointing operations in the Chicago area. Sources of data for this research include interviews with a diverse range of key informants and the review of archival material. This case study found local unions, municipal regulators, contractors, and major public users of construction services played a central role in the events and milestones that led to the early adoption of local exhaust ventilation in Chicago. The adoption of local exhaust ventilation technology in Chicago demonstrates the potential for local actors to fill an important void when rulemaking in vital areas of occupational of health impedes effective national regulation.

International trade of health services: global trends and local impact.

Science.gov (United States)

Lautier, Marc

2014-10-01

Globalization is a key challenge facing health policy-makers. A significant dimension of this is trade in health services. Traditionally, the flow of health services exports went from North to South, with patients travelling in the opposite direction. This situation is changing and a number of papers have discussed the growth of health services exports from Southern countries in its different dimensions. Less attention has been paid to assess the real scope of this trade at the global level and its potential impact at the local level. Given the rapid development of this area, there are little empirical data. This paper therefore first built an estimate of the global size and of the growth trend of international trade in health services since 1997, which is compared with several country-based studies. The second purpose of the paper is to demonstrate the significant economic impact of this trade at the local level for the exporting country. We consider the case of health providers in the South-Mediterranean region for which the demand potential, the economic effects and the consequence for the health system are presented. These issues lead to the overall conclusion that different policy options would be appropriate, in relation to the nature of the demand. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

48 CFR 1352.271-82 - Department of Labor occupational safety and health standards for ship repair.

Science.gov (United States)

2010-10-01

... occupational safety and health standards for ship repair. 1352.271-82 Section 1352.271-82 Federal Acquisition... of Provisions and Clauses 1352.271-82 Department of Labor occupational safety and health standards... Occupational Safety and Health Standards for Ship Repair (APR 2010) The contractor, in performance of all work...

Georgia Health – Go Local: Using Multidisciplinary Partnerships to Promote a Statewide Consumer Health Website

OpenAIRE

Smith, Rita B.

2011-01-01

The National Library of Medicine ended its support of the Go Local program in 2010 due to declining usage, but in many ways Georgia's project was a success. From its beginning, Georgia Health – Go Local was a model of successful collaboration among a variety of partners and institutions throughout the state. The high usage statistics for the Go Local website and the support garnered by the project exemplify the positive nature of the collaborations that made the project possible.

A survey of local health promotion initiatives for older people in Wales

Directory of Open Access Journals (Sweden)

Williams Nefyn H

2008-06-01

Full Text Available Abstract Background As the demographic profile of the UK changes, policy makers and practitioners have to respond to health challenges presented by a progressively ageing population. The health promotion plan for older people, aged over 50 years, in Wales included eight key areas: physical activity, healthy eating, home safety and warmth, emotional health, health protection, smoking, alcohol and sexual health. The aim of this study was to describe the extent, content and regional variation of existing health promotion initiatives for older people in Wales, provided by statutory, voluntary and private sector agencies. Method A questionnaire was sent to senior health promotion specialists employed in the 22 local authority areas in Wales to ascertain details of all projects promoting health and wellbeing in the eight key areas where the priority population was aged over 50, or the majority of users were older people. Additional information was sought from project leads and websites. Results Eighteen questionnaires were returned; not all were fully completed. Four areas did not return a questionnaire. Additional information was obtained from internet searches but this mainly concerned national initiatives rather than local projects. In all, 120 projects were included, 11 were throughout Wales. Best provision was for physical activity, with 3 national and 42 local initiatives, but local provision was patchy. Healthy eating, and home safety and warmth had far fewer initiatives, as did health protection, which comprised two national immunisation campaigns. Smoking and alcohol misuse were poorly provided for, and there was no provision for older people's sexual health. Evaluation arrangements were poorly described. Half of those who responded identified unmet training needs. Conclusion The reasons for patchy provision of services were not clear. Increased efforts to improve the coverage of interventions known to be effective should be made. Rigorous

ACADEMIC STRESS IN STUDENTS FROM HEALTH DEPARTMENTS IN A PUBLIC UNIVERSITY OF CARTAGENA-COLOMBIA

OpenAIRE

Montalvo-Prieto Amparo; Blanco-Blanco Katerin; Cantillo-Martínez Neyi; Castro-González Yuldor; Downs-Bryan Agatha; Romero-Villadiego Eliana

2015-01-01

Introduction: stress is a factor that influences in the quality of life and performance of the individual. It appears when a person identifies dangerous situations that exceeds its own resources and endanger its own being-well. Objective: to describe the stress level in university students from health departments in Cartagena-Colombia. Methods: a descriptive study was carried out in 266 female students chosen by random probabilistic sampling from departments of Nursing, Dent...

Asset-Based Community Development as a Strategy for Developing Local Global Health Curricula.

Science.gov (United States)

Webber, Sarah; Butteris, Sabrina M; Houser, Laura; Coller, Karen; Coller, Ryan J

2018-02-07

A significant and growing proportion of US children have immigrant parents, an issue of increasing importance to pediatricians. Training globally minded pediatric residents to address health inequities related to globalization is an important reason to expand educational strategies around local global health (LGH). We developed a curriculum in the pediatric global health residency track at the University of Wisconsin in an effort to address gaps in LGH education and to increase resident knowledge about local health disparities for global community members. This curriculum was founded in asset-based community development (ABCD), a strategy used in advocacy training but not reported in global health education. The initial curriculum outputs have provided the foundation for a longitudinal LGH curriculum and a community-academic partnership. Supported by a community partnership grant, this partnership is focused on establishing a community-based postpartum support group for local Latinos, with an emphasis on building capacity in the Latino community. Aspects of this curriculum can serve other programs looking to develop LGH curricula rooted in building local partnerships and capacity using an ABCD model. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Relationships between female tourists and male locals in Cuzco/Peru: implications for travel health education.

Science.gov (United States)

Bauer, Irmgard

2009-11-01

Health concerns regarding casual sexual encounters during travel have been recognized for some time. The perception that female travellers' motivations are more romantic rather than sexual when entering a relationship with local men may exclude them from receiving appropriate travel health advice. This may pose even greater health risks, not only to themselves but also to their local partners. This paper presents 11 Western female tourists' perceptions of their relationships with local men in Cuzco/Peru, based on in-depth interviews, observations, and informal discussions. Relationships with local men were often triggered by their physical appearance. Other themes identified were: methods and location of first contact, benefits for the local men, safe sex/condom use, and travel health advice received. The findings support calls for more emphasis on sexual health in travel health education. Three aspects should be included: 1) an awareness that unfamiliar environment can cause 'out of character' behaviour, 2) an emphasis on not only to use but to not stop using condoms, and 3) the need to acquire negotiation skills.

The 50-th anniversary of the Federal Department for Biomedical and Extreme Problems at the Ministry of Health of Russia

International Nuclear Information System (INIS)

Reva, V.D.

1997-01-01

Due to the 50-th anniversary of the Federal Department for Biomedical and Extreme Problems of the Ministry of Health of Russian Federation, formerly the Third Main Department of the USSR Ministry of Health the, basic stages are considered of the establishment and development of this system amalgamating treatment-and-prophylactic, sanitary-and-antiepidemic, scientific and industrial institutions aimed at the health protection of personnel dealing with ionizing radiation. Organizational and staff structures are discussed as well as activities of the institutions of the Department under present economic conditions

HIV provider and patient perspectives on the Development of a Health Department "Data to Care" Program: a qualitative study.

Science.gov (United States)

Dombrowski, Julia C; Carey, James W; Pitts, Nicole; Craw, Jason; Freeman, Arin; Golden, Matthew R; Bertolli, Jeanne

2016-06-10

U.S. health departments have not historically used HIV surveillance data for disease control interventions with individuals, but advances in HIV treatment and surveillance are changing public health practice. Many U.S. health departments are in the early stages of implementing "Data to Care" programs to assists persons living with HIV (PLWH) with engaging in care, based on information collected for HIV surveillance. Stakeholder engagement is a critical first step for development of these programs. In Seattle-King County, Washington, the health department conducted interviews with HIV medical care providers and PLWH to inform its Data to Care program. This paper describes the key themes of these interviews and traces the evolution of the resulting program. Disease intervention specialists conducted individual, semi-structured qualitative interviews with 20 PLWH randomly selected from HIV surveillance who had HIV RNA levels >10,000 copies/mL in 2009-2010. A physician investigator conducted key informant interviews with 15 HIV medical care providers. Investigators analyzed de-identified interview transcripts, developed a codebook of themes, independently coded the interviews, and identified codes used most frequently as well as illustrative quotes for these key themes. We also trace the evolution of the program from 2010 to 2015. PLWH generally accepted the idea of the health department helping PLWH engage in care, and described how hearing about the treatment experiences of HIV seropositive peers would assist them with engagement in care. Although many physicians were supportive of the Data to Care concept, others expressed concern about potential health department intrusion on patient privacy and the patient-physician relationship. Providers emphasized the need for the health department to coordinate with existing efforts to improve patient engagement. As a result of the interviews, the Data to Care program in Seattle-King County was designed to incorporate an HIV

A CLAS act? Community-based organizations, health service decentralization and primary care development in Peru. Local Committees for Health Administration.

Science.gov (United States)

Iwami, Michiyo; Petchey, Roland

2002-12-01

In 1994 Peru embarked on a programme of health service reform, which combined primary care development and community participation through Local Committees for Health Administration (CLAS). They are responsible for carrying out local health needs assessments and identifying unmet health needs through regular household surveys. These enable them to determine local health provision and tailor services to local requirements. CLAS build on grassroots self-help circles that developed during the economic and political crises of the 1980s, and in which women have been prominent. However, they function under a 3 year contract with the Ministry of Health and within a framework of centrally determined guidelines and regulations. These reforms were implemented in the context of neo-liberal economic policies, which stressed financial deregulation and fiscal and monetary restraint, and were aimed at reducing foreign indebtedness and inflation. We evaluate the achievements of the CLAS and analyse the relationship between health and economic policy in Peru, with the aid of two contrasting models of the role of the state - 'agency' and 'stewardship'. We argue that Peru's experience holds valuable lessons for other countries seeking to foster community involvement. These include the need for community capacity building and partnership between community organizations and state (and other civil) agencies.

Modeling the effects of influenza vaccination of health care workers in hospital departments

NARCIS (Netherlands)

van den Dool, C.; Bonten, M. J. M.; Hak, E.; Wallinga, J.

2009-01-01

Nowadays health care worker (HCW) vaccination is widely recommended. Although the benefits of this strategy have been demonstrated in long-term care settings, no studies have been performed in regular hospital departments. We adapt a previously developed model of influenza transmission in a

An exploratory study identifying where local government public health decision makers source their evidence for policy.

Science.gov (United States)

Stoneham, Melissa; Dodds, James

2014-08-01

The Western Australian (WA) Public Health Bill will replace the antiquated Health Act 1911. One of the proposed clauses of the Bill requires all WA local governments to develop a Public Health Plan. The Bill states that Public Health Plans should be based on evidence from all levels, including national and statewide priorities, community needs, local statistical evidence, and stakeholder data. This exploratory study, which targeted 533 WA local government officers, aimed to identify the sources of evidence used to generate the list of public health risks to be included in local government Public Health Plans. The top four sources identified for informing local policy were: observation of the consequences of the risks in the local community (24.5%), statewide evidence (17.6%), local evidence (17.6%) and coverage in local media (16.2%). This study confirms that both hard and soft data are used to inform policy decisions at the local level. Therefore, the challenge that this study has highlighted is in the definition or constitution of evidence. SO WHAT? Evidence is critical to the process of sound policy development. This study highlights issues associated with what actually constitutes evidence in the policy development process at the local government level. With the exception of those who work in an extremely narrow field, it is difficult for local government officers, whose role includes policymaking, to read the vast amount of information that has been published in their area of expertise. For those who are committed to the notion of evidence-based policymaking, as advocated within the WA Public Health Bill, this presents a considerable challenge.

Information seeking for making evidence-informed decisions: a social network analysis on the staff of a public health department in Canada

Directory of Open Access Journals (Sweden)

Yousefi-Nooraie Reza

2012-05-01

Full Text Available Abstract Background Social network analysis is an approach to study the interactions and exchange of resources among people. It can help understanding the underlying structural and behavioral complexities that influence the process of capacity building towards evidence-informed decision making. A social network analysis was conducted to understand if and how the staff of a public health department in Ontario turn to peers to get help incorporating research evidence into practice. Methods The staff were invited to respond to an online questionnaire inquiring about information seeking behavior, identification of colleague expertise, and friendship status. Three networks were developed based on the 170 participants. Overall shape, key indices, the most central people and brokers, and their characteristics were identified. Results The network analysis showed a low density and localized information-seeking network. Inter-personal connections were mainly clustered by organizational divisions; and people tended to limit information-seeking connections to a handful of peers in their division. However, recognition of expertise and friendship networks showed more cross-divisional connections. Members of the office of the Medical Officer of Health were located at the heart of the department, bridging across divisions. A small group of professional consultants and middle managers were the most-central staff in the network, also connecting their divisions to the center of the information-seeking network. In each division, there were some locally central staff, mainly practitioners, who connected their neighboring peers; but they were not necessarily connected to other experts or managers. Conclusions The methods of social network analysis were useful in providing a systems approach to understand how knowledge might flow in an organization. The findings of this study can be used to identify early adopters of knowledge translation interventions, forming

Information seeking for making evidence-informed decisions: a social network analysis on the staff of a public health department in Canada

Science.gov (United States)

2012-01-01

Background Social network analysis is an approach to study the interactions and exchange of resources among people. It can help understanding the underlying structural and behavioral complexities that influence the process of capacity building towards evidence-informed decision making. A social network analysis was conducted to understand if and how the staff of a public health department in Ontario turn to peers to get help incorporating research evidence into practice. Methods The staff were invited to respond to an online questionnaire inquiring about information seeking behavior, identification of colleague expertise, and friendship status. Three networks were developed based on the 170 participants. Overall shape, key indices, the most central people and brokers, and their characteristics were identified. Results The network analysis showed a low density and localized information-seeking network. Inter-personal connections were mainly clustered by organizational divisions; and people tended to limit information-seeking connections to a handful of peers in their division. However, recognition of expertise and friendship networks showed more cross-divisional connections. Members of the office of the Medical Officer of Health were located at the heart of the department, bridging across divisions. A small group of professional consultants and middle managers were the most-central staff in the network, also connecting their divisions to the center of the information-seeking network. In each division, there were some locally central staff, mainly practitioners, who connected their neighboring peers; but they were not necessarily connected to other experts or managers. Conclusions The methods of social network analysis were useful in providing a systems approach to understand how knowledge might flow in an organization. The findings of this study can be used to identify early adopters of knowledge translation interventions, forming Communities of Practice, and

Cost and appropriateness of treating asthma with fixed-combination drugs in local health care units in Italy

Directory of Open Access Journals (Sweden)

Ruggeri I

2012-12-01

Full Text Available Isabella Ruggeri,1 Donatello Bragato,2 Giorgio L Colombo,3,4 Emanuela Valla,3 Sergio Di Matteo41Servizio Governo Area Farmaceutica, Azienda Sanitaria Locale, Milano, Binasco, 2Data Solution Provider, Milan, 3University of Pavia, Department of Drug Sciences, School of Pharmacy, 4Studi Analisi Valutazioni Economiche, MilanBackground: Bronchial asthma is a chronic airways disease and is considered to be one of the major health problems in the Western world. During the last decade, a significant increase in the use of β2-agonists in combination with inhaled corticosteroids has been observed. The aim of this study was to assess the appropriateness of expenditure on these agents in an asthmatic population treated in a real practice setting.Methods: This study used data for a resident population of 635,906 citizens in the integrated patient database (Banca Dati Assistito of a local health care unit (Milano 2 Azienda Sanitaria Locale in the Lombardy region over 3 years (2007–2009. The sample included 3787–4808 patients selected from all citizens aged ≥ 18 years entitled to social security benefits, having a prescription for a corticosteroid + β2-agonist combination, and an ATC code corresponding to R03AK, divided into three groups, ie, pressurized (spray drugs, inhaled powders, and extrafine formulations. Patients with chronic obstructive lung disease were excluded. Indicators of appropriateness were 1–3 packs per year (underdosed, inappropriate, 4–12 packs per year (presumably appropriate, and ≥13 packs per year (overtreatment, inappropriate.Results: The corticosteroid + β2-agonist combination per treated asthmatic patient increased from 37% in 2007 to 45% in 2009 for the total of prescribed antiasthma drugs, and 28%–32% of patients used the drugs in an appropriate manner (4–12 packs per years. The cost of inappropriately used packs increased combination drug expenditure by about 40%, leading to inefficient use of health care

Public health accreditation and metrics for ethics: a case study on environmental health and community engagement.

Science.gov (United States)

Bernheim, Ruth Gaare; Stefanak, Matthew; Brandenburg, Terry; Pannone, Aaron; Melnick, Alan

2013-01-01

As public health departments around the country undergo accreditation using the Public Health Accreditation Board standards, the process provides a new opportunity to integrate ethics metrics into day-to-day public health practice. While the accreditation standards do not explicitly address ethics, ethical tools and considerations can enrich the accreditation process by helping health departments and their communities understand what ethical principles underlie the accreditation standards and how to use metrics based on these ethical principles to support decision making in public health practice. We provide a crosswalk between a public health essential service, Public Health Accreditation Board community engagement domain standards, and the relevant ethical principles in the Public Health Code of Ethics (Code). A case study illustrates how the accreditation standards and the ethical principles in the Code together can enhance the practice of engaging the community in decision making in the local health department.

Delivering on a gendered definition of health needs in local government budgeting: experiences and concepts.

Science.gov (United States)

Buyana, K

2009-10-01

Local governments are granted budgetary power in the Local Governments Act of the Republic of Uganda, which allows for local-level participation and flexibility in the allocation of financial grants channelled annually from central to local governments. The act prescribes a legal mandate to allocate public resources based on local priorities including the health needs of women compared with men. This study investigated the responsiveness of local government budgeting to the health needs of women as compared to men. A qualitative study was conducted in Mpigi district using a set of data collection methods including: a) three (3) focus group discussions with 8 female and 8 male respondents in each group; b) face-to-face interviews with a random sample of 120 households, 75% of which were male-headed and 25% female-headed ; c) key informant interviews with a sample of 10 administrative officers in Mpigi district ; and d) desk-review of the Mpigi district Budget Framework Paper. Health needs consist of the daily requirements, which, arise out of common disease infections and the socioeconomic constraints that affect the well-being of women and men. However, the primary concern of the district health sector is disease control measures, without emphasis on the differing socio-economic interests of women as compared to men. Local government budgeting, therefore, does not reflect the broad community-wide understanding of health needs. Local government budgeting should be informed by a two-fold framework for the gendered definition of health needs. The two-fold framework combines both disease-based health needs and socio-economic needs of women as compared to men.

Environmental health--champions of One Health.

Science.gov (United States)

Eddy, Christopher; Stull, Paul A; Balster, Erik

2013-01-01

The authors find overwhelming evidence among environmental health practitioners that One Health disease reporting concepts are essential to the early detection of, and expedient recovery from, pandemic disease events. The authors also find, however, extraordinary evidence that local public health is not prepared, and potentially unaware of their responsibility, to be the initiator of the zoonotic infectious disease information intelligence necessary to make such early event mitigation possible. The authors propose that NEHA take an affirmative step towards the development of local public health-initiated biosurveillance systems by organizing and leading a tabletop study group that includes the Centers for Disease Control and Prevention, American Veterinary Medical Association, American Medical Association, Food and Drug Administration, U.S. Department of Agriculture, Institute of Medicine, and a robust panel of NEHA state affiliates. This study group should discuss the infrastructure necessary for local public health-the frontline against community-acquired infectious disease-to be the initiators of environmental health, veterinary, and medical One Health biosurveillance systems. The need to establish a community-focused, integrated disease prevention strategy that cautions people about the risks associated with food, water, animal, and contaminated environmental media, both prior to and during epidemic and pandemic events is equally important.

Evaluating the Effectiveness of Community and Hospital Medical Record Integration on Management of Behavioral Health in the Emergency Department.

Science.gov (United States)

Ngo, Stephanie; Shahsahebi, Mohammad; Schreiber, Sean; Johnson, Fred; Silberberg, Mina

2017-11-09

This study evaluated the correlation of an emergency department embedded care coordinator with access to community and medical records in decreasing hospital and emergency department use in patients with behavioral health issues. This retrospective cohort study presents a 6-month pre-post analysis on patients seen by the care coordinator (n=524). Looking at all-cause healthcare utilization, care coordination was associated with a significant median decrease of one emergency department visit per patient (p management of behavioral health patients.

Strategies to enhance price and quality competition in health care: lessons learned from tracking local markets.

Science.gov (United States)

Lesser, Cara S; Ginsburg, Paul B

2006-06-01

Drawing on observations from tracking changes in local health care markets over the past ten years, this article critiques two Federal Trade Commission and Department of Justice recommendations to enhance price and quality competition. First, we take issue with the notion that consumers, acting independently, will drive greater competition in health care markets. Rather we suggest an important role remains for trusted agents who can analyze inherently complex price and quality information and negotiate on consumers' behalf. With aggregated information identifying providers who deliver cost-effective care, consumers would be better positioned to respond to financial incentives about where to seek care and thereby drive more meaningful competition among providers to reduce costs and improve quality. Second, we take issue with the FTC/DOJ recommendation to provide more direct subsidies to prevent distortions in competition. In the current political environment, it is not practical to provide direct subsidies for all of the unfunded care that exists in health care markets today; instead, some interference with competition may be necessary to protect cross subsidies. Barriers can be reduced, though, by revising pricing policies that have resulted in marked disparities in the relative profitability of different services.

45 CFR 400.63 - Preparation of local resettlement agencies.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Preparation of local resettlement agencies. 400.63 Section 400.63 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM...

45 CFR 400.68 - Notification to local resettlement agency.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Notification to local resettlement agency. 400.68 Section 400.68 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM...

mHealth Tool for Alcohol Use Disorders Among Latinos in Emergency Department.

Science.gov (United States)

Abujarad, Fuad; Vaca, Federico E

2015-06-01

Latino drinkers experience a disparate number of negative health and social consequences. Emergency Department Alcohol Screening Brief Intervention and Referral to Treatment (ED-SBIRT) is viable and effective at reducing harmful and hazardous drinking. However, barriers (e.g. readily available language translators, provider time burden, resources) to broad implementation remain and account for a major lag in adherence to national guidelines. We describe our approach to the design of a patient-centered bilingual Web-based mobile health ED-SBIRT App that could be integrated into a clinically complex ED environment and used regularly to provide ED-SBIRT for Spanish speaking patients.

Effects of Economic Conditions and Organizational Structure on Local Health Jurisdiction Revenue Streams and Personnel Levels in Connecticut, 2005-2012.

Science.gov (United States)

Pallas, Sarah Wood; Kertanis, Jennifer; O'Keefe, Elaine; Humphries, Debbie L

2015-01-01

We investigated whether or not changes in economic conditions during the 2008-2010 U.S. recession were associated with changes in Connecticut local health jurisdictions' (LHJs') revenue or personnel levels. We analyzed Connecticut Department of Public Health 2005-2012 annual report data from 91 Connecticut LHJs, as well as publicly available data on economic conditions. We used fixed- and random-effect regression models to test whether or not LHJ per capita revenues and full-time equivalent (FTE) personnel differed during and post-recession compared with pre-recession, or varied with recession intensity, as measured by unemployment rates and housing permits. On average, total revenue per capita was significantly lower during and post-recession compared with pre-recession, with two-thirds of LHJs experiencing per capita revenue reductions. FTE personnel per capita were significantly lower post-recession. Changes in LHJ-level unemployment rates and housing permits did not explain the variation in revenue or FTE personnel per capita. Revenue and personnel differed significantly by LHJ organizational structure across all time periods. Economic downturns can substantially reduce resources available for local public health. LHJ organizational structure influences revenue levels and sources, with implications for the scope, quality, and efficiency of services delivered.

Diffusion of innovation in women's health care delivery: the Department of Veterans Affairs' adoption of women's health clinics.

Science.gov (United States)

Yano, Elizabeth M; Goldzweig, Caroline; Canelo, Ismelda; Washington, Donna L

2006-01-01

In response to concerns about the availability and quality of women's health services in Department of Veterans Affairs (VA) medical centers in the early 1990s, Congress approved landmark legislation earmarking funds to enhance women's health services. A portion of the appropriation was used to launch Comprehensive Women's Health Centers as exemplars for the development of VA women's health care throughout the system. We report on the diffusion and characteristics of VA women's health clinics (WHCs) 10 years later. In 2001, we surveyed the senior women's health clinician at each VA medical center serving > or =400 women veterans (83% response rate) regarding their internal organizational characteristics in relation to factors associated with organizational innovation (centralization, complexity, formalization, interconnectedness, organizational slack, size). We evaluated the comparability of WHCs (n = 66) with characteristics of the original comprehensive women's health centers (CWHCs; n = 8). Gender-specific service availability in WHCs was comparable to that of CWHCs with important exceptions in mental health, mammography and osteoporosis management. WHCs were less likely to have same-gender providers (p business case for managers faced with small female patient caseloads.

Anatomy of a public health agency turnaround: the case of the general health district in Mahoning County.

Science.gov (United States)

Honoré, Peggy A; Stefanak, Matthew; Dessens, Scott

2012-01-01

A turnaround describes an organization's ability to recover from successive periods of decline. Current and projected declines in US economic conditions continue to place local public health departments at risk of fiscal exigency. This examination focused on turnaround methodologies used by a local public health department to reverse successive periods of operational and financial declines. Illustrations are provided on the value added by implementing financial ratio and trend analysis in addition to using evidence-based private sector turnaround strategies of retrenchment, repositioning, and reorganization. Evidence has shown how the financial analysis and strategies aided in identifying operational weakness and set in motion corrective measures. The Public Health Uniform Data System is introduced along with a list of standards offered for mainstreaming these and other routine stewardship practices to diagnose, predict, and prevent agency declines.

Report on the baseline measurement of the administrative burden from the Department of Health

OpenAIRE

Department of Health (Ireland)

2013-01-01

The Irish Government in March 2008 set a target to identify measure and reduce the Administrative Burden (AB) of domestic regulation for businesses by 25% by the end of 2012 – on foot of a European Council invitation to all member states in March 2007. As part of a cross-Government process led by the Business Regulation Unit of the Department of Jobs, Enterprise and Innovation (DJEI), the Department of Health carried out a measurement exercise in 2012 on the main Information Obligations...

Introducing INSPIRE: an implementation research collaboration between the Department of Foreign Affairs, Trade and Development Canada and the World Health Organization.

Science.gov (United States)

Blais, Pierre; Hirnschall, Gottfried; Mason, Elizabeth; Shaffer, Nathan; Lipa, Zuzanna; Baller, April; Rollins, Nigel

2014-11-01

The government of Canada, through the Department of Foreign Affairs, Trade and Development (DFATD) has supported global efforts to reduce the impact of the HIV pandemic. In 2012, WHO and DFATD launched an implementation research initiative to increase access to interventions that were known to be effective in the prevention of mother-to-child transmission of HIV and to learn how these could be successfully integrated with other essential services for mothers and children. In addition to facilitating the implementation research projects, DFATD and WHO promoted four approaches: (1) Country-specific implementation research prioritization exercises, (2) Ministry of Health involvement, (3) Country-led, innovative, high-quality research, and (4) Leveraging regional networks and learning opportunities. While no single aspect of INSPIRE is unique, the process endeavors to promote and support high-quality, rigorous, locally-led implementation research that will have a substantial impact on the health and survival of HIV-infected women and their children.

Influenza | Florida Department of Health

Science.gov (United States)

Health Women's Health WIC Program Community Health Minority Health & Health Equity People with influenza A viruses since early March. * This late-season circulation of influenza B is expected. View the

Integrating Local Public Health Agencies into the Homeland Security Community

National Research Council Canada - National Science Library

Reed, Patricia D

2007-01-01

After more than seven years of funding through The Centers for Disease Control and Prevention, local public health agencies have made inconsistent progress in fulfilling their Homeland Security objectives...

Building sustainable health and education partnerships: stories from local communities.

Science.gov (United States)

Blank, Martin J

2015-11-01

Growing health disparities have a negative impact on young people's educational achievement. Community schools that involve deep relationships with partners across multiple domains address these disparities by providing opportunities and services that promote healthy development of young people, and enable them to graduate from high school ready for college, technical school, on-the-job training, career, and citizenship. Results from Milwaukie High School, North Clackamas, OR; Oakland Unified School District, Oakland, CA; and Cincinnati Community Learning Centers, Cincinnati, OH were based on a review of local site documents, web-based information, interviews, and e-mail communication with key local actors. The schools and districts with strong health partnerships reflecting community schools strategy have shown improvements in attendance, academic performance, and increased access to mental, dental, vision, and health supports for their students. To build deep health-education partnerships and grow community schools, a working leadership and management infrastructure must be in place that uses quality data, focuses on results, and facilitates professional development across sectors. The leadership infrastructure of community school initiatives offers a prototype on which others can build. Moreover, as leaders build cross-sector relationships, a clear definition of what scaling up means is essential for subsequent long-term systemic change. © 2015 Institute for Educational Leadership. Journal of School Health published by Wiley Periodicals, Inc. on behalf of American School Health Association.

Performance of the local health system and contingent influences in Northeast-Brazil: breaking vicious and virtuous circles

Directory of Open Access Journals (Sweden)

Regianne Leila Rolim Medeiros

2013-11-01

Full Text Available Organizational theory has long emphasized the importance of contingent, environmental influences on organizational performance. Similarly, research has demonstrated the importance of local political culture and informal management on the performance of the local health system, establishing vicious and virtuous circles of influence that contribute to increasing inequalities in performance among decentralized local health systems. A longitudinal ethnography studied the relationship between these elements in the same rural municipality in Northeast Brazil after a four-year interval. The second study found the local health system performance much improved. Two main factors appear to have interacted to bring this about: leadership vision and power to implement of one individual; professionalization of the local health system by hiring a significant number of senior health staff. The origins of these influences combine initiatives at local, state and federal levels.

An Evaluation of the Cybersecurity Policies for the United States Health & Human Services Department: Criteria, Regulations, and Improvements

OpenAIRE

Derek Mohammed; Ronda Mariani

2014-01-01

This paper examines the criteria necessary for the evaluation of the cybersecurity policies for the United States Health and Human Services Department of the Federal Government. The overall purpose of cybersecurity policies and procedures is supported through compliance with Federal mandated regulation and standards, which serve to protect the organizational services and goals of the United States Health and Human Services Department, and to promote the best possible security practices in the...

Data, Staff, and Money: Leadership Reflections on the Future of Public Health Informatics.

Science.gov (United States)

Leider, Jonathon P; Shah, Gulzar H; Williams, Karmen S; Gupta, Akrati; Castrucci, Brian C

Health informatics can play a critical role in supporting local health departments' (LHDs') delivery of certain essential public health services and improving evidence base for decision support. However, LHDs' informatics capacities are below an optimum level. Efforts to build such capacities face ongoing challenges. Moreover, little is known about LHD leaders' desires for the future of public health informatics. Conduct a qualitative analysis of LHDs' future informatics plans, perceived barriers to accomplishing those plans, and potential impact of future advances in public health informatics on the work of the public health enterprise. This research presents findings from 49 in-depth key informant interviews with public health leaders and informatics professionals from LHDs, representing insights from across the United States. Interviewees were selected on the basis of the size of the population their LHD serves, as well as level of informatics capacity. Interviews were transcribed, verified, and double coded. Major barriers to doing more with informatics included staff capacity and training, financial constraints, dependency on state health agency, and small LHD size/lack of regionalization. When asked about the role of leadership in expanding informatics, interviewees said that leaders could make it a priority through (1) learning more about informatics and (2) creating appropriate budgets for integrated information systems. Local health department leaders said that they desired data that were timely and geographically specific. In addition, LHD leaders said that they desired greater access to clinical data, especially around chronic disease indicators. Local health department leadership desires to have timely or even real-time data. Local health departments have a great potential to benefit from informatics, particularly electronic health records in advancing their administrative practices and service delivery, but financial and human capital represents the

HIV provider and patient perspectives on the Development of a Health Department “Data to Care” Program: a qualitative study

Directory of Open Access Journals (Sweden)

Julia C. Dombrowski

2016-06-01

Full Text Available Abstract Background U.S. health departments have not historically used HIV surveillance data for disease control interventions with individuals, but advances in HIV treatment and surveillance are changing public health practice. Many U.S. health departments are in the early stages of implementing “Data to Care” programs to assists persons living with HIV (PLWH with engaging in care, based on information collected for HIV surveillance. Stakeholder engagement is a critical first step for development of these programs. In Seattle-King County, Washington, the health department conducted interviews with HIV medical care providers and PLWH to inform its Data to Care program. This paper describes the key themes of these interviews and traces the evolution of the resulting program. Methods Disease intervention specialists conducted individual, semi-structured qualitative interviews with 20 PLWH randomly selected from HIV surveillance who had HIV RNA levels >10,000 copies/mL in 2009–2010. A physician investigator conducted key informant interviews with 15 HIV medical care providers. Investigators analyzed de-identified interview transcripts, developed a codebook of themes, independently coded the interviews, and identified codes used most frequently as well as illustrative quotes for these key themes. We also trace the evolution of the program from 2010 to 2015. Results PLWH generally accepted the idea of the health department helping PLWH engage in care, and described how hearing about the treatment experiences of HIV seropositive peers would assist them with engagement in care. Although many physicians were supportive of the Data to Care concept, others expressed concern about potential health department intrusion on patient privacy and the patient-physician relationship. Providers emphasized the need for the health department to coordinate with existing efforts to improve patient engagement. As a result of the interviews, the Data to Care

21 CFR 346.10 - Local anesthetic active ingredients.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Local anesthetic active ingredients. 346.10 Section 346.10 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... ingredient: (a) Benzocaine 5 to 20 percent. (b) Benzyl alcohol 1 to 4 percent. (c) Dibucaine 0.25 to 1...

Health Departments’ Engagement in Emergency Preparedness Activities: The Influence of Health Informatics Capacity

OpenAIRE

Gulzar H. Shah; Bobbie Newell; Ruth E. Whitworth

2016-01-01

Background: Local health departments (LHDs) operate in a complex and dynamic public health landscape, with changing demands on their emergency response capacities. Informatics capacities might play an instrumental role in aiding LHDs emergency preparedness. This study aimed to explore the extent to which LHDs’ informatics capacities are associated with their activity level in emergency preparedness and to identify which health informatics capacities are associated with improved em...

Radiological emergency response planning: Handbook for Federal Assistance to State and Local Governments

International Nuclear Information System (INIS)

1978-12-01

The handbook is directed toward those federal agencies involved in providing direct field assistance to state and local governments in radiological emergency response planning. Its principal purpose is to optimize the effectiveness of this effort by specifying the functions of the following federal agencies: Nuclear Regulatory Commission, Environmental Protection Agency, Department of Energy, Department of Health, Education, and Welfare, Department of Transportation, Defense Civil Preparedness Agency, Federal Disaster Assistance Administration, and Federal Preparedness Agency

Electronic health record case studies to advance environmental public health tracking.

Science.gov (United States)

Namulanda, Gonza; Qualters, Judith; Vaidyanathan, Ambarish; Roberts, Eric; Richardson, Max; Fraser, Alicia; McVeigh, Katharine H; Patterson, Scott

2018-03-01

Data from traditional public health surveillance systems can have some limitations, e.g., timeliness, geographic level, and amount of data accessible. Electronic health records (EHRs) could present an opportunity to supplement current sources of routinely collected surveillance data. The National Environmental Public Health Tracking Program (Tracking Program) sought to explore the use of EHRs for advancing environmental public health surveillance practices. The Tracking Program funded four state/local health departments to obtain and pilot the use of EHR data to address several issues including the challenges and technical requirements for accessing EHR data, and the core data elements required to integrate EHR data within their departments' Tracking Programs. The results of these pilot projects highlighted the potential of EHR data for public health surveillance of rare diseases that may lack comprehensive registries, and surveillance of prevalent health conditions or risk factors for health outcomes at a finer geographic level. EHRs therefore, may have potential to supplement traditional sources of public health surveillance data. Published by Elsevier Inc.

Structural Health Monitoring Based on Combined Structural Global and Local Frequencies

Directory of Open Access Journals (Sweden)

Jilin Hou

2014-01-01

Full Text Available This paper presents a parameter estimation method for Structural Health Monitoring based on the combined measured structural global frequencies and structural local frequencies. First, the global test is experimented to obtain the low order modes which can reflect the global information of the structure. Secondly, the mass is added on the member of structure to increase the local dynamic characteristic and to make the member have local primary frequency, which belongs to structural local frequency and is sensitive to local parameters. Then the parameters of the structure can be optimized accurately using the combined structural global frequencies and structural local frequencies. The effectiveness and accuracy of the proposed method are verified by the experiment of a space truss.

Epidemiology of Mental Health Attendances at Emergency Departments: Systematic Review and Meta-Analysis.

Directory of Open Access Journals (Sweden)

Helen Barratt

Full Text Available The characteristics of Emergency Department (ED attendances due to mental or behavioural health disorders need to be described to enable appropriate development of services. We aimed to describe the epidemiology of mental health-related ED attendances within health care systems free at the point of access, including clinical reason for presentation, previous service use, and patient sociodemographic characteristics.Systematic review and meta-analysis of observational studies describing ED attendances by patients with common mental health conditions.18 studies from seven countries met eligibility criteria. Patients attending due to mental or behavioural health disorders accounted for 4% of ED attendances; a third were due to self-harm or suicidal ideation. 58.1% of attendees had a history of psychiatric illness and up to 58% were admitted. The majority of studies were single site and of low quality so results must be interpreted cautiously.Prevalence studies of mental health-related ED attendances are required to enable the development of services to meet specific needs.

Dimensions of the local health care environment and use of care by uninsured children in rural and urban areas.

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Gresenz, Carole Roan; Rogowski, Jeannette; Escarce, José J

2006-03-01

Despite concerted policy efforts, a sizeable percentage of children lack health insurance coverage. This article examines the impact of the health care safety net and health care market structure on the use of health care by uninsured children. We used the Medical Expenditure Panel Survey linked with data from multiple sources to analyze health care utilization among uninsured children. We ran analyses separately for children who lived in rural and urban areas and assessed the effects on utilization of the availability of safety net providers, safety net funding, supply of primary care physicians, health maintenance organization penetration, and the percentage of people who are uninsured, controlling for other factors that influence use. Fewer than half of uninsured children had office-based visits to health care providers during the year, 8% of rural and 10% of urban children visited the emergency department at least once, and just over half of children had medical expenditures or charges during the year. Among uninsured children in rural areas, living closer to a safety net provider and living in an area with a higher supply of primary care physicians were positively associated with higher use and medical expenditures. In urban areas, the supply of primary care physicians and the level of safety net funding were positively associated with uninsured children's medical expenditures, whereas the percentage of the population that was uninsured was negatively associated with use of the emergency department. Uninsured children had low levels of utilization over a range of different health care provider types and settings. The availability of safety net providers in the local area and the safety net's capacity to serve the uninsured influence access to care among children. Possible measures for ensuring access to health care among uninsured children include increasing the density of safety net providers in rural areas, enhancing funding for the safety net, and policies

[Local public health networks. Apropos of an experience].

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Guix, Joan; Bocio, Ana; Ferràs, Joaquim; Margalef, Jordi; Osanz, Anna C; Serrano, Mónica; Sentenà, Anna

2013-01-01

Public health action on a territory is complex and requires the involvement of multiple actors, who do not always act coordinately. Networks of organizations structures including the whole of the local actors facilitate the generation of synergies and enable greater effectiveness and efficiency of the joint action from the different actors on a same landscape. We present 3 years experience of four Public Health Committees in a region of Catalonia (Spain), composed by the main actors in public health planning. Each of the committees is organized on a plenary and working groups on issues arising from the regional health diagnosis, and coincident with the Health Plan of the Region. Coordination in no case implies the loss or dilution of the firm of the actor generator of intervention initiative in public health, but their empowerment and collaboration by the other actors. In conclusion welcomes the creation of a culture of collaboration and synergies between the different organizations concerned. Lack of specificity is observed in establishing operational objectives, and the need for greater coordination and involvement of the components of the various working groups. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

Internal evaluation of public health department of Semnan university of medical sciences

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Behrad Pour- Mohammadi

2011-10-01

Full Text Available Introduction: Internal evaluation is a fundamental determinant to quality development in teachingdepartments and faculties. The purpose of this study was an internal departmental evaluation in the publichealth department of Semnan university of medical sciences (SUMS.Materials and Methods: This work was performed (during 2008-2009 in department of public health ofSUMS utilizing an accreditation model. The assessment covered 9 areas, namely: educational missions andobjectives, management and organization, educational programs, scientific board, students, educationalresources, research activities, assessment and evaluation, and graduates. Questionnaires were developed bythe scientific members of the department. After collecting the data, results were categorized according toGourman scoring scale, from unsatisfied class to very strong class, with the range of 1-5 scores.Results: The mean scores in the 9 evaluation areas were obtained and the rankings were as below:Educational programs area was in strong ranking; educational missions and objectives, scientific board,and assessment and evaluation areas were in good ranking; management and organization area was in morethan satisfied ranking; students area was in satisfied ranking; educational resources and research activitiesareas were in borderline ranking; and finally, the department was ranked as unsatisfied in the graduatesarea.Conclusions: Results showed that by achieved mean of 3.19 in whole of the evaluation areas, the publichealth department has placed in "more than satisfied" class. Although the overall status is acceptable, thereis a need to modify the weak points in the suboptimal areas to improve the educational quality in thisdepartment.

Residential Stability Reduces Unmet Health Care Needs and Emergency Department Utilization among a Cohort of Homeless and Vulnerably Housed Persons in Canada.

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Jaworsky, Denise; Gadermann, Anne; Duhoux, Arnaud; Naismith, Trudy E; Norena, Monica; To, Matthew J; Hwang, Stephen W; Palepu, Anita

2016-08-01

This study examined the association of housing status over time with unmet physical health care needs and emergency department utilization among homeless and vulnerably housed persons in Canada. Homeless and vulnerably housed individuals completed interviewer-administered surveys on housing, unmet physical health care needs, health care utilization, sociodemographic characteristics, substance use, and health conditions at baseline and annually for 4 years. Generalized logistic mixed effects regression models examined the association of residential stability with unmet physical health care needs and emergency department utilization, adjusting for potential confounders. Participants were from Vancouver (n = 387), Toronto (n = 390), and Ottawa (n = 396). Residential stability was associated with lower odds of having unmet physical health needs (adjusted odds ratio (AOR), 0.82; 95 % confidence interval (CI), 0.67, 0.98) and emergency department utilization (AOR, 0.74; 95 % CI, 0.62, 0.88) over the 4-year follow-up period, after adjusting for potential confounders. Residential stability is associated with fewer unmet physical health care needs and lower emergency department utilization among homeless and vulnerably housed individuals. These findings highlight the need to address access to stable housing as a significant determinant of health disparities.

The Use of Social Media by State Health Departments in the US: Analyzing Health Communication Through Facebook.

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Jha, Ayan; Lin, Leesa; Savoia, Elena

2016-02-01

The use of social media as a powerful health communication tool is an area of current research interest. Our objective was to describe use of Facebook by State Health Departments (SHDs) in US, and their relationship with CDC's Behavioral Risk Factor Surveillance System (BRFSS) data. Facebook pages of 34 SHDs were studied over a 200 day period, coding 2597 posts into 19 broad health communication categories. Mean number of Facebook posts per SHD was 76.4 (range 34-133); most frequent topic areas included healthy living (12%), communicable diseases (9%), vaccines and immunization (7%), emergency preparedness and response (7%), infant and child health (5%), smoking and tobacco use (5%), and miscellaneous (32%). Through web-based interactive graphics (Google motion charts), we contrasted Facebook posts with CDC's BRFSS data on adult nutrition and physical activity, vaccination, smoking, adolescent health and road traffic accidents. Our research finds an apparent disconnect between content provided on Facebook by SHDs and the health conditions that affect their populations. Acknowledging the severe limitations in funding and human resources faced by the SHDs, our research attempts to present the factual situation in embracing a vastly popular social media platform for health communication. We believe there is a need for research exploring methods to balance the demands and resources.

Interactions between global processes and local health problems. A human ecology approach to health among indigenous groups in the Amazon

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Maj-Lis Follér

Full Text Available This article deals with methodological issues and how to link global processes - social and ecological - with environmental changes and human health in local communities. The discussion concerns how interdisciplinary approaches can help us find tools to develop new knowledge. Scientific knowledge and local knowledge are not seen as opposite epistemological forms, but as socially and culturally constructed. Power and social legitimacy have to be included when analyzing how to deal with the interaction between global processes and local environmental change and the health/disease interface.

Health promotion at local level: a case study of content, organization and development in four Swedish municipalities

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Jansson Elisabeth VG

2010-08-01

Full Text Available Abstract Background Several health determinants are related to local conditions and prerequisites at community level. For this reason, strengthening community action has been one of five strategies implemented in health promotion since the end of the 1980s. Such action includes setting priorities, making decisions, planning strategies, and implementing them to achieve better health. The aim of this paper is to obtain a deeper understanding of content, organization and processes in the development of local health promotion. Methods A qualitative multiple case study of four Swedish municipalities. The cases were analyzed in accordance with the principles of cross-case study analysis, and a content analysis of documents and interviews was conducted in two steps. First, a manifest content analysis was performed to identify present and former actors and measures. Thereafter, a latent content analysis was performed to investigate structures and processes in local contexts. Results The results of the inductive content analysis showed development of local health promotion in three phases: initiation, action, and achievement. Strengthening factors were local actors, health statistics and events. Hindering factors were lack of resources and vague objectives. External factors, e.g. national policies, were not perceived as prominent influencing factors. Media reports were regarded as having had an influence, but only to some extent. The content of local health promotion has developed from ad-hoc lifestyle and behaviour-related actions into structural, intersectoral actions related to determinants of health. Conclusions The municipalities have organized and developed their health promotion targets, actions and priorities on the basis of local needs and prerequisites. The three phases in the identified health promotion processes were experienced and documented as being subject to greater influence from internal rather than external strengthening and hindering

Findings from case studies of state and local immunization programs.

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Fairbrother, G; Kuttner, H; Miller, W; Hogan, R; McPhillips, H; Johnson, K A; Alexander, E R

2000-10-01

As part of its examination of federal support for immunization services during the past decade, the Institute of Medicine (IOM) Committee on Immunization Finance Policies and Practices (IFPP) commissioned eight case studies of the states of Alabama, Maine, Michigan, New Jersey, North Carolina, Texas, and Washington; and a two-county study of Los Angeles and San Diego in California. Specifically, the IOM Committee and these studies reviewed the use of Section 317 grants by the states. Section 317 is a discretionary grant program that supports vaccine purchase and other immunization-related program activities. These studies afforded the Committee an in-depth look at local policy choices, the performance of immunization programs, and federal and state spending for immunization during the past decade. The case-study reports were developed through interviews with state and local health department officials, including immunization program directors, Medicaid agency staff, budget analysts, and Centers for Disease Control and Prevention public health advisors to the jurisdiction. Other sources included state and federal administrative records and secondary sources on background factors and state-level trends. The case studies were supplemented by site visits to Detroit, Houston, Los Angeles, Newark, and San Diego. The nature of immunization "infrastructure" supported by the Section 317 program is shifting from primarily service delivery to a broader set of roles that puts the public effort at the head of a broad immunization partnership among public health, health financing, and other entities in both the public and private sectors. The rate and intensity of transition vary across the case-study areas. In the emerging pattern, service delivery increasingly takes place in the private sector and is related to managed care. "Infrastructure" is moving beyond supporting a core state staff and local health department service delivery to include such activities as immunization

Occupational Exposure to HIV: Advice for Health Care Workers

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... coworkers. Seek immediate medical care. Go to your employee health unit, emergency department, or personal doctor. Once ... you may want to seek support. Try an employee-assistance program or local mental health expert. Questions ...

An integrated program to train local health care providers to meet post-disaster mental health needs Programa integrado para entrenar a proveedores de servicios sanitarios locales a satisfacer las necesidades de salud mental después de un desastre

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Stan Kutcher

2005-11-01

Full Text Available This paper describes a post-disaster mental health training program developed by the International Section of the Department of Psychiatry at Dalhousie University (Halifax, Canada and delivered in Grenada after Hurricane Ivan struck the country in September 2004. This train-the-trainer program used an integrated community health model to help local health care providers develop the necessary skills for the identification and evidenced-based treatment of mental disorders occurring after a natural disaster. The approach also provided for ongoing, sustainable mental health care delivered in the community setting, as advocated by the World Health Organization and the Pan American Health Organization. This approach is in contrast to the largely ineffective and costly vertical whole-population psychosocial counseling activities that have often been used in the Caribbean following natural disasters.En el presente trabajo se describe un programa de entrenamiento para la atención de la salud mental después de desastres, desarrollado por la Sección Internacional del Departamento de Psiquiatría de la Universidad de Dalhousie (Halifax, Canadá y llevado a cabo en la isla de Granada después de que el huracán Iván azotó ese país en septiembre de 2004. Este programa de entrenamiento para entrenadores utilizó un modelo integrado de salud comunitaria para ayudar a los proveedores de los servicios sanitarios locales a desarrollar las habilidades necesarias para identificar los trastornos mentales frecuentes después de un desastre natural y aplicar tratamientos basados en pruebas científicas. Este programa también favorece el enfoque actual de atención sostenible de salud mental en la comunidad, promovido por la Organización Mundial de la Salud y la Organización Panamericana de la Salud. Además, se contrapone a las actividades verticales de consejería psicosocial dirigidas a toda la población, en su mayoría ineficaces y costosas, que se han

20 years of local ecological public health: the experience of Sandwell in the English West Midlands.

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Middleton, J; Saunders, P

2015-10-01

A long-term picture of the economy and living conditions of Sandwell, an area of England's industrial Midlands, is presented to explore how these underpin and influence its 'health economy'. Sandwell's experience illustrates how public health actors have to tackle industrial and other factors which shape human health. The paper explores how the ecological public health perspective has helped inform the modern public health task in an area such as Sandwell. Some lessons are offered, including: the need to understand the specific economic legacy of a local area (in Sandwell, principally one of polluting and then declining manufacturing industries); the continuing story of infection control; the complexity of tackling poor diet; and the importance of the built environment and town planning. Faced by such challenges, local public health action represents, in effect, an attempt to transcend unecological public health. This can be exciting, innovative and ultimately successful; but it also means being prepared to face daunting and politically charged obstacles and superior national or international forces over which local public health practitioners conventionally have little leverage. The paper argues that, in such unequal power circumstances, public health practitioners have to draw on the creativity within the local population and build a facilitative alliance of formal and informal pro-public health actors. Despite the confounding odds and ever-present stretched resources, the Sandwell experience gives grounds for optimism, being a story of constant creativity and effective local alliances. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Health and equity in all policies in local government: processes and outcomes in two Norwegian municipalities.

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Von Heimburg, Dina; Hakkebo, Berit

2017-08-01

To identify key factors in implementing Health and Equity in All Policies (HEiAP) at the local level in two Norwegian municipalities in order to accelerate the progress of promoting health, well-being and equity in other local governments. This case study is presented as a narrative from policy-making processes in two Norwegian municipalities. The story is told from an insider perspective, with a focus on HEiAP policy makers in these two municipalities. The narrative identified key learning from implementing HEiAP at the local level, i.e. the importance of strengthening system and human capacities. System capacity is strengthened by governing HEiAP according to national legislation and a holistic governance system at the local level. Municipal plans are based on theory, evidence and local data. A 'main story' is developed to support the vision, defining joint societal goals and co-creation strategies. Policies are anchored by measuring and monitoring outcomes, sharing accountability and continuous dialogue to ensure political commitment. Human capacity is strengthened through participatory leadership, soft skills and health promotion competences across sectors. Health promotion competence at a strategic level in the organization, participation in professional networks, crowd sourcing toward common goals, and commitment through winning hearts and minds of politicians and other stakeholders are vital aspects. Our experience pinpoints the importance of strengthening system and human capacity in local governments. Further, we found it important to focus on the two strategic objectives in the European strategy 'Health 2020': (1) Improving health for all and reducing health inequalities; (2) improving leadership and participatory governance for health.

An Evaluation of the Cybersecurity Policies for the United States Health & Human Services Department: Criteria, Regulations, and Improvements

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Derek Mohammed

2014-04-01

Full Text Available This paper examines the criteria necessary for the evaluation of the cybersecurity policies for the United States Health and Human Services Department of the Federal Government. The overall purpose of cybersecurity policies and procedures is supported through compliance with Federal mandated regulation and standards, which serve to protect the organizational services and goals of the United States Health and Human Services Department, and to promote the best possible security practices in the protection of information systems from unauthorized actors and cyber-threats. The criteria of the cybersecurity evaluation is identified and analyzed for quality, strengths, weaknesses, and future applicability. Topics within the criteria include organizational operation, regulations and industrial standards compliance, service delivery to national customers, and the prevention and mitigation of IT system and security failure. This analysis determines the strengths and weaknesses, and makes recommendations for revising the cybersecurity policies within the United States Health and Human Services Department.

Developing an academia-based public health observatory: the new global public health observatory with emphasis on urban health at Johns Hopkins Bloomberg School of Public Health

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Carlos Castillo-Salgado

2015-11-01

Full Text Available Abstract Health observatories may differ according to their mission, institutional setting, topical emphasis or geographic coverage. This paper discusses the development of a new urban-focused health observatory, and its operational research and training infrastructure under the academic umbrella of the Department of Epidemiology and the Institute of Urban Health at the Johns Hopkins Bloomberg School of Public Health (BSPH in Baltimore, USA. Recognizing the higher education mission of the BSPH, the development of a new professional training in public health was an important first step for the development of this observatory. This new academia-based observatory is an innovative public health research and training platform offering faculty, investigators, professional epidemiology students and research partners a physical and methodological infrastructure for their operational research and training activities with both a local urban focus and a global reach. The concept of a public health observatory and its role in addressing social health inequalities in local urban settings is discussed.

Developing an academia-based public health observatory: the new global public health observatory with emphasis on urban health at Johns Hopkins Bloomberg School of Public Health.

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Castillo-Salgado, Carlos

2015-11-01

Health observatories may differ according to their mission, institutional setting, topical emphasis or geographic coverage. This paper discusses the development of a new urban-focused health observatory, and its operational research and training infrastructure under the academic umbrella of the Department of Epidemiology and the Institute of Urban Health at the Johns Hopkins Bloomberg School of Public Health (BSPH) in Baltimore, USA. Recognizing the higher education mission of the BSPH, the development of a new professional training in public health was an important first step for the development of this observatory. This new academia-based observatory is an innovative public health research and training platform offering faculty, investigators, professional epidemiology students and research partners a physical and methodological infrastructure for their operational research and training activities with both a local urban focus and a global reach. The concept of a public health observatory and its role in addressing social health inequalities in local urban settings is discussed.

Achieving Health Equity Through Community Engagement in Translating Evidence to Policy: The San Francisco Health Improvement Partnership, 2010?2016

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Grumbach, Kevin; Vargas, Roberto A.; Fleisher, Paula; Arag?n, Tom?s J.; Chung, Lisa; Chawla, Colleen; Yant, Abbie; Garcia, Estela R.; Santiago, Amor; Lang, Perry L.; Jones, Paula; Liu, Wylie; Schmidt, Laura A.

2017-01-01

Background The San Francisco Health Improvement Partnership (SFHIP) promotes health equity by using a novel collective impact model that blends community engagement with evidence-to-policy translational science. The model involves diverse stakeholders, including ethnic-based community health equity coalitions, the local public health department, hospitals and health systems, a health sciences university, a school district, the faith community, and others sectors. Community Context We report o...

[Attitudes and behaviour concerning cigarette smoking among the students of the first year at the Health Department].

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Kowalska, Alina; Rzeźnicki, Adam; Drygas, Wojciech

2006-01-01

Smoking is still very common in Poland. Our country is among the leading countries with the greatest consumption of cigarettes. It is estimated that currently, there are about 40% smokers among men and 20% among women. In the future, most of the graduates from the Health Department will take care of the promotion of healthy life style and health education in the society. It is important that their theoretical knowledge be supported by proper health bases. A health centre worker who is inhaling smoke and at the same time encouraging quitting smoking is by no means credible. The aim of this work was to establish the participation of those students who are inhaling tobacco smoke that is among the students of the three departments of daily students of the Health Department. There were 108 female students who underwent the survey among the first year students of the Heath Department of Medical University of Lodz. The tool used was a survey. In the research carried out between 1st and 15th March 2006, 104 students (96.3%) took part. Among those who handed the surveys back, there were 32 males (30.8%) and 72 women (69.2%). In the group of respondents, which included 104 people, 33 (31.7%) stated that in January and February 2006 smoked cigarettes and 71 people (68.3%) claimed that within that time they did not smoke a single cigarette. Among the smokers, there were 11 males (f = 0.33) and 22 women (f = 0.67), whereas in the non-smokers' group, there were 21 male students (f = 0.30) and 50 female students (f = 0.70). In the past, there were 55 surveyed who inhaled tobacco smoke (52.9%), whereas 49 surveyed (47.1%) stated that they had never smoked in the past. In the smokers' group, there were 18 male students (f = 0.30) and 37 female students (f = 0.70). Among those who claimed they had never smoked before, there were 14 male students (f = 0.30) and 35 female students studies of the Health Department of Medical University of Lodz inhaled tobacco smoke. In comparison with

Microbiological quality of local soymilk: a public health appraisal ...

African Journals Online (AJOL)

The ubiquity in the hawking of locally produced soymilk, packaged in different forms, was considered a public health concern. The attendant increase in the rate of soymilk consumption has encouraged low scale production of the milk under household condition with little or no regard to quality control measures. Accordingly ...

Health Impact Assessment (HIA) in Ireland and the role of local government

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O' Mullane, Monica, E-mail: Monica.omullane@truni.sk [Department of Public Health, Faculty of Health Care and Social Work/Fakulta Zdravotnictva a Socialnej Prace, Trnavska univerzita, Univerzitne namestie 1, 917 01 Trnava (Slovakia); Quinlivan, Aodh, E-mail: A.quinlivan@ucc.ie [Department of Government, College of Business and Law, 2nd Floor O' Rahilly Building, University College Cork (Ireland)

2012-01-15

Background: Health Impact Assessment (HIA) in Ireland has developed significantly since its endorsement in the health strategies of the Republic of Ireland (2001) and Northern Ireland (2002). Throughout 2007 and 2008, research was conducted to examine HIA as a policy-informing tool throughout both jurisdictions. One aspect of this research investigated the role of local government and its relationship in advancing HIA practise and use in Ireland. Methods: A case study research design was used which employed qualitative research methods, including semistructured interviewing and participant observation. In total 48 interviews were conducted with members of the HIA steering committees and individuals closely involved in the HIAs. Results: The relationship between local government and HIA in Northern Ireland is a positive one given the strong tradition of local government in the jurisdiction. The Review of Public Administration (RPA) negatively influenced the integration of HIA into local authority procedures. In the Republic of Ireland, the influence of social values and political will was found to be negatively present with the HIA on Traveller accommodation. Evidence from the HIA conducted on traffic and transport in Dublin was used to plan further health promotion and community planning activities in the area. Conclusion: Local government plays a vital role in HIA practise and development in both jurisdictions. The willingness to work with external partners (such as the health care services) was an important enabler or barrier to HIA operation. This will remain the case in the foreseeable future. - Highlights: Black-Right-Pointing-Pointer We investigated influences on the use of HIA knowledge of four cases from Northern Ireland and the Republic of Ireland. Black-Right-Pointing-Pointer The engagement of the public authorities assists implementation of the findings of the HIA. Black-Right-Pointing-Pointer Tension continues between positivist and incrementalist

Health Impact Assessment (HIA) in Ireland and the role of local government

International Nuclear Information System (INIS)

O'Mullane, Monica; Quinlivan, Aodh

2012-01-01

Background: Health Impact Assessment (HIA) in Ireland has developed significantly since its endorsement in the health strategies of the Republic of Ireland (2001) and Northern Ireland (2002). Throughout 2007 and 2008, research was conducted to examine HIA as a policy-informing tool throughout both jurisdictions. One aspect of this research investigated the role of local government and its relationship in advancing HIA practise and use in Ireland. Methods: A case study research design was used which employed qualitative research methods, including semistructured interviewing and participant observation. In total 48 interviews were conducted with members of the HIA steering committees and individuals closely involved in the HIAs. Results: The relationship between local government and HIA in Northern Ireland is a positive one given the strong tradition of local government in the jurisdiction. The Review of Public Administration (RPA) negatively influenced the integration of HIA into local authority procedures. In the Republic of Ireland, the influence of social values and political will was found to be negatively present with the HIA on Traveller accommodation. Evidence from the HIA conducted on traffic and transport in Dublin was used to plan further health promotion and community planning activities in the area. Conclusion: Local government plays a vital role in HIA practise and development in both jurisdictions. The willingness to work with external partners (such as the health care services) was an important enabler or barrier to HIA operation. This will remain the case in the foreseeable future. - Highlights: ► We investigated influences on the use of HIA knowledge of four cases from Northern Ireland and the Republic of Ireland. ► The engagement of the public authorities assists implementation of the findings of the HIA. ► Tension continues between positivist and incrementalist approaches towards HIA.

Demarcation of local neighborhoods to study relations between contextual factors and health

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Chor Dora

2010-06-01

Full Text Available Abstract Background Several studies have highlighted the importance of collective social factors for population health. One of the major challenges is an adequate definition of the spatial units of analysis which present properties potentially related to the target outcomes. Political and administrative divisions of urban areas are the most commonly used definition, although they suffer limitations in their ability to fully express the neighborhoods as social and spatial units. Objective This study presents a proposal for defining the boundaries of local neighborhoods in Rio de Janeiro city. Local neighborhoods are constructed by means of aggregation of contiguous census tracts which are homogeneous regarding socioeconomic indicators. Methodology Local neighborhoods were created using the SKATER method (TerraView software. Criteria used for socioeconomic homogeneity were based on four census tract indicators (income, education, persons per household, and percentage of population in the 0-4-year age bracket considering a minimum population of 5,000 people living in each local neighborhood. The process took into account the geographic boundaries between administrative neighborhoods (a political-administrative division larger than a local neighborhood, but smaller than a borough and natural geographic barriers. Results The original 8,145 census tracts were collapsed into 794 local neighborhoods, distributed along 158 administrative neighborhoods. Local neighborhoods contained a mean of 10 census tracts, and there were an average of five local neighborhoods per administrative neighborhood. The local neighborhood units demarcated in this study are less socioeconomically heterogeneous than the administrative neighborhoods and provide a means for decreasing the well-known statistical variability of indicators based on census tracts. The local neighborhoods were able to distinguish between different areas within administrative neighborhoods

Demarcation of local neighborhoods to study relations between contextual factors and health.

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Santos, Simone M; Chor, Dora; Werneck, Guilherme Loureiro

2010-06-29

Several studies have highlighted the importance of collective social factors for population health. One of the major challenges is an adequate definition of the spatial units of analysis which present properties potentially related to the target outcomes. Political and administrative divisions of urban areas are the most commonly used definition, although they suffer limitations in their ability to fully express the neighborhoods as social and spatial units. This study presents a proposal for defining the boundaries of local neighborhoods in Rio de Janeiro city. Local neighborhoods are constructed by means of aggregation of contiguous census tracts which are homogeneous regarding socioeconomic indicators. Local neighborhoods were created using the SKATER method (TerraView software). Criteria used for socioeconomic homogeneity were based on four census tract indicators (income, education, persons per household, and percentage of population in the 0-4-year age bracket) considering a minimum population of 5,000 people living in each local neighborhood. The process took into account the geographic boundaries between administrative neighborhoods (a political-administrative division larger than a local neighborhood, but smaller than a borough) and natural geographic barriers. The original 8,145 census tracts were collapsed into 794 local neighborhoods, distributed along 158 administrative neighborhoods. Local neighborhoods contained a mean of 10 census tracts, and there were an average of five local neighborhoods per administrative neighborhood.The local neighborhood units demarcated in this study are less socioeconomically heterogeneous than the administrative neighborhoods and provide a means for decreasing the well-known statistical variability of indicators based on census tracts. The local neighborhoods were able to distinguish between different areas within administrative neighborhoods, particularly in relation to squatter settlements. Although the literature on

Health insurance, neighborhood income, and emergency department usage by Utah children 1996–1998

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Knight Stacey

2005-04-01

Full Text Available Abstract Background It is estimated that approximately half of emergency department (ED usage in the U.S. and other developed countries is for non-urgent conditions and that this usage is related to availability, social, and economic factors. We examined pediatric ED usage in a U.S. state with respect to income, health insurance status, types of medical conditions, and whether introduction of managed care affected utilization by Medicaid children. Methods Emergency department usage rates were calculated from 1996 through 1998 using Utah ED data for children with commercial health insurance, Medicaid, for uninsured children, and by income group estimating neighborhood household income from Zip code of residence. We analyzed usage following the July 1996 transition of Utah Medicaid to managed care. Results Children with Medicaid had approximately 50% greater ED utilization rates than children with commercial health insurance or uninsured children. The majority of usage for Medicaid and uninsured children was for non-traumatic conditions. Only 35% of total ED usage was for non-emergent or non-urgent conditions and this was related to both Medicaid and low household income. Children lacking health insurance were more likely to be discharged against medical advice (OR = 2.36, 95% C.I. 1.88–2.96. There was no reduction in Medicaid ED usage following the transition to managed care. Conclusion Usage of ED services is related to both health insurance status and income. Children lacking health insurance and Medicaid children have excessive usage for conditions which could be treated in a primary care setting. That managed care does not reduce Medicaid ED usage is consistent with findings of other studies.

What predicts recovery orientation in county departments of mental health? A pilot study.

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Brown, Timothy T; Mahoney, Christine B; Adams, Neal; Felton, Mistique; Pareja, Candy

2010-09-01

In this pilot study we examined the determinants of recovery orientation among employees and influential stakeholders in a sample of 12 county departments of mental health in California. A two-level hierarchical linear model with random intercepts was estimated. Analyses show that recovery orientation has a U-shaped relationship with the age of staff/influential stakeholders and is negatively related to the difference between the desired level of adhocracy and the current level of adhocracy. Recovery orientation is positively related to the education level of staff/influential stakeholders, satisfying transformational leadership outcomes, and larger mental health budgets per capita. Policy implications are discussed.

Does eating local food reduce the environmental impact of food production and enhance consumer health?

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Edwards-Jones, Gareth

2010-11-01

The concept of local food has gained traction in the media, engaged consumers and offered farmers a new marketing tool. Positive claims about the benefits of local food are probably not harmful when made by small-scale producers at the local level; however, greater concern would arise should such claims be echoed in policy circles. This review examines the evidence base supporting claims about the environmental and health benefits of local food. The results do not offer any support for claims that local food is universally superior to non-local food in terms of its impact on the climate or the health of consumers. Indeed several examples are presented that demonstrate that local food can on occasions be inferior to non-local food. The analysis also considers the impact on greenhouse gas emissions of moving the UK towards self-sufficiency. Quantitative evidence is absent on the changes in overall emissions that would occur if the UK switched to self-sufficiency. A qualitative assessment suggests the emissions per item of food would probably be greater under a scenario of self-sufficiency than under the current food system. The review does not identify any generalisable or systematic benefits to the environment or human health that arise from the consumption of local food in preference to non-local food.

Estimating the Health and Economic Impacts of Changes in Local Air Quality

Science.gov (United States)

Carvour, Martha L.; Hughes, Amy E.; Fann, Neal

2018-01-01

Objectives. To demonstrate the benefits-mapping software Environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE), which integrates local air quality data with previously published concentration–response and health–economic valuation functions to estimate the health effects of changes in air pollution levels and their economic consequences. Methods. We illustrate a local health impact assessment of ozone changes in the 10-county nonattainment area of the Dallas–Fort Worth region of Texas, estimating the short-term effects on mortality predicted by 2 scenarios for 3 years (2008, 2011, and 2013): an incremental rollback of the daily 8-hour maximum ozone levels of all area monitors by 10 parts per billion and a rollback-to-a-standard ambient level of 65 parts per billion at only monitors above that level. Results. Estimates of preventable premature deaths attributable to ozone air pollution obtained by the incremental rollback method varied little by year, whereas those obtained by the rollback-to-a-standard method varied by year and were sensitive to the choice of ordinality and the use of preloaded or imported data. Conclusions. BenMAP-CE allows local and regional public health analysts to generate timely, evidence-based estimates of the health impacts and economic consequences of potential policy options in their communities. PMID:29698094

Health promotion in Danish schools: local priorities, policies and practices.

Science.gov (United States)

Simovska, Venka; Nordin, Lone Lindegaard; Madsen, Katrine Dahl

2016-06-01

This article discusses the findings from a study mapping out the priorities, policies and practices of local authorities concerning health promotion (HP) and health education (HE) in primary and lower secondary schools in Denmark. The aim of the study was to identify the gaps, tensions and possibilities associated with the demand to increase the quality and effectiveness of HP in schools. The recent national school reform, which emphasizes the importance of health and well-being while simultaneously increasing the focus on performance and accountability in terms of subject proficiency and narrowly defined academic attainment, provides the broader political context for the study. Data were generated through a structured online survey administered to all 98 Danish municipalities. Respondents were educational consultants or others representing the administrative units responsible for the municipality's schools. The findings were discussed within the conceptual framework of Health Promoting Schools. The study points to a potential tension between the health and education sectors, despite evidence of intersectoral collaboration. While there is a strong policy focus on health and well-being in schools, it is disconnected from the utilization of the HE curriculum by the municipal consultants. The study also points to a lack of professional development opportunities for teachers in the field of HP in schools. On the basis of these findings and theoretical perspectives used, we argue that HP in schools needs to (re)connect with the core task of the school, education, and to integrate both health and education goals in local priorities, policies and practices. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Florida Department of Health Workers’ Response to 2004 Hurricanes: A Qualitative Analysis

Science.gov (United States)

Herberman Mash, Holly B.; Fullerton, Carol S.; Kowalski-Trakofler, Kathleen; Reissman, Dori B.; Scharf, Ted; Shultz, James M.; Ursano, Robert J.

2015-01-01

Objective Examinations of the demands on public health workers after disaster exposure have been limited. Workers provide emergency care while simultaneously risking injury, damage to personal property, and threats to their own and their family’s safety. We examined the disaster management experiences of 4323 Florida Department of Health workers 9 months after their response to 4 hurricanes and 1 tropical storm during a 7-week period in August and September of 2004. Methods Participants completed a self-report questionnaire focused on work performance, mental and physical health, daily functioning, sleep disturbance, physiological arousal, and injury and work demand at the time of the hurricanes, and answered open-ended questions that described their experiences in more detail. Results A qualitative analysis conducted from the write-in data yielded 4 domains: (1) work/life balance; (2) training for disaster response role; (3) workplace support; and (4) recovery. Conclusions Study findings highlighted a number of concerns that are important to public health workers who provide emergency care after a disaster and, in particular, multiple disasters such as during the 2004 hurricane season. The findings also yielded important recommendations for emergency public health preparedness. PMID:24618166

Florida Department of Health workers' response to 2004 hurricanes: a qualitative analysis.

Science.gov (United States)

Herberman Mash, Holly B; Fullerton, Carol S; Kowalski-Trakofler, Kathleen; Reissman, Dori B; Scharf, Ted; Shultz, James M; Ursano, Robert J

2013-04-01

Examinations of the demands on public health workers after disaster exposure have been limited. Workers provide emergency care while simultaneously risking injury, damage to personal property, and threats to their own and their family's safety. We examined the disaster management experiences of 4323 Florida Department of Health workers 9 months after their response to 4 hurricanes and 1 tropical storm during a 7-week period in August and September of 2004. Participants completed a self-report questionnaire focused on work performance, mental and physical health, daily functioning, sleep disturbance, physiological arousal, and injury and work demand at the time of the hurricanes, and answered open-ended questions that described their experiences in more detail. A qualitative analysis conducted from the write-in data yielded 4 domains: (1) work/life balance; (2) training for disaster response role; (3) workplace support; and (4) recovery. Study findings highlighted a number of concerns that are important to public health workers who provide emergency care after a disaster and, in particular, multiple disasters such as during the 2004 hurricane season. The findings also yielded important recommendations for emergency public health preparedness.

Integration of environmental stewardship and local economic development to enhance community health.

Science.gov (United States)

Levine, Jay F

2011-01-01

Environmental groups working to preserve natural ecosystems and groups working to enhance local economic development often find themselves on philosophically opposite sides of the negotiation table. Case histories of cooperative engagement are provided that serve as examples of how environmental stewardship is compatible with local economic development and community health.

The value from investments in health information technology at the U.S. Department of Veterans Affairs.

Science.gov (United States)

Byrne, Colene M; Mercincavage, Lauren M; Pan, Eric C; Vincent, Adam G; Johnston, Douglas S; Middleton, Blackford

2010-04-01

We compare health information technology (IT) in the Department of Veterans Affairs (VA) to norms in the private sector, and we estimate the costs and benefits of selected VA health IT systems. The VA spent proportionately more on IT than the private health care sector spent, but it achieved higher levels of IT adoption and quality of care. The potential value of the VA's health IT investments is estimated at $3.09 billion in cumulative benefits net of investment costs. This study serves as a framework to inform efforts to measure and calculate the benefits of federal health IT stimulus programs.

[Local planning: the speech of basic health care center manager].

Science.gov (United States)

Cubas, Márcia Regina

2005-01-01

As planning is understood as a management tool, this article offers an argument through the speech framework of Basic Health Care Center Managers in the city of Curitiba-PR, by means of the Collective Subject Speech Methodology on local planning aspects. Its purpose is to bring local managers to a reflection concerning their styles, practices and experiences, as well as to collaborate with central level leading teams towards building their planning processes in an upward, participatory, communicative and strategic way. Considerations of the speeches built from central ideas are presented: planning methodology; inter-sectoriality; territorial basis; team and community participation; training, autonomy and particular profile of local managers; the manager's agenda; and institutional culture.

Radiological safety programme for the health departments in Parana, Brazil

International Nuclear Information System (INIS)

Schmidt, M.F.S.; Tilly, J.G. Jr.

1998-01-01

As a result of Brazil's centralized administration in the past, various parts of the public service were somewhat inefficient. Another reason was the size of the country. To improve the situation in the health sector, it was decided to transfer administrative responsibility to the municipal authorities. Accordingly, the public health system is now defined under the appropriate legislation as the 'Unified Health System' (SUS), comprising federal, state and municipal levels. This system promotes decentralization of therapeutic or preventive services (including the Radiation Facility Health Inspectorate) and proposes any additional legislation required. In Parana the Radiation Facility Health Inspectorate has 3600 organizations listed, employing ionizing radiation in medicine, industry and research, which need to be regularly inspected for licensing and control. In 1994, 50% of the annual inspection target in the state was attained. The Radiation Safety Programme for the Health Departments in Parana directs these activities in this State. Its strategies are: (1) to establish implementation phases for activities planned for each area; (2) to take advantage of the SUS structure to introduce or expand operational services at the primary, secondary and tertiary levels with appropriate equipment. The tertiary level involves co-ordination of the Programme and complementary executive functions, as well as maintaining an information system with other related organizations. The other levels include licensing, control and emergency response. As the Programme develops, indicators will be established to help identify progress achieved and correct operating strategy where necessary. Thus, the services provided to the public will be enhanced in quality and the radiation doses reduced. In addition, in emergency situations, the time elapsing between the event and its notification to the authorities will be reduced, minimizing the consequences of any accidents. (author)

Lessons Learned in Promoting Evidence-Based Public Health: Perspectives from Managers in State Public Health Departments.

Science.gov (United States)

Allen, Peg; Jacob, Rebekah R; Lakshman, Meenakshi; Best, Leslie A; Bass, Kathryn; Brownson, Ross C

2018-03-02

Evidence-based public health (EBPH) practice, also called evidence-informed public health, can improve population health and reduce disease burden in populations. Organizational structures and processes can facilitate capacity-building for EBPH in public health agencies. This study involved 51 structured interviews with leaders and program managers in 12 state health department chronic disease prevention units to identify factors that facilitate the implementation of EBPH. Verbatim transcripts of the de-identified interviews were consensus coded in NVIVO qualitative software. Content analyses of coded texts were used to identify themes and illustrative quotes. Facilitator themes included leadership support within the chronic disease prevention unit and division, unit processes to enhance information sharing across program areas and recruitment and retention of qualified personnel, training and technical assistance to build skills, and the ability to provide support to external partners. Chronic disease prevention leaders' role modeling of EBPH processes and expectations for staff to justify proposed plans and approaches were key aspects of leadership support. Leaders protected staff time in order to identify and digest evidence to address the common barrier of lack of time for EBPH. Funding uncertainties or budget cuts, lack of political will for EBPH, and staff turnover remained challenges. In conclusion, leadership support is a key facilitator of EBPH capacity building and practice. Section and division leaders in public health agencies with authority and skills can institute management practices to help staff learn and apply EBPH processes and spread EBPH with partners.

[Management policy-making for work and education in health: the case of the Bahia State Health Department, Brazil, 2007-2008].

Science.gov (United States)

Pinto, Isabela Cardoso de Matos; Teixeira, Carmen Fontes

2011-09-01

The construction of Brazil's Unified National Health System (SUS) has raised a set of challenges for the health sector's administrators and personnel, including issues of work management and continuing education for health workers, in view of the financial, political, and organizational constraints in the process of changing the healthcare model. The current study aimed to analyze the process of formulating the Health Work and Education Management Policy by the Bahia State Health Department. Public policy cycle was used as the theoretical framework. The study analyzed data from institutional documents and records of participant observation by one of the authors. The results include mapping the governmental and nongovernmental stakeholders that participated in the process. The analysis highlights a series of problems in the SUS in Bahia related to work management and health workers' profile, taken as the point of departure for priority-setting in the State Strategic Agenda and Health Plan for 2008-2011.

[Local health promotion plans: intersetoralities created in the territory].

Science.gov (United States)

Moysés, Simone Tetu; Franco de Sá, Ronice

2014-11-01

The article highlights the importance of considering the specificities of spaces/territories/ locations of individual and collective life in creating health promotion actions. It explores how this approach has conceptually consolidated respect for territoriality and territorial actions as a principle and an operational health promotion strategy. Based on the literature, the article also points to the need to envision the territory occupied as a locus to put intersetorialities into practice, giving a voice to people who live there, seek to and solve their complex problems, to existing and emerging social networks. It also presents a nationally and internationally validated strategy/method (Bamboo Method) for the development of local health promotion plans, which enables the prioritization of actions by listening to the people and to the managers.

Implementation of a guideline for local health policy making by regional health services: exploring determinants of use by a web survey

NARCIS (Netherlands)

Kuunders, T.J.M.; Jacobs, M.A.M.; Goor, I.A.M. van de; Bon-Martens, M.J.H. van; Oers, H.A.M. van; Paulussen, T.G.W.M.

2017-01-01

Background. Previous evaluation showed insufficient use of a national guideline for integrated local health policy by Regional Health Services (RHS) in the Netherlands. The guideline focuses on five health topics and includes five checklists to support integrated municipal health policies. This

Local health rules and building regulations: a survey on local hygiene and building regulations in Italian municipalities.

Science.gov (United States)

Gola, Marco; Signorelli, Carlo; Buffoli, Maddalena; Rebecchi, Andrea; Capolongo, Stefano

2017-01-01

WHO has highlighted the need to strengthen the relationship between health and built environment factors, such as inappropriate housing conditions. Local Health Rules (LHRs) and Building Regulations (BRs) are tools which provide safety and building hygiene in construction practices. Currently the Italian Government is considering to establish a National Building Regulation and, related to the following purpose, this paper presents a survey on the status of adoption and updating of LHRs and BRs in Italian municipalities. The current Italian state of LHRs, BRs and Municipal Development Plans (MDPs) have been examined by a survey considering a sample of about 550 cities, with different demo graphic and geographic features, starting from the previous research work by Signorelli et al. (1999). The analysis underlines a serious shortage of updated LHRs, especially in small and medium-sized municipalities whereas BRs and MDPs are widespread. Only 30% of them are previously approved and validated by Local Health Authorities. Starting from a survey, the present scenario of Building Regulations requires the introduction of further performance guidelines instead of normative ones and, therefore, the current actions to give rise to a National Building Regulation could be integrated by building hygiene contents of LHRs.

Order of draw practices in venous blood sampling at clinical biochemistry departments in the Danish health care system

DEFF Research Database (Denmark)

Jacobsen, Katja Kemp; Brandt, Ida; Christensen, Anne Vindahl

2018-01-01

the procedures in venous blood sampling among clinical biochemistry departments to assess the uniformity of order of blood draw and adherence to international guidelines in the Danish health care system. METHODS: We collected venous order of draw procedures from 49 clinical biochemistry departments at 22 public...... 15189:2012 accreditation (p = .57). CONCLUSIONS: Venous order of draw procedures is diverse at Danish clinical biochemistry departments and show moderate adherence to international guidelines....

Local health care expenditure plans and their opportunity costs.

Science.gov (United States)

Karlsberg Schaffer, Sarah; Sussex, Jon; Devlin, Nancy; Walker, Andrew

2015-09-01

In the UK, approval decisions by Health Technology Assessment bodies are made using a cost per quality-adjusted life year (QALY) threshold, the value of which is based on little empirical evidence. We test the feasibility of estimating the "true" value of the threshold in NHS Scotland using information on marginal services (those planned to receive significant (dis)investment). We also explore how the NHS makes spending decisions and the role of cost per QALY evidence in this process. We identify marginal services using NHS Board-level responses to the 2012/13 Budget Scrutiny issued by the Scottish Government, supplemented with information on prioritisation processes derived from interviews with Finance Directors. We search the literature for cost-effectiveness evidence relating to marginal services. The cost-effectiveness estimates of marginal services vary hugely and thus it was not possible to obtain a reliable estimate of the threshold. This is unsurprising given the finding that cost-effectiveness evidence is rarely used to justify expenditure plans, which are driven by a range of other factors. Our results highlight the differences in objectives between HTA bodies and local health service decision makers. We also demonstrate that, even if it were desirable, the use of cost-effectiveness evidence at local level would be highly challenging without extensive investment in health economics resources. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Implementation of a guideline for local health policy making by regional health services : Exploring determinants of use by a web survey

NARCIS (Netherlands)

Kuunders, T.J.M.; Jacobs, M.A.M.; Paulussen, T.G.W.M.; van de Goor, L.A.M.; van Bon, M.J.H.; van Oers, J.A.M.

Background Previous evaluation showed insufficient use of a national guideline for integrated local health policy by Regional Health Services (RHS) in the Netherlands. The guideline focuses on five health topics and includes five checklists to support integrated municipal health policies. This study

Leadership of the Department of Epidemiology of the Johns Hopkins Bloomberg School of Public Health in Its First Century.

Science.gov (United States)

Celentano, David D

2016-03-01

This commentary reviews the contributions of each of the 7 Chairs of the Department of Epidemiology from the Department's inception in 1919 to the advent of the Centennial Celebration of the Johns Hopkins Bloomberg School of Public Health in 2016. The founding Chair, Wade Hampton Frost (1919-1938), was among the handful of foundational thinkers in the discipline of epidemiology. Kenneth Maxcy (1938-1954) and Philip Sartwell (1954-1970) oversaw the Department through the epidemiologic transition from a preponderance of morbidity and mortality due to infectious diseases to a preponderance of noncommunicable diseases. Abraham Lilienfeld (1970-1975) and Leon Gordis (1975-1993) were perhaps best known for their mastery of teaching, influencing generations of both medical and public health students. Jonathan Samet (1994-2008) oversaw a major curriculum revision and expanded the Department significantly, and David Celentano (2008-) is working to rebalance the practice of epidemiology with the etiological foundations of epidemiology. All Chairs were a product of their times, and their research focus and portfolios influenced the direction of the Department. Future generations of Johns Hopkins students will be influenced directly or indirectly by the heritage of these Chairs' actions and those of their faculty. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Health of the Elderly Migration Population in China: Benefit from Individual and Local Socioeconomic Status?

Science.gov (United States)

Wang, Qing

2017-04-01

The study aims to estimate the relationship between the individual/local socioeconomic status and the health of internal elderly migrants in China. A multilevel logistic model was used to estimate this association. The estimations were undertaken for 11,111 migrants aged over 60 years, using nationally representative data: the 2015 Migrant Dynamics Monitoring Survey (MDMS), which was carried out in China. Odds ratios with 95% confidence intervals were reported. Both the household income per capita and the area-level average wage were positively associated with migrants' self-reported health; however, public service supply was not significantly related to their health. In addition, given the household income, migrants living in communities with a higher average wage were more likely to report poor health. Migrants' health benefited from individual socioeconomic status, but not from the local socioeconomic status, which the migrants cannot enjoy. This study highlights the importance of multilevel and non-discriminatory policies between migrants and local residents.

Evaluation of radiation protection in x rays room design in diagnostic radiography department in Omdurman locality

International Nuclear Information System (INIS)

Adam, Ahmed yusif Abdelrahman

2013-03-01

The purpose of this study is conducted in order to evaluate the application of radiation protection in x-ray rooms design in diagnosis radiology department, evaluate personal monitoring devices, to assess primary scatter and leakage radiation dose, to assess monitoring devices if available, in period from March 2013 to August 2013. The design data included room size, control room size, manufacture of equipment, room surrounding areas, workload of all equipment rooms, type of x-ray equipment, radiation worker's in all hospital, number of patient in each shift, structural material and shielding, K vp and m As used in x-ray room department during examination testing. The results of this study show that there is x-ray room design, the design of x-ray equipment is accepted according to the radiation safety institute team of quality control. Also the study shows that the radiation protection devices are available and in a good condition and enough in number. The study shows that there are not personal monitoring devices and services. the radiological technologist are well trained. Also the study investigation the radiation protection in x-ray room in diagnostic department in Omdurman locality. Finally the study shows that there is compact able to ICRP recommended and National quality control in Sudan Atomic Energy Council exception, Alwedad, Abusied and Blue Nile there are have not control room concludes that there is only in relationship hospital have a window without shield.(Author)

Students' attitudes towards impact of the health department website on their health literacy in Semnan University of Medical Sciences.

Science.gov (United States)

Mahdizadeh, Jamileh; Valinejadi, Ali; Pooyesh, Behnoosh; Jafari, Fatemeh; Kahouei, Mehdi

2018-01-01

Health literacy has been of interest to policymakers because of its impact on health decision-making as one of the important issues for promoting community health and improving the quality of health care delivery. Therefore, it seems necessary to examine the status of the website of the health sector of the University of Medical Sciences in promoting health literacy from the viewpoint of the students. This cross-sectional study was performed on 529 medical and allied students in schools affiliated to Semnan University of Medical Sciences, Semnan, Iran between 2016 and 2017. In this study, a valid and reliable adult health literacy questionnaire designed by Montazeri et al. was used. The questionnaire was distributed among students in medical and allied health schools and they were asked to complete the questionnaire. Independent-samples t-test, one-way ANOVA, and Pearson product-moment correlation were used to analyze data by SPSS 19. Mean scores of the participants' attitudes towards reading of health information was 3.14 and towards decision and usage of health information was 2.53. Relationship between the study subjects' demographic characteristics and their attitudes was significant (pwebsite. Hence, the results of this study showed that the website of the health department needs to be redesigned, and this design would allow a better link between the University of Medical Sciences and its audience to promote health literacy.

The NIHR Public Health Research Programme: responding to local authority research needs in the United Kingdom.

Science.gov (United States)

Dorling, Hannah; Cook, Andrew; Ollerhead, Liz; Westmore, Matt

2015-12-11

The remit of the National Institute for Health Research Public Health Research (PHR) Programme is to evaluate public health interventions, providing new knowledge on the benefits, costs, acceptability and wider impacts of interventions, set outside of the National Health Service, intended to improve the health of the public and reduce inequalities. This paper illustrates how the PHR Programme is providing new knowledge for public health decision makers, based on the nine key areas for local authority public health action, described by the King's Fund. Many funded PHR projects are evaluating interventions, applied in a range of settings, across the identified key areas for local authority influence. For example, research has been funded on children and young people, and for some of the wider determinants of health, such as housing and travel. Other factors, such as spatial planning, or open and green spaces and leisure, are less represented in the PHR Programme. Further opportunities in research include interventions to improve the health of adolescents, adults in workplaces, and communities. Building evidence for public health interventions at local authority level is important to prioritise and implement effective changes to improve population health.

GIS, Pollution Prevention and Public Health

Science.gov (United States)

Using examples of preventing pollution and reducing risk of exposure to communities, this guide answers basic interest and start-up questions, addresses benefits and limitations and illustrates the value of GIS for local health departments.

Interpersonal influence among public health leaders in the United States department of health and human services.

Science.gov (United States)

Harris, Jenine K; Carothers, Bobbi J; Wald, Lana M; Shelton, Sarah C; Leischow, Scott J

2012-02-17

In public health, interpersonal influence has been identified as an important factor in the spread of health information, and in understanding and changing health behaviors. However, little is known about influence in public health leadership. Influence is important in leadership settings, where public health professionals contribute to national policy and practice agendas. Drawing on social theory and recent advances in statistical network modeling, we examined influence in a network of tobacco control leaders at the United States Department of Health and Human Services (DHHS). Fifty-four tobacco control leaders across all 11 agencies in the DHHS were identified; 49 (91%) responded to a web-based survey. Participants were asked about communication with other tobacco control leaders, who influenced their work, and general job characteristics. Exponential random graph modeling was used to develop a network model of influence accounting for characteristics of individuals, their relationships, and global network structures. Higher job ranks, more experience in tobacco control, and more time devoted to tobacco control each week increased the likelihood of influence nomination, as did more frequent communication between network members. Being in the same agency and working the same number of hours per week were positively associated with mutual influence nominations. Controlling for these characteristics, the network also exhibited patterns associated with influential clusters of network members. Findings from this unique study provide a perspective on influence within a government agency that both helps to understand decision-making and also can serve to inform organizational efforts that allow for more effective structuring of leadership.

Interpersonal influence among public health leaders in the United States Department of Health and Human Services

Directory of Open Access Journals (Sweden)

Jenine K. Harris

2012-02-01

Full Text Available Background. In public health, interpersonal influence has been identified as an important factor in the spread of health information, and in understanding and changing health behaviors. However, little is known about influence in public health leadership. Influence is important in leadership settings, where public health professionals contribute to national policy and practice agendas. Drawing on social theory and recent advances in statistical network modeling, we examined influence in a network of tobacco control leaders at the United States Department of Health and Human Services (DHHS. Design and Methods. Fifty-four tobacco control leaders across all 11 agencies in the DHHS were identified; 49 (91% responded to a web-based survey. Participants were asked about communication with other tobacco control leaders, who influenced their work, and general job characteristics. Exponential random graph modeling was used to develop a network model of influence accounting for characteristics of individuals, their relationships, and global network structures. Results. Higher job ranks, more experience in tobacco control, and more time devoted to tobacco control each week increased the likelihood of influence nomination, as did more frequent communication between network members. Being in the same agency and working the same number of hours per week were positively associated with mutual influence nominations. Controlling for these characteristics, the network also exhibited patterns associated with influential clusters of network members. Conclusions. Findings from this unique study provide a perspective on influence within a government agency that both helps to understand decision-making and also can serve to inform organizational efforts that allow for more effective structuring of leadership.