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Investigating the role of state and local health departments in addressing public health concerns related to industrial food animal production sites.

ABSTRACT: OBJECTIVES: Evidence of community health concerns stemming from industrial food animal production (IFAP) facilities continues to accumulate. This study examined the role of local and state health departments in responding to and preventing community-driven concerns associated with IFAP. METHODS: We conducted semi-structured qualitative interviews with state and county health department staff and community members in eight states with high densities or rapid growth of IFAP operations. We investigated the extent to which health concerns associated with IFAP sites are reported to health departments, the nature of health departments' responses, and barriers to involvement. RESULTS: Health departments' roles in these matters are limited by political barriers, lack of jurisdiction, and finite resources, expertise, and staff. Community members reported difficulties in engaging health departments on these issues. CONCLUSIONS: Our investigation suggests that health departments frequently lack resources or jurisdiction to respond to health concerns related to IFAP sites, resulting in limited engagement. Since agencies with jurisdiction over IFAP frequently lack a health focus, increased health department engagement may better protect public health.

SUBMITTER: Fry JP

PROVIDER: S-EPMC3559890 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Investigating the role of state and local health departments in addressing public health concerns related to industrial food animal production sites.

Fry Jillian P JP Laestadius Linnea I LI Grechis Clare C Nachman Keeve E KE Neff Roni A RA

PloS one 20130130 1

<h4>Objectives</h4>Evidence of community health concerns stemming from industrial food animal production (IFAP) facilities continues to accumulate. This study examined the role of local and state health departments in responding to and preventing community-driven concerns associated with IFAP.<h4>Methods</h4>We conducted semi-structured qualitative interviews with state and county health department staff and community members in eight states with high densities or rapid growth of IFAP operations ...[more]

PMID: 23382947

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Project description:BackgroundPublic health resources are limited and best used for effective programs. This study explores associations of mis-implementation in public health (ending effective programs or continuing ineffective programs) with organizational supports for evidence-based decision making among U.S. local health departments.MethodsThe national U.S. sample for this cross-sectional study was stratified by local health department jurisdiction population size. One person was invited from each randomly selected local health department: the leader in chronic disease, or the director. Of 600 selected, 579 had valid email addresses; 376 completed the survey (64.9% response). Survey items assessed frequency of and reasons for mis-implementation. Participants indicated agreement with statements on organizational supports for evidence-based decision making (7-point Likert).ResultsThirty percent (30.0%) reported programs often or always ended that should have continued (inappropriate termination); organizational supports for evidence-based decision making were not associated with the frequency of programs ending. The main reason given for inappropriate termination was grant funding ended (86.0%). Fewer (16.4%) reported programs often or always continued that should have ended (inappropriate continuation). Higher perceived organizational supports for evidence-based decision making were associated with less frequent inappropriate continuation (odds ratio?=?0.86, 95% confidence interval 0.79, 0.94). All organizational support factors were negatively associated with inappropriate continuation. Top reasons were sustained funding (55.6%) and support from policymakers (34.0%).ConclusionsOrganizational supports for evidence-based decision making may help local health departments avoid continuing programs that should end. Creative mechanisms of support are needed to avoid inappropriate termination. Understanding what influences mis-implementation can help identify supports for de-implementation of ineffective programs so resources can go towards evidence-based programs.

Project description:The public health emergency caused by the COVID-19 pandemic stimulated stakeholders from diverse disciplines and institutions to establish new collaborations to produce informed public health responses to the disease. Wastewater-based epidemiology for COVID-19 grew quickly during the pandemic and required the rapid implementation of such collaborations. The objective of this article is to describe the challenges and results of new relationships developed in Detroit, MI, USA among a medical school and an engineering college at an academic institution (Wayne State University), the local health department (Detroit Health Department), and an environmental services company (LimnoTech) to utilize markers of the COVID-19 virus, SARS-CoV-2, in wastewater for the goal of managing COVID-19 outbreaks. Our collaborative team resolved questions related to sewershed selection, communication of results, and public health responses and addressed technical challenges that included ground-truthing the sewer maps, overcoming supply chain issues, improving the speed and sensitivity of measurements, and training new personnel to deal with a new disease under pandemic conditions. Recognition of our complementary roles and clear communication among the partners enabled city-wide wastewater data to inform public health responses within a few months of the availability of funding in 2020, and to make improvements in sensitivity and understanding to be made as the pandemic progressed and evolved. As a result, the outbreaks of COVID-19 in Detroit in fall and winter 2021-2022 (corresponding to Delta and Omicron variant outbreaks) were tracked in 20 sewersheds. Data comparing community- and hospital-associated sewersheds indicate a one- to two-week advance warning in the community of subsequent peaks in viral markers in hospital sewersheds. The new institutional relationships impelled by the pandemic provide a good basis for continuing collaborations to utilize wastewater-based human and pathogen data for improving the public health in the future.

Project description:ObjectiveThe United States Public Health Service released clinical practice guidelines for daily oral preexposure prophylaxis (PrEP) in May 2014. Local health departments (LHDs) are expected to play a critical role in PrEP implementation. We surveyed LHDs to assess awareness of and interest in supporting PrEP implementation, what roles they were taking, or believed they should take, in supporting PrEP, and what resources would be required to do so.MethodsLHDs were surveyed in 2015 to assess their engagement in PrEP implementation (n = 500). The study employed a cross-sectional survey design with a randomly selected stratified sample.ResultsAmong responding LHDs (n = 284), 109 (29%, weighted proportion) reported engagement in PrEP implementation. LHDs serving large jurisdictions (population 500,000+) and located in the West were more likely to be engaged in PrEP implementation. Making referrals for PrEP (74%) and conducting education and outreach to community members (51%) were the activities most frequently reported by LHDs engaged in PrEP implementation; 45% anticipated expanding their level of engagement. Among LHDs not engaged in PrEP implementation, 13% expected to become engaged over the next four years, 46% were undecided, and 41% reported it was unlikely. Information about PrEP for health care providers and information about PrEP for health department staff were the most frequently reported resource needs for LHDs engaged and not engaged in PrEP implementation, respectively.ConclusionsPrEP implementation by LHDs was limited in 2015, three years after Food and Drug Administration approval and one year after the U.S. Public Health Service issued clinical practice guidelines. PrEP is a recently available intervention that is requiring LHDs to adjust existing HIV prevention efforts and service delivery models. Additional resources and implementation research is needed to effectively support PrEP scale-up by LHDs. Efforts must also be undertaken to increase PrEP awareness, knowledge, and implementation capacity among LHDs.

Dataset Information

Investigating the role of state and local health departments in addressing public health concerns related to industrial food animal production sites.

Publications

Investigating the role of state and local health departments in addressing public health concerns related to industrial food animal production sites.

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