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

2018 ◽  
Vol 13 (03) ◽  
pp. 647-649
Author(s):  
Dorothy Bernard ◽  
Souleymane Konate ◽  
Elena Savoia

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

2019 ◽  
Vol 135 (1) ◽  
pp. 97-106 ◽  
Author(s):  
Megan Wallace ◽  
Joshua Sharfstein ◽  
Justin Lessler

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


Author(s):  
Lauren A. Clay ◽  
Kahler W. Stone ◽  
Jennifer A. Horney

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


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Geri Rosen Cramer ◽  
Gary J. Young ◽  
Simone Singh ◽  
Jean McGuire ◽  
Daniel Kim

Abstract Background The Patient Protection and Affordable Care Act of 2010 (ACA) encouraged nonprofit hospitals to collaborate with local public health experts in the conduct of community health needs assessments (CHNAs) for the larger goal of improving community health. Yet, little is known about whether collaborations between local health departments and hospitals may be beneficial to community health. In this study, we investigated whether individuals residing in communities with stronger collaboration between nonprofit hospitals and local public health departments (LHDs) reported healthier behaviors. We further explored whether social capital acts as a moderating factor of these relationships. Methods We used multilevel cross-sectional models, controlling for both individual and community-level factors to explore LHD-hospital collaboration (measured in the National Association of County and City Health Officials (NACCHO) Forces of Change Survey), in relation to individual-level health behaviors in 56,826 adults living in 32 metropolitan and micropolitan statistical areas, captured through the 2015 Behavioral Risk Factor Surveillance System (BRFSS) SMART dataset. Nine health behaviors were examined including vigorous exercise, eating fruits and vegetables, smoking and binge drinking. Social capital, measured using an index developed by the Northeast Regional Center for Rural Development, was also explored as an effect modifier of these relationships. Results Stronger collaboration between nonprofit hospitals and LHDs was associated with not smoking (odds ratio, OR 1.32, 95% CI 1.11 to 1.58), eating vegetables daily (OR 1.29; 95% CI 1.06 to 1.57), and vigorous exercise (OR 1.17; 95% CI 1.05 to 1.30). The presence of higher social capital also strengthened the relationships between LHD-hospital collaborations and wearing a seatbelt (p for interaction = 0.01) and general exercise (p for interaction = 0.03). Conclusions Stronger collaboration between nonprofit hospitals and LHDs was positively associated with healthier individual-level behaviors. Social capital may also play a moderating role in improving individual and population health.


PEDIATRICS ◽  
1952 ◽  
Vol 9 (1) ◽  
pp. 130-134

ONE of the pending medical bills which will undoubtedly receive active attention in the second session of the 82d Congress is the Local Health Units Bill (S.445). This bill, to which we have referred in this column (March 1951 ), proposes an increase in Federal aid to the States to help establish and maintain a Nation-wide network of full-time local health departments. The stimulating effect of a tie-in with the defense program was given to the measure when the President urged Congress to approve such legislation in order that communities in defense areas may be provided with the means of meeting the increased burdens of sanitation, protection of food and water supplies, services for preschool and school children and other services to prevent disease and promote health. S.445 was passed by the Senate. The House Interstate Commerce Committee is now considering this and similar bills. Several points at issue are whether this measure should be limited to the defense emergency period ; how public health services should be defined; and the kind of minimum standards to be required. While this legislation is currently under discussion, new light has been thrown upon many of the important questions involved. A highly significant report, recently published by the American Public Health Association, describes the changing concepts of the functions of local health departments and the extent to which they are now operating general medical care programs. in the first place, this report calls attention to the trend to place responsibility for medical care of the indigent and the needy in state and local departments of health.


2020 ◽  
pp. 152483992097298
Author(s):  
Alexis K. Grant

Local health departments (LHDs) are positioned to act as the community health strategist for their catchment area, which requires cross-sector collaboration. However, little research exists to understand how much and what types of cross-sector collaboration occur and its impact on LHD practice. Data from 490 LHDs who participated in the 2016 National Profile of Local Health Departments survey were analyzed to identify patterns of cross-sector collaboration among LHDs. In the survey, LHDs reported the presence of collaborative activities for each of 22 categories of organizations. Factor analysis was used to identify patterns in the types of organizations with which LHDs collaborate. Then, cluster analysis was conducted to identify patterns in the types of cross-sector collaboration, and cross-sectional analyses examined which LHD characteristics were associated with cluster assignment. LHDs collaborated most with traditional health care–oriented organizations, but less often with organizations focused on upstream determinants of health such as housing. Three distinct clusters represented collaboration patterns in LHDs: coordinators, networkers, and low-collaborators. LHDs who were low-collaborators were more likely to serve smaller populations, be unaccredited, have a smaller workforce, have a White top executive, and have a top executive without a graduate degree. These findings imply that public health practitioners should prioritize building bridges to a variety of organizations and engage in collaboration beyond information sharing. Furthermore, LHDs should prioritize accreditation and workforce development activities for supporting cross-sector collaboration. With these investments, the public health system can better address the social and structural determinants of health and promote health equity.


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