Pillars of Governmental Environmental Public Health | A Guide to Scalable Environmental Public Health Programs
Assess and monitor population health status and community needs.
schools, childcare facilities, and other institutions. Every department must develop an all-hazards emergency response plan, as EPH plays a role in preparing for and responding to all disaster types, including natural, biolog- ical (including pandemics), chemical, and radiological pub- lic health emergencies (PHNCI, 2022).
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Jurisdictions should perform regular community health assessments to identify trends in health problems and environmental hazards. Health offcials can use the results of this assessment to identify health disparities and inequities, prioritize issues and allocate resources, and compare their community to state and national health indi- cators (Association of State and Territorial Health Offcials [ASTHO], 2018; PHNCI, 2022). A survey conducted by the Association of State and Territorial Health Offcials (ASTHO) in 2012 found that only 45% of state EPH departments had completed a health impact assessment in the past 2 years, although this number was up from 23% in 2010 (ASTHO, 2014). Resources for conducting assessments include the National Association of County and City Health Offcials’ (NACCHO) Protocol for Assessing Community Excel- lence in Environmental Health, NACCHO’s Mobilizing for Action Through Planning and Partnerships Hand- book (NACCHO, 2015), and the National Association of Local Boards of Health’s (NALBOH) Public Health Gov- erning Entity Assessment Handbook (NALBOH, 2013). Once the assessment is completed, NACCHO’s Local Implementation Guide can be used to help local health departments take action based on the identified trends (NACCHO, 2013). In addition to a community health assessment, jurisdictions should have the capacity to collect, store, and analyze EPH data using the most up-to-date methods and technologies (American Public Health Association [APHA], 2001; NAC - CHO, 2005). They should be able to interpret results and visualize trends over time and have a plan to address any gaps in data. Jurisdictions should also participate in a sur- veillance system that enables them to undertake rapid risk assessments of environment-related diseases and should maintain records and documentation of all surveillance activities (APHA, 2001; NALBOH, 2013).
Inform, educate, and empower people about EPH issues.
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EPH professionals should be able to effectively commu- nicate environmental health risks and convey the impor- tance of EPH programs to partners, media, and the public (APHA, 2001; NALBOH, 2013; PHNCI, 2022). A success- ful EPH program is often “invisible,” meaning the commu- nity is generally unaware of the benefits of EPH, so it is diffcult to generate support (CDC, 2003; Herb et al., 2021). Communication plans should disseminate data from the community health assessment (APHA, 2001) and should include an emergency communication plan developed alongside the program’s all-hazard emergency response plan. Jurisdictions should also create policies and inter- ventions that promote health education (NALBOH, 2013; PHNCI, 2022). All information, resources, and communica- tions should be accessible and culturally and linguistically appropriate (APHA, 2001; ASTHO, 2018; NALBOH, 2013; PHNCI, 2022). Mobilize community partnerships. To maximize EPH program effectiveness, staff should partner with other government agencies, academic and research institutions, and members of the private sec- tor who can contribute to or benefit from environmental health. Potential partner organizations include health, transportation, housing, and environmental groups (PHNCI, 2022). Creating partnerships might involve iden- tifying key constituents and partners, maintaining a com- prehensive directory of those groups with an interest in EPH services, and encouraging constituents to participate in decision-making and policy development. 4 Wherever possible, staff should share data and resources and collaborate with partners to address EPH problems, including health equity and access to resources (APHA, 2001; ASTHO, 2018; ASTHO, 2021; NALBOH, 2013).
Investigate, diagnose, and address health problems and hazards.
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EPH programs ideally should have 24/7 access to labo- ratories that can support public health laboratory testing and timely EPH investigations, which can enable staff to quickly respond to outbreaks (NALBOH, 2013; PHNCI, 2022). Staff should also be able to perform inspections, testing, licensing, and regulation of a wide range of estab- lishments, including food service facilities, recreational waters, drinking water, wastewater, body art facilities,
Create and implement policies, plans, and laws.
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Data collected by EPH programs should be used to inform policies, programs, and interventions intended to improve community health (NALBOH, 2013; PHNCI, 2022). This
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