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.

One of the most important sources of data about local public health practice, workforce, and infrastructure is the National Profile of Local Health Departments, otherwise known as the Profile study. NACCHO fields the Profile study every three years, sending the survey to every local health department (LHD) in the country. In 2016, 76% of LHDs completed the survey, helping NACCHO to present a complete and accurate overview of LHD funding, workforce programs, and partnerships.

The Profile study is a valuable source of data for NACCHO, LHDs, policymakers, funders, researchers, and academics. NACCHO uses the data to advocate for federal policy and funding to support the many challenges LHDs face today. The study also forms the basis for NACCHO’s technical assistance and capacity-building programs. LHDs use Profile data to benchmark their health departments against their peers, providing a one-of-a-kind snapshot of LHD demographics, workforce, funding, and activities. (Learn more about how researchers and academics use the Profile data.)

During the years in between Profile studies, NACCHO conducts the Forces of Change surveys which, though smaller in scope than the Profile, help to identify local public health infrastructure challenges and opportunities to strengthen LHD capacity. The latest Forces of Change survey showed that although the economic situation is slowly improving for many LHDs, workforce capacity challenges persist: One-third of LHDs reported experiencing job losses in 2017. In addition to these budget and staffing realities, LHDs also face emerging threats to their communities such as the increased use of opioids, high severity of influenza seasons, and impacts of climate change.

In addition to these comprehensive surveys, NACCHO also conducts a variety of targeted research on local public health issues. Here are three examples from the past year:

  • Assessing Preparedness Capacity across the United States
    In December, NACCHO released the 2018 Preparedness Profile Assessment, which describes the landscape of public health emergency preparedness across the United States. Results showed that although LHDs continue to make strong efforts to prepare for, respond to, and recover from disasters and emergencies that threaten the health of their communities, gaps are still present in key public health preparedness sectors. LHDs are concerned about but feel unprepared to respond to emerging threats (e.g., opioid abuse, active shooter incidents). The assessment includes recommendations to inform priorities at the local, state, and national levels and influence NACCHO’s preparedness activities.
  • Assessing Retail Food Regulatory Programs to Bolster Food Safety
    NACCHO conducted an assessment to understand how local, state, tribal, and territorial governmental public health agencies are using the U.S. Food and Drug Administration’s Voluntary National Retail Food Regulatory Program Standards (Retail Program Standards) to continuously improve their retail food regulatory programs. Over 400 agencies completed the assessment, which indicates that while agencies face many barriers to meeting all the criteria within the Retail Program Standards, working toward the standards has a positive impact on their work and their communities.
  • Examining the Nationwide Inclusion of People with Disabilities in LHD Programs and Activities
    NACCHO completed a follow-up to a 2014 national assessment of the knowledge, awareness, and inclusion of disabilities in LHDs’ public health practices. Of the 253 health departments that completed the 2018 assessment, 54% said they considered people with disabilities as a population that experienced health disparities in their jurisdictions, compared to only 11% of respondents in 2014.

These are just a few examples of the research that NACCHO conducts to assist and advocate for LHDs. It is worth mentioning that NACCHO’s Research and Evaluation team is available to help fulfill data requests from LHDs.  Recently in New Jersey, we embarked upon efforts to increase state funding to local health departments. I reached out to the NACCHO Research and Evaluation team, which provided me with New Jersey funding and resource data, and how it compared to national averages.  The team was able to provide data that supported our position that New Jersey local health departments were underfunded compared to most of the rest of the country, and that we had smaller staffs for the populations we serve. In fact, this credible information helped us secure a promise of $2.5 million from our state to focus on infectious disease activities at the local level. The NACCHO data, supported by input from our members, has helped New Jersey local health departments, and we thank all who respond to the requests and to NACCHO’s team for producing such quality and practical data.

One final note: The 2019 Profile study is currently in the field. Please be sure to complete the survey by April 19. It’s critical that all LHDs respond, so that the 2019 Profile report contains accurate information. If you have any questions about the survey, e-mail profile@naccho.org or call 800-758-6471.