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APHA Scientific Session and Event Listing

Recorded presentation

Justeen Hyde, PhD¹, Alison Tovar, MS¹, Massachusetts Health Officers Association², Massachusetts Association of Public Health Nursing³, Massachusetts Environmental Health Association⁴, Massachusetts Association of Health Boards⁵, and Massachusetts Public Health Association⁶. (1) Institute for Community Health, Cambridge Health Alliance, 163 Gore Street, Cambridge, MA 02141, 617-499-6684, jhyde@challiance.org, (2) MHOA, 61 Wellesley Avenue, Lowell, MA 01851, (3) MAPHN, Merrimac Town Office, 2 School St., Merrimac, MA 01860, (4) MEHA, 150 Concord Street, Framingham, MA 01702, (5) MAHB, 56 Taunton St., Plainville, MA 02762, (6) MPHA, 434 Jamaicaway, Boston, MA 02130

Since the 1988 publication of IOM's report on the state of public health, numerous calls have been made to improve the public health infrastructure in the U.S. In Massachusetts, the Coalition for Local Public Health (CLPH) is working to improve the capacity and performance of local public health authorities (LPHAs) through advocacy and education. In 2005, the CLPH commissioned the Institute for Community Health to conduct a statewide survey of LPHAs. The survey gathered basic information about annual budgets, descriptions of the workforce, responsibilities, and staffing needs.

Methods: Self-administered surveys were distributed to the state's 352 LPHAs during regional emergency preparedness meetings and through mail or email. Survey data were entered into an Access database and analyzed in SAS 9.0.

Results: Approximately 54% of all LPHAs participated in the study. Little consistency across municipalities was found with respect to staffing levels, education requirements for personnel, or annual budgets. Larger communities (>40,000) reported the greatest increases in annual budgets over a 3-year period (10%), a fuller array of public health employees, and a highly educated workforce. Smaller communities (<10,000) reported only a 2% increase in annual budgets and 47% have no full-time staff. Smaller communities are also more likely to contract out essential public health services. Other findings indicate future workforce challenges, with nearly 20% of the workforce eligible to retire in the next 2 years.

Discussion: The implications of study findings and how the data will be used to advocate for improvements in local public health infrastructure will be discussed.

Learning Objectives: At the conclusion of this session, participants will be able to

1)Recognize the need for statewide data on local public health systems and how this data can be used as a foundation for advocacy efforts.
• Identify the strengths and gaps in the public health infrastructure of a northeastern state.
• Apply the findings and lessons learned from this study to future studies of local public health infrastructures.

Keywords: Infrastructure, Public Health Advocacy

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation