NACCHO Annual 2019: Improving the Nation’s Health through Public and Private Partnerships

By Taylarr Lopez, Communications Specialist, NACCHO

On July 9–11, over 1,300 local public health professionals gathered in Orlando for the 2019 NACCHO Annual Conference. Attendees participated in dozens of insightful sharing sessions, learned from leading experts, and discovered solutions to improve local public health in their communities.

This year’s theme, “Improving the Nation’s Health through Public and Private Partnerships,” focused specifically on how local public health professionals can build strong, effective cross-disciplinary partnerships. Each general session held its own focus, however; all echoed the importance of developing effective partnerships, addressing the social determinants of health, improving health equity, and telling compelling stories.

Attendees connected with old friends and networked with new peers at several conference events including the President’s welcome reception, the Public Health Accreditation Board Health Department Learning Reception, and networking lunches. Guests also took part in the first-ever NACCHO Annual Golf Tournament.

Conference-goers and those who watched the livestreams of the general sessions were very active on Twitter. Tweeters used the conference hashtag, #NA19, which generated over 19 million impressions. Some of the top #NA19 influencers include Vice Admiral Jerome Adams, MD, MPH, Surgeon General of the United States; Soledad O’Brien, Emmy-award winning journalist and Chief Executive Officer of Starfish Media Group; and Umair Shah, MD, MPH, Local Health Authority and Executive Director for Harris County Public Health (TX).

Tuesday: The Essence of Private and Public Partnerships: Connecting the Dots

On the first day of NACCHO Annual 2019, attendees participated in pre-conference workshops and sharing sessions. Lori Tremmel Freeman, NACCHO Chief Executive Officer, opened the first general session, by welcoming attendees to Orlando. She went on to recognize the NACCHO staff; the NACCHO Board of Directors; the NACCHO Annual Conference Committee; and staff from Orlando County.

Nasseam McPherson James, MBA, MSW, Assistant Health Department Director for the Florida Department of Health in Orange County, welcomed attendees on behalf of Orlando Mayor Buddy Dyer.

Jerry Demings, the Mayor of Orange County addressed the audience by encouraging them to explore Orlando and its diverse community.

Raul Pino, MD, MPH, Interim Health Administrator for the Florida Department of Health in Orange County, spoke about the public health challenges that Orlando is facing and discussed how effective partnerships have been critical to eliminating health disparities and improving health among residents.

Scott A. Rivkees, MD, Florida Surgeon General, advocated for education to increase vaccination rates to prevent diseases. He highlighted local health department initiatives that are aimed at mitigating the growing HIV virus. Dr. Rivkees mentioned that local health departments are taking “bold, new approaches,” like mobile clinics and working with dating apps to raise HIV prevention awareness. He closed by encouraging meaningful exchange among agencies and building new relationships.

New NACCHO President George T. Roberts, Jr. recognized outgoing President Kevin G. Sumner, MPH, Executive Director of the Middle-Brook Regional Health Commission (NJ). Roberts, who serves as Chief Executive Officer of the Northeast Texas Public Health District, expressed the need for local public health professionals to become transformational leaders in their communities. He shared that it’s important that transformational leaders have a seat at the table.

Randall Hyer, MD, PhD, MPH, Vice President of Clinical Development and Medical Affairs for Dynavax Technologies, discussed how his company developed a hepatitis B vaccine to help prevent increased rates in adults.

Pamela Hymel, MD, MPH, FACOEM, Chief Medical Officer of Experiences and Products for Disney Parks, discussed her company’s wellness program, which focuses on ensuring cast members have access to healthy food options, opportunities for exercise, and implementation of a park-wide smoke-free policy.

The keynote speaker, Leonard Marcus, PhD, Director of the Program for Health Care Negotiation and Conflict Resolution at Harvard T.H. Chan School of Public Health, closed out the program by discussing qualities of leadership and mentioned that public-private partnerships are about building and understanding complexity, then developing solutions.

Attendees also mingled and toured the Exhibit Hall during the President’s Welcome Reception and enjoyed a few networking events.

Wednesday: It’s Not Them, It’s Us: Reframing Public Health for More Effective Cross-sector Collaborations

On Wednesday, Freeman opened up the day’s general session by recapping the previous day and thanking the Annual Conference Committee, exhibitors, sponsors, the NACCHO staff, and the public health workforce for their continued efforts to improve health outcomes across the nation. She also introduced Jose Montero, MD, MHCDS, Director of the Centers for Disease Control and Prevention’s Center for State, Tribal, Local, and Territorial Health.

Vice Admiral Dr. Jerome Adams, MD, MPH, Surgeon General of the United States, discussed the importance of communicating the science around health to the American people, while being cautious of being overbearing. He emphasized the value of being able to effectively communicate to the entities that fund local public health work and make sure messages resonate. Dr. Adams also pushed for well-resourced communications teams at health departments.

Wednesday’s general session, presented by the de Beaumont Foundation, featured a dynamic panel of experts. John Dreyzehner, MD, MPH, FACOEM, Former Commissioner of Health in Tennessee, introduced the day’s panel, which included Soledad O’Brien, Chief Executive Officer of Starfish Media Group; Dr. Nat Kendall-Taylor, Chief Executive Officer of the FrameWorks Institute; and Shelia Hiddleson, RN, MS, Health Commissioner for the Delaware General Health District in Ohio and PHRASES Fellow.

Dr. Dreyzehner kicked off the panel by saying, “We all know partnerships are essential, but they’re hard to develop. They require commitment and constant, effective communication.”

Nat Kendall-Taylor spoke about how framing public health messaging is just as important as the science and how sometimes messages that don’t resonate with the public can be pushed away. He explained by saying, “The disconnect happens because ‘culture’ stands in between what you say and what people hear. We have to see and appreciate the diverse cultures of the people you serve, so you can work with them more effectively.”

O’Brien highlighted the importance of telling captivating stories. She said,  “Storytelling is a skill, yet there’s a sense that everyone in public health should be able to use their expertise to translate their work into good stories. But we have to teach people how to tell stories and tell them well.” O’Brien encouraged the audience to be proactive with their storytelling to build relationships and understanding.

The final speaker, Hiddleson discussed the difficulties that public health professionals have getting out into their communities to engage and connect, due to frequent day-to-day workloads. She closed the session by expressing the significance of trusting and training staff members to build partnerships on behalf of their agencies.

Attendees also celebrated this year’s award winners at the 25th Anniversary Awards Gala, including over 50 Model Practice Award winners, seven Local Health Department of the Year awardees, four National Health Security Strategy awardees, and a number of Promising Practice Award winners.

Thursday Morning: Transforming Local Public Health Practice Through Global-local Exchange

Thursday morning’s general session was led by Umair Shah, MD, MPH, Executive Director and Local Health Authority of Harris County Public Health (TX). Speakers included Michael Edelstein, MD, Consultant Epidemiologist, National Infection Service, Public Health England; David Fleming, MD, Vice President of Global Health Programs at PATH; and Nafissa Cisse-Egbuonye, PhD, MPH, Health Director of the Black Hawk County Health Department (IA).

Speakers discussed the importance of sharing across the global health system and shared their own experiences of integrating global health strategies into their own agencies.

Dr. Shah kicked off the session by saying, “We truly live in a global society and, as people move from jurisdiction and country to country, our domestic public health practice has to consider how we can connect with and learn from our global health partners.”

Next, Dr. Fleming addressed the audience and expressed a need to integrate global health strategies into local health models because of culture and language barriers. Regarding how to implement global health strategies into local health, he said, “There’s no one approach to implementing global health practices into local health departments. The key message is you need to start where the community is to accurately identify the problems.”

Dr. Edelstein highlighted the need to establish global networks to connect with local experts. In regards to surveillance, he discussed that the idea of “local” doesn’t exist anymore. He stated, “You’re within 24 hours of everywhere in the world, so we can’t work in isolation. We must be able to connect the dots between the seemingly singular cases of disease each country sees.”

Dr. Cisse-Egbuonye discussed the significance of engaging immigrant populations who are suffering the most from health inequities. She mentioned that one of her health department’s approaches to helping the immigrant populations in her community is by learning how they want to be helped. She expressed that rural health departments should be intentional in creating representation for immigrant groups and they should try to hire professionals within that community.

Thursday Afternoon: Innovating Successful Public Private Partnerships in Health — The Blue Zones Project

The final general session began with Freeman’s state of the association address. She shared NACCHO’s advocacy activities and capacity-building opportunities developed for local health departments and their partners.

The general session featured the Blue Zones Project, a community-focused health promotion initiative that leverages policy-based approaches designed to have an impact on social and environmental factors to enable healthy choices to be the easy choice.

The session featured speakers Richard Killingsworth, MPH, Director for the Center for Public Private Partnerships in Health at the University of Delaware; Nick Buettner, Vice President of the Blue Zones Project; Deb Logan, Executive Director of the Blue Zones Project in Southwest Florida; and Melissa Lyon, MPH, Director of the Erie County Department of Health.

Killingsworth encouraged attendees to engage partners who are atypical to local public health efforts; assess initiatives for leadership, resources, evidence-plan, and accountability to succeed; and reach out to the private sector and find one approach to collaborate and partner.

Buettner discussed the Blue Zones Project and how they traveled to communities all over the world that had high rates of life expectancy to find the commonalities that contribute to their longevity. He said that most of the people in these communities had great attitudes about aging, were very family- and friends-oriented, and integrated some sort of physical activity into their daily routine. He closed by saying, “There is a need for sufficient funding and talent, an evidence-based design, and performance and impact measures to see successful changes in our communities.”

Logan then discussed how the Blue Zones Project is improving the health of her communities in Southwest Florida. She shared that because of the infusion of the Blue Zones Project into the existing health work, people have been able to remain engaged and Collier County has been ranked number one in national well-being.

The final speaker, Lyon discussed the Blue Zones Project that her department launched in Cori, PA. She shared that funders were asked to contribute equal amounts and nontraditional partners were sought after. She closed her presentation by saying, “We must have courageous conversations about doing new initiatives and engage partners that can help create significant impacts.”

This year’s conference provided attendees the opportunity to learn from leaders in the field, connect with potential partners, gather new resources and skills to implement in their own agencies, and engage in conversations to help build a framework to address and improve health in their communities. Save the date for NACCHO Annual 2020, July 7–9 in Denver. For more about the conference, visit http://nacchoannual.org.

Final Reflections: Outgoing NACCHO President Kevin Sumner Reflects on His Term and Hopes for the Future

Interview by Taylarr Lopez, Communications Specialist, NACCHO

Let me preface this conversation by mentioning how hard it was to gather these reflections. It’s not that this past year has been so difficult—quite the contrary because it has been so rewarding, and busy— but because the end of the year is bittersweet. In many ways, the energy and passion of NACCHO, its members, its staff, its Chief Executive Officer Lori Tremmel Freeman, and the public health workforce in general, has provided a source of fuel to keep me engaged with and motivated about public health.

Firstly, I want to thank the NACCHO staff that are so dedicated and talented and keep the NACCHO operation in motion. The staff has worked hard to support my efforts over the past year. I am grateful to the Board of Directors whose visions and thoughts guide the NACCHO operation and assure that we are working for all the local health departments across the country. Finally, I’d like to thank the Officers: Dr. Umair Shah, Past-President, Jennifer Kertanis, President-Elect; and George Roberts, NACCHO’s incoming President.

I am comforted by the upcoming leadership and the support system around them. NACCHO is in great hands and I am confident it will continue to grow, improve, and prosper in the future. Although I will always be available to support and assist, I will dearly miss the direct involvement.

What have you learned during your tenure as president and what advice would you like to pass on to the next president?

This past year has solidified my long-held belief that the NACCHO staff and members are some of the most awesome people. It has affirmed my belief that the public health workforce is indomitable. They work on challenging issues, in trying, stressful, under-resourced conditions, and yet they do it with a smile on their face and an unending belief that they will make a difference.

While local health departments and communities across the country have issues that are different, we are essentially all the same in many ways. We are working on many of the same public health concerns, struggling with similar challenges, and yet, are regularly achieving positive outcomes for our communities. As I listened to our members across the country, it was evident that the public health workforce is a community unto itself and we can—and do—share with and learn from each other. Our shared experiences and expertise are likely to be useful no matter where we are. For this reason I encourage you all to get engaged with NACCHO and your colleagues across the country.

At the same time, NACCHO is made up of an incredibly diverse group of members and we must remember that NACCHO is here to serve all local health departments in the best way possible. Although we may have structural or political differences, we need to address all concerns, provide for all types of local health departments, and find common ground that can lead to greater consistency and efficiencies across the country.

To George Roberts, the incoming NACCHO President, and those who will follow, I remind you to always remember whom you are representing. We all come to this position with our own unique education, experiences, beliefs, and biases, but we should try to set them aside to assure equitable representation for all local health departments. As leaders, we need to take a stand, but do so in a way that reflects the needs of local health across the country. The diversity and dedication of the NACCHO Board of Directors makes this fairly easy, as they are truly representative of local health and provide the insight needed to assure equity.

What are some of the most notable initiatives or projects you worked on as NACCHO president?

At the 2018 NACCHO Annual Conference, I outlined three initiatives I hoped to begin work on throughout the year and that would be carried forward in future years. First was to support our newly hired Chief Executive Officer (CEO) Lori Tremmel Freeman. Lori has done a tremendous job in her position, and while the Board and I will continue to support her and the staff, I have great confidence that she will continue to lead NACCHO in a positive direction. Lori made this initiative especially easy.

Second, I expressed a desire to improve existing and create new partnerships. Through the efforts of the Board, the CEO, and other NACCHO staff, I am happy to say that existing partner relations have greatly improved and new partnerships have been developed. NACCHO has been asked by partners to take on new projects, exhibiting the level of trust our partners have in us. More specifically, the Robert Wood Johnson Foundation (RWJF) is providing funding for NACCHO’s new global health initiative. This area was initially broached by Past-President Dr. Umair Shah. Through the efforts of Umair and Lori, who continued to foster the relationship with RWJF, we are moving forward with new funding.

The most thrilling example of our partnership development came in March 2019. For the first time, we collaborated with the Association of State and Territorial Health Officials (ASTHO) and the National Association of Local Board of Health (NALBOH) during our annual visits in Washington D.C. to advocate for public health on Capitol Hill. As a result, three different organizations descended upon policymakers with the same message to support public health. We had an unprecedented number of visits with policymakers. Our public health voice was collective and loud. Recognizing that coordinating this effort placed a large burden on NACCHO staff, I do hope that we find a way to continue, and maybe even expand, these collaborative efforts to amplify the voice of public health in the future.

Finally, my third initiative was to address the needs of small- and medium-sized health departments across the country. The first step in this initiative is to define what we mean by these terms. Historically, we have defined local health departments by the size of the populations they serve, but this may not always be the best way to categorize as resources, staff size, geography, and other factors may all play a role in how we are defined and operate. This initiative is very much a work in progress, but I am pleased that the Board of Directors continues to discuss this.

These discussions are leading to strategic conversations in other venues such as NACCHO membership and accreditation through the Public Health Accreditation Board. Jurisdictions have unique challenges and opportunities based on their size and structure but we need to understand these challenges and opportunities better.  By doing so NACCHO will be better positioned to find ways to assure we meet the needs of all local health departments from the “small” rural health department in Washington to the “small” urban health department in New Jersey, and everyone else.  We need to understand their differences and similarities, and how we as an organization can best learn from them and serve them all.

During your time as president, what changes have you seen in public health and what challenges do you think local health departments faced the most?

I’ve noticed some changes at the highest levels of the federal government in recognizing the work of local health departments and a greater willingness to work directly with local public health. We have a long way to go, but improvements have been noticed. I have seen a change in NACCHO over the past year. Morale appears to be higher, our financial status is more stable, our partnerships and collaborations are growing and improving, and the Board of Directors is more focused on strategic activities; all positives in my mind and trends that I expect will continue through the upcoming years and leadership.

I don’t think the challenges for local health departments has changed much. We always struggle to have the resources we need to do the jobs expected of us, especially for our workforce. However, I do see a possible “silver lining” as we have a large cadre of public health students in the pipeline. Undergraduate and graduate public health programs across the country are booming. We just need to assure that we have the financial resources dedicated to local public health that allows local health departments to hire and mentor these new, young public health professionals so that local public health can continue to thrive and make a difference for our communities far into the future.

What are some of the most pressing issues you see on the horizon for local public health and how can local health departments address them?

I think the most pressing issue for public health is how we elevate its value with our residents and policymakers. We need to find a way to impress upon the community that public health is important all the time, not just during and immediately following a major incident; that public health is everywhere and everyone all the time. As we all know, if we do our jobs right public health is largely invisible. This means that we are notoriously under-resourced and unrecognized. Unfortunately, I think this often leads public health professionals, to dwell on these facts, and focus on the money.

To defend our requests for resources, we depend on science-based information that demonstrates our value. While this is completely necessary, I am not sure how successful it has been. Therefore, I have been asking my colleagues to focus on the art of public health, in addition to the science. I have asked colleagues to tell stories in a compelling and passionate way that convinces the public of our value, but does not require them to understand the science that supports our actions.

My wife, a children’s librarian, is always using stories and crafts to develop a child’s interest in reading. It is our job to continue to develop the science and to use it to our advantage, but I also think it is our duty to create an interest in public health by expressing to our communities and policymakers the value of public health through stories, images, and art. We need to be a compelling force for public health and we should hone our skills in the arts to match our scientific abilities such that we can communicate the joy and impact of public health effectively to all parties.

What was your favorite thing about being president and after your term, what are you most looking forward to doing in your free time?

Virtually, all my experiences as President over the past year have been positive, but my favorite two things are very much related. I loved travelling to meetings around the country to talk about NACCHO and the work it is doing. I’ve enjoyed meeting representatives of local health departments across the country. I also cherished the opportunities to listen and talk to different local health department representatives. Meeting with and talking to State Associations of County and City Health Officials and their members, hearing about their challenges and concerns, as well as their successes, helped me understand how NACCHO can better serve, but also helped me as a public health professional.  I was able to learn from my colleagues and I hope I will be able to translate that learning into greater public health success with my department and colleagues in New Jersey.

Being President of NACCHO has been incredibly rewarding, humbling, and inspiring, but it has also been time consuming. I hope that in my “free time” I will be able to reengage with my New Jersey State colleagues on some state initiatives and focus more on public health in my jurisdiction. My staff has been great at filling the gaps of my physical and mental absence, but it is time for me to focus more efforts at home. This also includes my personal home.

I hope to spend more time with my wife doing the things we enjoy such as hiking, travelling, and visiting small, local craft breweries. Who knows—if there is enough free time, I might even work on the development of a personal art and start playing music again. A long time ago, a close friend told me when I finished an emergency medical training program, that I would soon find something to fill the free time. Sure enough, he was right and ultimately that master’s degree helped me become President of this great association. I look forward to whatever fills my free time and to the upcoming adventures. Thank you for this great opportunity!

Local Health Departments and Communities Will Benefit from the Recently Passed FY2020 LHHS Spending Bill

Appropriations Bill Includes Strong Spending Levels for Many Local Health Department Priorities

NACCHO thanks the House of Representatives for passing a FY2020 Labor, Health and Human Services, Education, and Related Agencies (LHHS) funding bill that includes strong spending levels for many local health department priorities. They include a total of $8.3 billion for the Centers for Disease Control and Prevention (CDC) and strong top-line funding levels for other federal agencies that help support public health activities through local health departments.

“The House Appropriations Committee sent a strong message today that they are not only supportive of public health, but willing to put the dollars needed into the system,” said Adriane Casalotti, NACCHO Chief of Government and Public Affairs. “These federal investments are key to supporting the work of local health departments to prepare for, identify, prevent, and respond to public health issues. These funds are critical to enable local health departments to work each day to strengthen their communities across the country.”

H.R. 2740 includes the following:

  • $700 million, an increase of $25 million, for public health emergency preparedness cooperative agreements, which provide every state, eight territories, and four directly funded cities with funding to foster all-hazards emergency
  • $650 million, an increase of $39 million, for the Section 317 Immunization
  • $100 million for the first year of a multi-year effort to support modernization of public health data surveillance and analytics at CDC, state and local health departments, and the National Center for Health
  • $56 million, an increase of $5 million, in public health workforce initiatives to address workforce

NACCHO urges the Senate to also include robust funding to protect the public’s health in its FY2020 LHHS appropriations bill. The association also urges Congress and the White House to reach a budget deal to raise the caps on discretionary spending without delay in order to make increased funding for these public health priorities a reality.

Homelessness Among Individuals with Disabilities: Influential Factors and Scalable Solutions

By Erin Vinoski Thomas, MPH, CHES, Health and Disability Fellow, NACCHO; and Chloe Vercruysse, MBA

This post originally ran in NACCHO Essential Elements blog.

People experiencing homelessness lack sustainable access to housing and instead turn to emergency shelters, transitional housing, or places not meant for overnight residence. In the Unites States on a single night in January 2018, 552,830 people experienced homelessness; between 2.5 and 3.5 million people experience homelessness over the course of any given year. Housing is an important determinant of health, and those who experience homelessness are at greater risk for health challenges. Continue reading

Member Spotlight Interview: Health Director Emily Brown Discusses the Importance of Rural Health Representation

NACCHO’s Member Spotlight series features interviews with local health department leaders and staff about their careers in public health. This interview features Emily Brown, MPH, CPH, Health Director for the Rio Grande County Public Health in Colorado. Below she highlights the importance of rural health being represented in all levels of government and shares how her health department is addressing inequities in health as they relate to poverty.

Tell us about your career path into public health.

I received my undergraduate degree in Communications from the University of Colorado in Boulder. During my last semester, I took a Communications and Health elective, which I sometimes credit for leading me to a career in public health or at least making me think about how important communications are in the health field. Continue reading

Minneapolis Environmental Health Awarded 2019 Crumbine Consumer Protection Award for Excellence in Food Protection

NACCHO recently announced Minneapolis Environmental Health as the recipient of the 2019 Samuel J. Crumbine Consumer Protection Award for Excellence in Food Protection at the Local Level. This award is given annually to local environmental health jurisdictions that demonstrate unsurpassed achievement in providing outstanding food protection services to their communities. Continue reading

NACCHO Announces 2019 Model Practice Award Winners

The National Association of County and City Health Officials (NACCHO) named its 2019 Model Practice Award Winners, an annual recognition of programs demonstrating exemplary and replicable qualities in response to a critical local public health need. This year, 53 outstanding local health department programs have received this recognition, addressing a broad range of public health issues, including immunization, infectious diseases, environmental health, and emergency preparedness. Continue reading