A new framework to evaluate environmental public health capacity indicators

Public health systems (PHS) research examines the capacity—-the organization, financing, and delivery of public health services--of a public health system and the public health impact of that system. To examine the PHS, indicators can be developed to examine the effectiveness of the system in improving the public's health. Yet, research heretofore has focused on creating individual indicators without consideration to linking service performance to public health outcomes and little of this work has focused on the environmental public health (EPH) infrastructure. Consequently, this research will build on existing indicator development and evaluation work to create a new EPH capacity indicator framework.

A modified cross-case synthesis review was utilized to examine existing indicator models in order to identify key criteria and outline a reliable, valid, and systematic process for selecting and evaluating EPH capacity indicators. This new framework consists of four phases—1) Indicator Type, 2) Relevance and Scientific Validity, 3) Analytic, Technical, and Economic Properties, and 4) Interpretation and Use—and describes the various considerations, elements, and criteria one must evaluate in selecting EPH capacity indicators for use.

This new framework can be used by EPH and public health practitioners working within the federal, state, or local health protection infrastructure to select and evaluate indicators for use at the local level to assess and improve EPH practice.