Journal of Public Health Management and Practice最新文献

Amid escalating public health challenges, the communications workforce plays a vital but under-resourced role in government public health. Using 2024 Public Health Workforce Interests and Needs Survey data, we provide the first national profile of this workforce (N = 48 518). The majority identify as female (83%), white (65%), and are relatively new to the workforce, with 73% having held their position for 5 years or less. While nearly half (49%) report spending some time working in Communications/Public Information and 73% in Health Education, only 11% and 8%, respectively, identify these as program areas where they perform the majority of their job duties. This misalignment underscores a gap between the communications workforce's responsibilities and official roles. The findings highlight the need for public health agencies to invest in dedicated communications roles, leverage the diverse experiences of their employees, and elevate the importance of communications as a core public health service.

Objective: To assess perceptions of effective communication training needs among US state and local government public health employees and examine variations across generations and other worker characteristics.

Design: Cross-sectional survey analysis using data from the 2024 Public Health Workforce Interests and Needs Survey.

Setting: State health agencies and local health departments across 48 states in the US.

Participants: A total of 56 595 state and local government public health employees (37% response rate) representing 4 generations: Baby boomers (16%), Gen X (39%), millennials (38%), and Gen Z (7%).

Main outcome measures: Training needs for effective communication, defined as the combination of ability to communicate effectively across audiences and ability to communicate persuasively. Training needs were identified when respondents rated skills as moderately or very important but reported being unable to perform or at beginner level.

Results: Overall, 11% of respondents identified a training need for effective communication, including 7% with gaps in communicating effectively with different audiences and 9% in persuasive communication. Gen Z staff ranked persuasive communication as their top training need regardless of skill level. Logistic regression revealed that Communications and Policy staff (adjusted odds ratio 1.46, 95% CI 1.21-1.76) and Environmental Health staff (adjusted odds ratio 1.20, 95% CI 1.04-1.37) had higher odds of prioritizing communication training. Women and older generations were less likely to prioritize communication training compared to men and Gen Z, respectively.

Conclusions: Although effective communication was identified as a training need, respondents did not consistently identify effective communication as their top perceived training need. Given the importance of communication to effective public health practice, training interventions should be tailored to different generations, roles, and programmatic areas.

Context: Chronic diseases are leading causes of death and disability in the United States and have disproportionate impacts in our communities due to demographic, geographic, and socioeconomic factors that affect health outcomes. Limitations in timeliness, representativeness, and granularity of chronic disease data hinder efforts to understand trends, factors contributing to differences in health outcomes, and community needs.

Discussion: In this paper, we explore strengths and gaps in chronic disease surveillance capacity in the United States. Then we consider similarities and differences between chronic and infectious disease surveillance needs and approaches. Finally, we make the case for working towards a more comprehensive and integrated approach to data modernization that prioritizes the leading causes of death, disability, and differences in health outcomes in our communities, regardless of etiology, to build a public health surveillance ecosystem that can provide the timely, representative, and local data required to develop responsive and effective health policies and community-based interventions.

Context: Drug overdose deaths in the United States remain a leading cause of preventable mortality. Existing data systems, such as vital statistics and hospital records, often suffer from reporting delays and limited geographic resolution, hindering timely public health responses.

Objectives: To identify high-risk locations for overdose-related emergency calls in Detroit, Michigan, using Risk Terrain Modeling (RTM) and publicly available 911 call data from 2022 to 2024.

Design: A retrospective geospatial analysis using RTM was conducted to evaluate the spatial relationship between overdose incidents and built environment features.

Setting: City of Detroit, Michigan, USA.

Participants: Emergency call data for overdose-related incidents (N = 18 034) were analyzed. No individual-level data were used.

Intervention: No intervention was implemented. The study employed RTM as a geospatial method to identify environmental risk factors and predict high-risk locations for overdose events.

Main outcome measure: Relative Risk Scores (RRS) generated from RTM to quantify overdose risk across 250 × 250 m grid cells in Detroit.

Results: Overdose-related emergency calls were spatially concentrated. RTM identified 8 significant risk factors, including ATMs, retail locations, and religious organizations. Relative Risk Scores ranged from 1 to 142.5 (mean = 9.77, SD = 8.55), with 2.7% of locations classified as very high risk.

Conclusions: RTM applied to 911 call data offers a timely, place-based approach to identifying overdose risk. Public health agencies may use this method to prioritize harm reduction strategies and allocate resources more effectively.

Background: Hospitalized food-insecure patients face a critical 72-hour gap in food support post-discharge, impacting recovery. HealthyLink aimed to design and pilot-test a contextually attuned model for patients in need.

Methods: The HealthyLink model leveraged the infrastructure of a research-health care system-regional grocery partnership. The project has 3 phases: co-design, implementation, and evaluation. During co-design, participatory processes assessed the needs of patients, community partners, and frontline workers. The pilot, guided by the Plan-Do-Study-Act method, tested iterative changes. Post-delivery surveys gathered feedback, and evaluation compared cost-related medication underuse, self-reported health, and program satisfaction. Intervention costs were tracked.

Results: A strategic partnership among Washington University, BJC HealthCare, and Schnucks (grocery chain) was fostered. HealthyLink was integrated into the hospital social worker referral platform, streamlining patient identification, enrollment, and food delivery. A heart-healthy list was curated with fresh, frozen, and shelf-stable nutrient-dense foods. Home delivery was chosen to overcome infrastructure constraints and transportation issues. Implementation lasted for 6 months with 90 patients/families receiving food delivery. Fifty-nine patients responded to the post-delivery survey, with satisfaction ratings ranging from 86.4% to 98.3%, and healing assistance ratings ranging from 88.1% to 98.3%. The self-reported physical and mental health improved, with fewer individuals reporting fair or poor health (69.5%-42.2%, 47.5%-25.4%). The average food cost per delivery was $108. The combined service fee, delivery fee, and tip amounted to $17.

Conclusion: Incorporating co-design principles into the Food is Medicine program helps identify barriers and obstacles that may not be immediately apparent. While delivery offers a valuable solution for reaching hard-to-access populations, associated costs must be considered to ensure scalability and sustainability.

Big Cities Health Coalition member health departments (BCHC HDs) serve more than 60 million people across 35 jurisdictions nearly 20% of the US population. This brief focuses on BCHC HDs that participated in the 2024 Public Health Workforce Interests and Needs Survey (PH WINS), highlighting key workforce indicators during a period of historic investments in public health infrastructure. Results for BCHC HDs from the 2024 PH WINS survey show a positive change in recruitment and retention and strong job satisfaction. These changes correspond with historic financial investments, particularly through the Centers for Disease Control and Prevention (CDC) Public Health Infrastructure Grant (PHIG), suggesting that this substantial investment has played a role in the gains observed among the BCHC HD workforce.

Objective: The purpose of this study is to describe individual and organizational characteristics among those who report working remotely and examine how concordance between public health employees' work preferences and their actual work situations relates to burnout, satisfaction, and intention to leave.

Design: This cross-sectional study utilizes the 2024 Public Health Workforce Interests and Needs Survey (PH WINS). Bivariate relationships were analyzed by conducting chi-squared tests of individual and organizational characteristics by respondents' reported work situation, work preference, and concordance between work situation and work preference. Multivariate logistic regression models of workforce outcomes were performed holding race/ethnicity, gender, age, education level, public health degree attainment, role classification, tenure at current agency, current employer, current employment status, full-time employee, supervisory status, setting, and governance constant.

Setting: A nationally representative sample of government public health employees.

Participants: 55 742 government public health employees.

Main outcome measures: Job satisfaction, burnout, and intention to leave.

Results: Among respondents, most worked in-person, and 52.2% reported that their work situation matched their preference. Job satisfaction was high for the majority of respondents. Nearly 20% reported burnout, and 24.8% reported that they intended to leave their organization within a year. Work situation and preference varied significantly by age, education, tenure, employment status, and organizational setting. Older and less educated staff were more likely to work in their preferred setting (in-person). Multivariate models showed that concordance between work situation and preference was significantly associated with higher satisfaction and lower burnout and intent to leave.

Conclusions: Findings show that employees whose work situations align with their work preferences report higher job satisfaction, lower burnout, and decreased intention to leave their organizations. These effects are most pronounced among younger and highly educated workers, who experience more difficulty in achieving this alignment.

In response to the COVID-19 pandemic, the US government funded voluntary school-based testing to support safe, in-person learning. In Alabama, this effort led to over 925 000 tests across 814 schools. This Practice Brief Report outlines implementation challenges and adaptive strategies used by the Alabama COVID-19 Testing and Prevention program, led by School of Public Health faculty and staff at the University of Alabama at Birmingham School of Public Health. Key informant interviews revealed 4 main challenges: lack of buy-in, limited capacity, unclear program scope, and short lead time. The team responded by building relationships, offering incentives, engaging School Liaisons, hiring adaptable staff, and ensuring strong leadership. These efforts built trust, increased participation, and reduced staff burden. Findings highlight the importance of local engagement, flexibility, and trust-building in public health work. Lessons learned offer guidance for future school-public health partnerships, especially in politically conservative and resource-limited settings.