Safe Storage of Firearms Prevents Suicide

By Tony Gomez, BS, RS, Manager, Violence and Injury Prevention, Public Health Seattle & King County; Clinical Faculty Instructor, University of Washington, School of Public Health

There is an urgent public health need to reduce suicide rates in the United States. There were 40,600 suicides in 2012, making suicide the tenth leading cause of death.1 Increases in suicide rates among Americans ages 35 to 64 across the country are cause for alarm; suicide in this age group rose 28.4% from 1999 to 2010.2 The greatest increases in suicide rates occurred in people 50 to 54 years old, which increased by 48.4%, and 55- to 59-year-olds, which increased by 49.1%.2 Among the most common methods of  dying by suicide are firearms, the use of which increased by 14.4% from 1999 to 2010.1 In the United States, over half of suicide deaths are due to firearms; another 17% are due to poisoning by prescription medicines and other substances. Continue reading

Local Health Official Interview: Winifred M. Holland of the Florida Department of Health in Clay County

Holland, WWinifred M. Holland, MPH, MA, LMHC, Health Officer, Florida Department of Health in Clay County, has spent more than 30 years in public health. In this interview, Holland discusses her career path, the challenges of maintaining the fiscal viability of her LHD, and the rewards of working on teen pregnancy prevention programs.

  • Please tell us about your professional background and how you got to where you are today.

I have been a public health professional for over 30 years. My initial degree is in secondary education but once I was exposed to public health, it became my passion. Continue reading

Working with Local Health Departments to Support PrEP for HIV Prevention

World AIDS Day. December 1. By Gretchen Weiss, MPH, Senior Program Analyst and Alyssa Kitlas, Program Analyst

Yesterday was World AIDS Day, a day to remember those who have lost their lives to HIV and AIDS; recognize the challenges that remain in ending the epidemic and improving the lives of those living with HIV; celebrate the progress we have made in curbing the epidemic; and unite in commitment to an AIDS-free generation. Over the past few years, incredible progress has been made across the HIV care continuum. Among the key achievements and successes has been pre-exposure prophylaxis, or PrEP. PrEP, which involves taking a pill a day to prevent HIV, represents a breakthrough in biomedical HIV prevention.

For the past few years, NACCHO has been engaged in dialogue with local health departments and its federal and industry partners about achieving the full promise of PrEP, how PrEP will be rolled out in the “real world” (i.e., implemented outside of clinical trials and demonstration sites), and what the role of local health departments will be. In late 2013, NACCHO received funding from Gilead Sciences, Inc., the manufacture of Truvada, which is currently the only FDA approved medication for PrEP, to develop an educational program about PrEP as a component of comprehensive HIV prevention. NACCHO launched its Web-based PrEP and Local Health Departments educational series in October 2014. The series is composed of three modules, the third of which was released yesterday:

  • Module 1: The Science of PrEP for HIV Prevention and the US Public Health Service Clinical Practice Guidelines for PrEP
  • Module 2: Who Might Benefit from PrEP? Assessing Benefit at a Population and Individual Level
  • Module 3: Thinking About Incorporating PrEP into Your HIV Prevention Programs? Examples and Models from Local Health Departments

The goal of NACCHO’s educational series is to increase awareness and knowledge of PrEP among local health departments. To achieve this goal, NACCHO undertook a number of activities to explore, identify, and define the various roles that local health departments can play in supporting PrEP as part of a comprehensive HIV prevention strategy. Module 3 highlights the findings of these activities by detailing the various roles for local health departments and providing examples of what local health departments across the country are doing, such as providing PrEP through health department clinics; referring clients to providers for PrEP; creating online resource directories for providers and community members; and offering direct provider education and training opportunities. Similar to the previous two modules, Module 3 includes two webcasts (pre-recorded lectures), a discussion guide, and supporting resources and tools.

Recognizing that PrEP poses a number of questions and that implementation will look different across the country, NACCHO has hosted live webinars with series instructor Dr. Mark Thrun, Director, HIV/STD Prevention and Control, Denver Public Health. The webinars provide an opportunity for participants to ask questions, share information about their PrEP-related activities, and learn from colleagues and partners across the country. We hope that you will join us for our upcoming webinar on Dec. 16, 12:30–2:00 PM EST. Register here and come prepared to ask questions and share what your health department is doing to support PrEP in your jurisdiction.

We want to thank all the health departments that have provided input and guidance on NACCHO’s PrEP activities and look forward to engaging more of you in this important work. NACCHO is currently developing a PrEP Story Bank to document, share, and support local health department efforts. Please e-mail Gretchen Weiss on NACCHO’s HIV/STI team at if you would like to share how you are supporting PrEP delivery in your jurisdiction.

Ready vs. Project Public Health Ready

By Leigh Wilsey, Preparedness Coordinator, Florida Department of Health in Clay County

This article was originally published in NACCHO Exchange. To read the entire issue, download the newsletter from NACCHO’s online bookstore (login required).

PPHR-Logo-2006-300x203As a local health department (LHD), the Florida Department of Health in Clay County (DOH-Clay) has had many opportunities to respond to emergencies and disasters that impact public health. Large statewide public health response activations have included the following:

  • Hurricane Andrew, 1992;
  • Wildfires, 1998;
  • Hurricane Floyd, 1999;
  • Hurricanes Bonnie, Charley, Francis, and Jeanne, 2004, known in Florida as “The 4 of ’04”; and
  • Local activations for tropical storms, flooding, and wildfires.

Prior to 2006, DOH-Clay’s role in public health response was limited to staffing special medical needs shelters. Even though a basic written plan existed, staff had experience running the shelter and rarely referred to it. While staff always had a “we will get the job done” attitude, the lack of coordinated planning and training presented many challenges in the back-to-back activations during the 2004 hurricane season.  Continue reading

Stories from the Field: Food Safety Calendar Educates Entire Community

food-safety-calendar-storyThe following story was submitted to NACCHO’s Stories from the Field website by Jeanne Garbarino from Vineland City (NJ) Health Department on Sept. 17. NACCHO’s Stories from the Field website provides a means for local health departments (LHDs) to share their experiences and demonstrate the value of public health. Stories from the Field can be used to support advocacy, peer learning, and collaboration with state and federal partners. Share your story at

When the Vineland City Health Department (VCHD) in Vineland, NJ, discovered that a lack of education around proper hand washing was the number one public health offense in the city’s retail food establishments, local health department (LHD) and Food Safety Council staff thought up an unusual solution: let students do the teaching. Through a contest with cash prizes, the department tasked K-12 students to contribute drawings illustrating best practices related to hand washing; the winning art was then published in the VCHD’s inaugural “Serving Safe Food Calendar,” distributed to every retail food establishment in the city.

The calendar project began in 2005, after the VCHD conducted its first risk-factor study with the U.S. Food and Drug Administration’s voluntary standards program and identified poor personal hygiene as the biggest health issue present in the city’s restaurants. A lack of hand washing spreads the viruses and bacteria that can lead to a number of foodborne illnesses, such as norovirus and salmonella. The LHD wanted to combat this issue in a creative, original way in hopes of gaining more attention from the food service community, and raising a higher level of awareness surrounding hygiene issues. Along with the Food Safety Council, the VCHD began brainstorming education campaigns and someone suggested enlisting local students to draw posters; the idea quickly evolved into a calendar.

The original production focused only on hand washing, but in subsequent years, the VCHD has expanded its focus to also cover proper food temperatures and foodborne illnesses. It isn’t a regular series – in total, the project costs about $4,000, so the department only produces them when funds are available – but when the opportunity arises students, parents, teachers and food service industry workers jump at the chance to take part, whether that means contributing a drawing or just pinning a calendar on a wall. Calendars have since been produced in 2009, 2011, 2012, and 2014. Artwork is selected through a contest that offers 12 winners a $50 Visa gift card and the opportunity to receive their prize during a televised city council meeting. Surprisingly, it’s the brief TV appearance that really drives kids to participate, and not the cash.

To garner enough submissions, the VCHD reached out to local teachers – a challenge in itself, as catching teachers when they weren’t busy was not always achievable – and asked that they promote the contest to their students. Some biology teachers even turned contest participation into a graded classroom assignment; they studied the various foodborne illness that can arise due to improper hand washing or refrigeration and students incorporated their lessons into their drawings. Simple outreach efforts expanded the scope of the VCHD’s original project; students and teachers were able to engage with public health education in a more meaningful way, and came away from the project with a strong personal understanding of the issues.

Once published, every licensed retail food establishment in the city, from top-tier restaurants to coffee carts, receives a copy of the calendar. The VCHD even provides them to the supermarket departments that handle and prepare raw foods. And though there are no established, direct links between calendar production and changed habits, risk factor studies conducted in the nine years since the project began have shown an improvement in personal hygiene practices among the city’s food service professionals. Additionally, VCHD staff have heard anecdotal evidence about community members whose children have taken to monitoring their family’s hand washing habits, or contest winners who now manage restaurants. And, perhaps most poignantly, retail food establishments sing the praises of the calendars and greatly appreciate the educational opportunity they provide.

Despite the clear successes, the calendar project has not been without struggles. Every new production cycle the VCHD undertook illuminated new strategies they needed to follow in order to ensure a useful product. For instance, one of the biggest challenges was timing their initial outreach campaign with a break in teachers’ schedules. If teachers were too busy to deviate from their planned curriculum, the calendars didn’t receive the classroom promotion the VCHD relied on for success. The department has since identified May as the best month to solicit artwork from students and teachers. Another important step was ensuring students had quality information to inform their projects. The VCHD found that it was often necessary to provide resources directly to the teachers; as schools do not typically teach food safety, classrooms really relied on the health department to educate them about proper behaviors.

Any LHDs interested in replicating Vineland’s calendar project, or initiating their own food safety education campaign, should remember the importance of including the whole community in the process. By involving students in the calendar, the VCHD was able to educate children, parents, and teachers in addition to the food service establishments originally targeted. Food safety became education became the whole city’s mission, not just the health department’s.

Read more LHD stories from the field at

Tackling the Root Causes of Health Inequity

By Tiffany J. Huang, Program Analyst, Assessment and Planning, NACCHO

The Roots of Health Inequity is an online learning collaborative and Web-based course designed for the public health workforce. The site offers a starting place for those who want to address systemic inequities in health and wellness. Based on a social justice framework, the course introduces public health practitioners to concepts and strategies for taking action in everyday practice.

Launched in 2011, this course now has over 4,500 registered users and more than 120 multi-person learning groups, formed by local health departments, universities, community organizations, and other institutions. To help groups interested in exploring the concepts behind this course more deeply, NACCHO has recently released the following:

  • NA616PDFRoots of Health Inequity Facilitator’s Guide: In its first version, this resource manual provides further guidance for groups and organizations seeking to facilitate in-depth online and in-person discussions about the course content.


  • NA615PDFExploring the Roots of Health Inequity: Essays for Reflection: This collection of four short essays is designed to explore conceptual themes associated with health inequity. The essays are intended to generate dialogue among public health practitioners concerned about growing health inequities and to inspire reflection about strategies directed toward preventing inequities by focusing on the institutions and interests that drive them.


  • NA614PDFExpanding the Boundaries: Health Equity and Public Health Practice: This brief explores the ways in which health equity practitioners might act on the underlying social inequalities that are the root of health inequities, rather than only their consequences. It aims to invite dialogue among local health departments and their community allies.

The Cook County (IL) Department of Public Health is one local health department whose use of the course has helped to further their understanding of their community. As James E. Bloyd, Regional Health Officer, states, “Our jurisdiction has sharp and longstanding divisions along lines of race, class and neighborhood. The Roots of Health Inequity training helped our multi-disciplinary group come to grips with the complexity of the issues. We now have a base of staff who are better equipped to change how we practice in order to fulfill our mission. The monthly brown bag lunches we organized for discussions of each unit were a hit.”

To learn more and register, visit NACCHO staff are available to provide more information, including guidance documents on how organizations can use the course and obtain continuing education credits. Contact us at

Has your organization experienced the Roots of Health Inequity course? Are you interested in participating? Let us know in the comments.

What Local Health Departments Need to Know About Ebola


This post originally ran on NACCHO’s Preparedness Brief blog. For the latest updates on Ebola, visit

Since July 2014, NACCHO has been working to increase preparedness for Ebola in the United States by coordinating between our members at local health departments and federal and public health partners such as the Center for Disease Control and Prevention (CDC) and the Office of the Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health and Human Services. As local health departments consider their role in Ebola preparedness and response, NACCHO has assembled a list of Ebola resources for local health departments and their communities. For the latest Ebola resources and news, visit

For Local Health Departments

For Heathcare Providers and Facilities


For Travelers/Airlines/Points-of-Entry

For the General Public

For More Information

Do you have a resource on Ebola to share with local health departments? Please add it to the comments section below.

How is your local health department preparing for Ebola? Add your comments below or share your story on NACCHO’s Stories from the Field website.