Innovation Act of 2019. To build on these lessons, we recommended that the steps outlined in Figure 1 be implemented. The first step is to include environmental health in the mission statement. This inclu- sion would recognize that environmental health is a backbone of the public health sys- tem, which is beyond the scope of most doc- tors, nurses, and allied health professionals (Brooks & Ryan, 2021; Whiley et al., 2019). For example, communicable disease control specialists tend to take a narrower approach to managing risks as their expertise lies in the disease control itself, not the systems that generate risk (Dwyer, 2022). This step would also reflect that environmental health risks will continue to emerge, especially as Australia is now one of the more urbanized countries in the world (The World Bank, 2021). For example, per- and polyfluoroal- kyl substances (PFAS) emerged as an issue in the early 2000s and are found in dispos- able food packaging, cookware, furniture, carpet, and manufacturing plants (Sunder- land et al., 2019). The role of environmental health science is to understand the human health risks from PFAS and then, if neces- sary, implement interventions. Steps two, three, and four would require employment of credentialed environmen- tal health professionals coupled with a workforce development plan. Credentialed professionals would ensure that interdisci- plinary thinking from a whole-of-society perspective is ingrained into the Australian CDC. Also, the Australian CDC would need to work with Environmental Health Austra- lia to establish a credentialing framework to ensure alignment with other professions and colleagues in the UK and U.S. An en- vironmental health workforce plan would bring all these components together. A tem- plate could be the Environmental Health Workforce Act (2021), which was intro- duced to the U.S. Congress to prioritize the needs of new and existing environmental health professionals. The fifth step would be for the Australian CDC to work with local, state, and territo- rial governments to track and monitor en- vironmental health infrastructure, services, and risks. This work could be in the form of an index or registrar, which would al- low the Australian CDC to create a baseline, understand areas of need, and guide invest-
FIGURE 1
Steps to Reinforce Environmental Health Systems and Services and Goals of the Australian Centre for Disease Control (CDC)
Reinforcing Environmental Health Systems and Services
Goals of the Australian CDC
Step 1: Include Environmental Health in Mission Statement
Ensure Ongoing Pandemic Preparedness
Step 2: Employ a CDC Environmental Health Workforce
Step 3: Develop an Environmental Health Workforce Plan
Lead Federal Response to Future Infectious Disease Outbreaks
Step 4: Establish a Credentialing Pathway
Step 5: Develop and Monitor Baseline Environmental Health Infrastructure, Services, and Risks
Work to Prevent Noncommunicable and Communicable Diseases
Step 6: Embed a Population-Based Management Team Approach to Pubic Health Emergencies
Step 7: Establish a Framework for Implementation Research Focused on Environmental Health
Result: An Australian CDC That Reinforces Environmental Health Systems and Services
“World Class” Australian CDC
in Australia. For example, environmental health has a secondary role in the Australian CDC consultation paper and is not included in the Senate Select Committee on COVID-19: Final Report ; Fault Lines: An Independent Re- view Into Australia’s Response to COVID-19 ; Australian Government Crisis Management Framework ; or Australian COVID-19 Re- sponse Management Arrangements: A Quick Guide . Funding has also struggled to cover needs in workforce development, practi- tioner training, and research. Addition- ally, there is no job code for environmental health listed by the Australian Taxation Of- fice, but there are over 20 types of inspectors and more than 55 dierent types of nurses (Australian Taxation Oce, 2022; Whiley et al., 2019). Many nations have environmental health (i.e., science and workforce) integrated within their national public health agency
model (Dwyer, 2022). The OECD (2020) recognizes how enhancing environmental health systems can reduce the vulnerabil- ity of communities to disease outbreaks, epidemics, and pandemics while improving overall societal well-being and resilience. Also, following an environmental health approach supported by optimal practitio- ner performance significantly reduces the impact of diseases on both communities and health systems (Kelley & Anderson, 2012). In the U.S., the Centers for Disease Control and Prevention, National Environ- mental Health Association, and Baylor Uni- versity developed an initiative to support the environmental health workforce—Un- derstanding the Needs, Challenges, Oppor- tunities, Vision, and Emerging Roles in En- vironmental Health (UNCOVER EH)—and the profession is listed in the Pandemic and All-Hazards Preparedness and Advancing
43
March 2023 • Journal of Environmental Health
Powered by FlippingBook