Rachel Stevens

Availability and Perceived Effectiveness of Public Health Activities in the Nation’s Most Populous Communities

OBJECTIVES We examined the availability and perceived effectiveness of 20 basic public health activities in the communities where most Americans reside. METHODS A self-administered questionnaire was mailed to the 497 directors of US local health departments serving at least 100 000 residents. RESULTS On average, two thirds of the 20 public health activities were performed in the local jurisdictions surveyed, and the perceived effectiveness rating averaged 35% of the maximum possible. In multivariate models, availability of public health activities varied significantly according to population size, socioeconomic measures, local health department spending, and presence of local boards of health. CONCLUSIONS Local public health capacity varies widely across the nations most populous communities, highlighting the need for targeted improvement efforts.

The contributions of managed care plans to public health practice: evidence from the nation's largest local health departments.

Objective. The authors examine the extent and nature of managed care plans participating in local public health activities. Methods. In 1998, the authors surveyed the directors of all US local health departments serving jurisdictions of at least 100,000 residents to collect information about public health activities performed in their jurisdictions and about organizations participating in the activities. Multivariate logistic and linear regression models were used to examine organizational and market characteristics associated with managed care plan participation in public health activities. Results. Managed care plans were reported to participate in public health activities in 164 (46%) of the jurisdictions surveyed, and to contribute to 13% of the public health activities performed in the average jurisdiction. Plans appeared most likely to participate in public health activities involving the delivery or management of personal health services and the exchange of health-related information. Managed care participation was more likely to occur in jurisdictions with higher HMO penetration, fewer competing plans, and larger proportions of plans enrolling Medicaid recipients. Participation was positively associated with the overall scope and perceived effectiveness of local public health activities. Conclusions. Although plans participate in a narrow range of activities, these contributions may complement the work of public health agencies.

Development and implementation of a public health workforce training needs assessment survey in North Carolina

Assessing the training needs of local public health workers is an important step toward providing appropriate training programs in emergency preparedness and core public health competencies. The North Carolina Public Health Workforce Training Needs Assessment survey was implemented through the collaboration of several organizations, including the North Carolina Center for Public Health Preparedness at the North Carolina Institute for Public Health, the outreach and service unit of the University of North Carolina School of Public Health, the Office of Public Health Preparedness and Response in the North Carolina Division of Public Health Epidemiology Section, and local health departments across the state.

The NC accreditation learning collaborative: partners enhancing local health department accreditation.

North Carolina (NC) is one of several states that have developed an accreditation system for local public health agencies. The NC Collaborative, composed of the NC Association of Local Health Directors, the NC Division of Public Health, and the NC Institute of Public Health, conducted several initiatives to enhance the NC accreditation system and contribute to the Multi-state Learning Collaborative. Two of these projects, benefits of accreditation and the Accreditation Road Map, are of potential national interest and can inform the proposed national, voluntary accreditation model. Benefits of accreditation from the perspectives of various system participants were explored through the ongoing evaluation of the NC accreditation system. The development of the Accreditation Road Map and its intended uses are described. Implications for the proposed national model and public health systems research are discussed.

Public health practice in schools of public health: is there a fit?

Public health practice has been a part of schools of public health for a long time and yet it is still an emerging field of scholarship. Practice faculty often are isolated in their schools and not part of the mainstream. This article explores the elements of culture that are necessary to support a practice focus in a school of public health.