An Evaluation of Epidemic Intelligence Service Alumni in Public Health Leadership Roles

Background The U.S. Centers for Disease Control and Prevention (CDC) has administered the Epidemic Intelligence Service (EIS) fellowship for over 50 years, with the goal of developing scientists and leaders in applied epidemiology. Our objective was to understand the extent to which CDC EIS alumni are present in select public health leadership roles. Methods We conducted an evaluation describing EIS alumni representation in five preselected leadership positions (CDC director [1953–2016]; CDC center director, state epidemiologist, Field Epidemiology Training Program [FETP] resident advisor, and Career Epidemiology Field Officer [CEFO] [2000–2016]). We developed a dataset using multiple sources to identify staff in selected positions. We then matched these data with an internal EIS alumni dataset. Results Selected positions were staffed by 353 persons, of which 185 (52%) were EIS alumni; 10 persons served in >1 leadership position, of which 6 were EIS alumni. Among 12 CDC directors, four (33%) were EIS alumni; collectively these alumni led CDC for approximately 25 years. EIS alumni accounted for 29 (58%) of 50 CDC center directors, 61 (35%) of 175 state epidemiologists, 27 (56%) of 48 Field Epidemiology Training Program resident advisors, and 70 (90%) of 78 Career Epidemiology Field Officers. Of 185 EIS alumni in leadership positions, 136 (74%) were physicians, 22 (12%) were scientists, 21 (11%) were veterinarians, 6 (3%) were nurses; 94 (51%) were assigned to a state or local health department. Among 61 EIS alumni who served as state epidemiologists, 40 (66%) were assigned to a state or local health department during EIS. Conclusions EIS alumni accounted for between approximately one-third (CDC directors and state epidemiologists) and 90% (CEFOs) of people serving in essential leadership positions at multiple levels.

Local Government Approaches to Combating COVID-19 Inequities: A Durham County Department of Public Health Perspective

When a novel coronavirus disease (COVID-19) made major headlines in 2020, it further exposed an existing public health crisis related to inequities within our communities and health care delivery system. Throughout the COVID-19 pandemic, populations of color had higher infection and mortality rates, and even experienced greater disease severity compared to whites. Populations of color often bear the brunt of COVID-19 and other health inequities, due to the multifaceted relationship between systemic racism and the social determinants of health. As this relationship continues to perpetuate health inequities, the local health department is an agency that has the jurisdiction and responsibility to prevent disease and protect the health of the communities they serve. When equity is integrated into a health department’s operational infrastructure as a disease prevention strategy, it can elevate the agency’s response to public health emergencies. Collecting, reporting, and tracking demographic data that is necessary to identify inequities becomes a priority to facilitate a more robust public health response. The purpose of this paper is to present strategies of how a local health department operationalized equity in various stages of COVID-19 response and apply these methods to future public health emergencies to better serve vulnerable communities.

Collaborating to offer HPV vaccinations in jails: results from a pre-implementation study in four states

Background Correctional facilities are an underutilized venue for reaching young adults who have not vaccinated for human papillomavirus (HPV). The objective of this study was to identify factors that are associated with jail and local health department (LHD) interest in partnering to offer HPV vaccinations to young adults in jail. Methods Consolidated framework for implementation research (CFIR)-guided surveys were conducted with jail administrators in Iowa, Kansas, Missouri, and Nebraska, September 2017–October 2018. Jail survey data were analyzed using chi square distribution and relative risk regression. Using data from sister surveys conducted with LHD administrators in the same counties (results previously reported), we identified characteristics of counties in which both the jail and LHD indicated interest in collaborating to offer HPV vaccinations in the jail. Results Jail survey response was 192/347 (55.3%). Surveys with LHDs yielded 237/344 (68.9%) responses. Eleven communities were identified where both the jail and LHD expressed interest. Only “any vaccines provided in jail” predicted shared interest (RR: 5.36; CI: 2.52–11.40; p < .01). For jail administrators, offering other vaccines was 3 times (CI:1.49–6.01; p < .01) and employing a nurse 1.65 times more likely (CI: 1.20–2.28; p < .01) to predict interest in collaborating to offer HPV vaccination. Open-ended responses indicated that managing linkages and stakeholder investment were areas of emphasis where collaborations to provide vaccinations in the jails had been previously implemented. Conclusions Interest in jail-LHD partnerships to provide HPV vaccinations in jails exists in the Midwest but will require building-out existing programs and linkages and identifying and strengthening shared values, goals, and benefits at all levels.

Joining forces to administer COVID-19 vaccines

The national vaccination effort for novel coronavirus 2019 (COVID-19) is among the greatest operational challenges America has ever faced, the success of which depends upon reaching communities across the United States. In this Commentary, the Executive Dean of Ohio University’s Heritage College of Osteopathic Medicine (OUHCOM) describes the logistics and processes of vaccine delivery at OUHCOM, both on campus and beyond. Among those logistical considerations is a partnership with the local health department and hospital system, as well as student involvement in vaccination efforts.