Local Public Health Confronting Climate Change in Communities

By Kevin G. Sumner, MPH, NACCHO President and Health Officer and Director of the Middle-Brook Regional Health Commission in Green Brook, New Jersey

The effects of climate change are visible in communities across the country, from increasingly severe storms (e.g., the recent “bomb cyclone” in the Plains and Midwest) to more frequent wildfires, record-breaking floods, and prolonged heat waves. These extreme weather events and corresponding changes to the ecosystem threaten the public’s health.

As traditionally cooler regions experience warmer and longer summers, for example, mosquitoes and other vectors are migrating north and infecting populations previously not at risk. According to the Lancet Countdown on Health and Climate Change, vector-borne diseases transmitted by mosquitoes, ticks, and fleas, including Lyme disease and West Nile virus, tripled from 2004 to 2016.

Local health departments are uniquely positioned to confront these and other health outcomes of climate change in their jurisdictions. At the Middle-Brook Regional Health Commission, we are working with the New Jersey Climate Change Alliance, facilitated by Rutgers University’s Climate Institute and Bloustein School of Planning and Public Policy, to better understand the public health implications of climate change in New Jersey and to advocate for science-based policies and programs. In fact, we have an upcoming meeting focused on the relation between climate change and health equity. In addition, as part of our preparedness planning, we recognize that we are likely to be called upon more frequently to respond to natural events and disasters as a result of climate change. It seems we are responding to hurricanes or severe storm events on an annual basis. Climate change clearly has an impact on local health departments’ preparedness activities, communicable disease control measures, and efforts to improve the health of vulnerable populations.

NACCHO’s environmental health team educates local health departments about the health effects of climate change and offers steps to address those effects.

Here are a few of the ways NACCHO is supporting local health departments:

Climate and Health Adaptation Grants

With the support of the Centers for Disease Control and Prevention (CDC), NACCHO offered a funding opportunity to supplement local health departments’ ongoing climate change and health adaptation initiatives. In January 2019, NACCHO awarded the Boston Public Health Commission and the Marquette County Health Department in Michigan, each with $15,000 grants to use in climate and health projects through July 31, 2019.

Boston is using the grant to support the translation and printing of extreme temperature resource guides to reach all intended populations, particularly non-English speakers who may be the most vulnerable. NACCHO featured Boston’s climate change work in a recent blog post for National Public Health Week. Read more here.

Marquette County is developing a public health emergency response plan specifically addressing climate change-related localized flooding, which is predicted to increase in this rural locality.

Essential Actions for Climate Resilience in Local Health Departments

In 2018, NACCHO and its Global Climate Change (GCC) Workgroup developed a fact sheet on examining and addressing the local public health impacts of climate change: Essential Actions for Climate Resilience in Local Health Departments.

The essential actions are organized into five categories:

  • Learn – enhance climate literacy;
  • Participate and discuss – foster relationships in the community;
  • Collaborate – partner with organizations to plan for climate resilience;
  • Create – develop and implement a climate action plan; and
  • Reflect – define metrics and evaluate progress.

The actions complement the CDC’s Building Resilience Against Climate Effects (BRACE) Framework and align with the three core functions of public health (i.e., assessment, policy development, and assurance).

In developing this fact sheet, the GCC Workgroup placed an emphasis on health equity, recognizing the disproportionate risk that communities crippled by environmental injustices and socioeconomic inequities face from climate change.

Climate Change Success Stories from Local Health Departments

In 2017, NACCHO interviewed 11 local health departments to understand how cities and counties were preparing for the health impacts of climate change. This project sought to identify best practices and provide real-world case studies for other health departments to learn from and adapt.

These are a few of the accomplishments highlighted in the success stories:

  • The Green River District Health Department in Kentucky, identified local climate-related health indicators using a state grant and then conducted a community health assessment using those indicators.
  • The San Francisco Department of Public Health released the Climate and Health Adaptation Framework, the first comprehensive health adaptation plan for the City and County of San Francisco that is rooted in health equity and uses a place-based, data-driven approach to assessing climate change and solutions.
  • Austin Public Health developed a Community Climate Plan for communications and outreach that engaged 5,000 people through online discussions, community events, and group presentations and reached 500,000 people with educational content about climate through digital and advertising platforms.

See all the success stories here.

Policy and Advocacy to Address Climate Change

NACCHO’s Board of Directors has also approved the following policy statements related to climate change:

NACCHO advocates for funding for the National Center for Environmental Health including the CDC’s Climate and Health program. For several years, NACCHO has supported federal legislation that would require the U.S. Department of Health and Human Services to develop a national strategic action plan for addressing the public health impacts of climate change.

Learn more about NACCHO’s climate change work here, and visit NACCHO’s Toolbox to explore resources in the Climate Change Toolkit. Finally, I encourage you all to tell your stories to NACCHO, to your colleagues, and to the public about your work related to climate change to help raise greater awareness of the impact of climate change on the health of our communities.

To learn more about NACCHO’s work in climate change, click here.

NACCHO CEO Releases Statement on Ongoing Measles Outbreaks

By Lori Tremmel Freeman, NACCHO CEO

“Yesterday, the Centers for Disease Control and Prevention confirmed there have been 626 individual cases of measles diagnosed across 22 states in the United States since the first of this year. We are on track to have the highest number of measles cases in the United States in 25 years, and for man this disease of the past is becoming a threat of the present.

“626 cases are far too many. These cases are not just numbers—they represent sick children, missed days of work, and an incredible financial strain on our tax dollars that must be pulled away from other public health priorities.

“The image of a young child covered in the measles rash and suffering from an incredibly high fever is heartbreaking. No parent wants to see their child in pain, and all want to protect their children from harm. Even so, some well-intentioned parents have chosen not to protect their children from this devastating disease based on discredited and false information. In doing so, they are putting their children, themselves and others in their communities at risk.

“Simply put, vaccines are the best defense against the threat of vaccine-preventable diseases and play a vital role in protecting the health of communities. Immunization has been one of the most successful and effective public health measures available to populations worldwide, with an unparalleled record of disease reduction and prevention.

“The success of vaccines, however, has made it is easier to take our health for granted. Most Americans don’t remember the dangerous impact of vaccine-preventable diseases that have been made so rare and have allowed fear of the vaccine to displace fear of the illness.

“NACCHO is the voice of the nation’s nearly 3,000 local health departments who are on the front lines of tracking and responding to these preventable outbreaks. Our members in hard-hit communities are working tirelessly to halt the spread of measles in their area by educating the public, offering measles vaccinations, conducting outreach within their communities, and monitoring and tracking the spread of disease. They will continue to do so until these outbreaks can be brought under control. But it is up to all of us to redouble our efforts to educate our family members, friends and neighbors about the role we must all play in preventing these outbreaks before they start. Our nation’s children should not have to suffer from a serious illness we have known how to prevent for years.”

For more information, including tools and resources about vaccines, vaccine-preventable diseases, and immunization programs, click here.

NACCHO Highlights Need for Greater Support for Local Health Departments to Combat Rise in STDs

STD Awareness Month is an opportunity to raise awareness about Sexually Transmitted Diseases (STDs), also referred to as Sexually Transmitted Infections (STIs), with local health departments and with local and national policymakers, stakeholders, and the public. The National Association of County and City Health Officials (NACCHO), the voice of the nation’s nearly 3,000 local health departments is working diligently to support their members’ work to address rising STD rates across the country and to implement innovative projects, such as its Express STI Visits Initiative, to provide new ways to link individuals to testing and treatment.

“Local health departments work hard every day to reduce STD rates and improve health outcomes in their communities by testing for, treating, and ultimately, preventing STDs. This includes strong prevention and treatment messaging, as well as the essential work of disease intervention specialists (DIS) who are on the frontlines of efforts to disrupt the spread of STDs and prevent outbreaks,” said NACCHO Chief Executive Officer Lori Tremmel Freeman. “But as NACCHO’s research shows, they need more support—stagnant or decreasing resources are not enough, and local health departments and their partners need more resources to address these rapidly rising STD rates.”

While STD rates are quickly increasing, federal, state, and local resources have stayed the same or decreased, leaving public health systems strained, including local health departments. In 2017, NACCHO queried its HIV, STI, and Viral Hepatitis Sentinel Network and found that nearly one-third of local health departments reported anticipating budget cuts in the next fiscal year and the majority experiencing stagnant funding for STD programs at best.

As the latest Centers for Disease Control and Prevention (CDC) STD Surveillance Report shows, STD rates increased for the fourth consecutive year in 2017, and there has been a steep, sustained increases in the incidence of all three reportable STDs.

Gonorrhea diagnoses increased by almost 70% percent overall and nearly doubled among men. Increases in diagnoses among women — and the speed with which they are increasing — are also concerning, with cases going up for the third year in a row.

Primary and secondary syphilis diagnoses increased 76%. Congenital syphilis (transmitted from the pregnant person to the fetus) cases rose sharply with 918 cases in 2017, a number that has more than doubled since 2013. This included 64 reported stillbirths as a result of congenital syphilis (up from 41 in 2016).

Chlamydia remained the most common condition reported to CDC. More than 1.7 million cases were diagnosed in 2017, with 45% of cases among 15- to 24-year-old females. The preliminary data for 2018 sadly shows these trends continuing and a new CDC analysis suggests that gay and bisexual men are at higher risk for extragenital STDs (e.g. chlamydia or gonorrhea in the throat or rectum), which increases treatment difficulty, drug resistance, and the risk of HIV infection. While these STDs are treatable, if untreated, they can cause serious health consequences such as pelvic inflammatory disease, infertility, and stillbirth.

Throughout STD Awareness Month, NACCHO is highlighting each of CDC’s four STD Awareness campaigns: Syphilis Strikes Back, GYT: Get Yourself Tested, Treat Me Right, and Talk. Test. Treat. New blog posts are available each Thursday of April and will feature work that local health departments and NACCHO are doing around the country to address STDs.

For more information, read about our STD work and check out our STD policy statement.

Using Data to Improve Local Public Health Practice

By Kevin G. Sumner, MPH, NACCHO President and Health Officer and Director of the Middle-Brook Regional Health Commission in Green Brook, New Jersey

Data and research help us to understand our world and make informed decisions. As local health officials, data allow us to measure progress over time, identify emerging trends, and understand how our jurisdictions compare to others in a variety of different ways. Data inform much of our community health improvement planning; they lend credibility to our policy positions and support our funding requests. They also provide a common language as we work with our partners across sectors to address the social determinants of health, helping us to communicate and form a shared understanding of the issues we face. Continue reading

Advancing Health Equity and Racial Justice: Emerging Lessons from Los Angeles County’s Community Prevention and Population Health Taskforce

By Manal J. Aboelata, MPH, Deputy Executive Director, Prevention Institute

Across the country, local jurisdictions are employing a variety of tactics to achieve health equity and racial justice. In 2016, as Los Angeles County prepared to integrate the departments of mental health, public health, and health services under a single health agency umbrella, the Board of Supervisors recognized the value in creating an advisory body that would tap into the knowledge and expertise of community-based organizations and LA County residents to elevate priorities, challenges, and opportunities to eliminate gaps in public health outcomes through a focus on the determinants of health and wellbeing. This profile details the early days of the Taskforce, including its efforts to embed community-based health equity perspectives into county decision-making and center racial justice within its focus on health equity. It also outlines the critical role of the local public health department in supporting the Taskforce. The aim of this profile is to provide those in and outside of LA with a snapshot of this nascent effort and emergent lessons for those interested in addressing health equity and racial justice by forging stronger ties between local government decision-makers and diverse organizational and community-based interests. Though it’s too early to claim “success”, this profile sheds light on some of the formative experiences of the Taskforce to inform those interested in testing similar approaches elsewhere and provide background for those seeking to contribute to the effort underway in LA County. Continue reading

Member Spotlight: Health Director Lisa Macon Harrison Shares Technology’s Effect on Public Health Communication and Discusses Rural Health’s Need for a New Funding Model

Interview by Taylarr Lopez, Communications Specialist, NACCHO

NACCHO’s Member Spotlight series features interviews with local health department leaders and staff about their careers in public health. This interview features Lisa Macon Harrison, MPH, Health Director of the Granville Vance Public Health Department in North Carolina. Below, she shares the how her department is addressing mental health and substance use disorder; youth wellbeing; access to healthcare; how technological advances have affected public health communication; and the need for a new funding model for rural public health. Continue reading

Public Health on the Hill: A Coalition for Sustained Support

Adriane Casalotti, Chief of Government and Public Affairs, NACCHO

By Adriane Casalotti, Chief of Government and Public Affairs, NACCHO & Carolyn Mullen, Chief of Government Affairs and Public Relations, ASTHO

Our nation’s public health system is, at its core, a partnership between federal, state, and local governments. While these partnerships are clear on the ground in communities, many members of Congress are unaware of the important work being done each day to keep their states and communities safe and healthy.

That is why, for the first time ever, ASTHO and NACCHO will host a joint public health advocacy day on Capitol Hill in Washington, D.C., to help bring these messages to elected officials from across the country. Along with members of the Big Cities Health Coalition (BCHC), the State Associations of County and City Health Officials (SACCHOs), and the National Association of Local Boards of Health (NALBOH), state and local public health leaders will educate policymakers about the value and importance of federal funding for public health departments and programs throughout the country. In order to best protect and promote the health of all Americans, it is critical that there is a strong coordinated public health system at all levels. Without a robust system, people suffer. Continue reading