of functions into disease control units or divisions as a reduction in capacity versus maintaining that operational knowledge in a broader group that includes environmen- tal health specialists. Further, there are other areas where there are great opportunities for improvement but obstacles exist in taking appropriate action. Water pollution poses a significant risk to public health through contaminants like lead, industrial chemicals, and agricultural runo. Local departments are often responsible for regular water quality testing and enforcement of regulations to ensure safe drinking water. State agencies develop broader water quality standards and oversee local compliance but face funding and stang challenges. Other factors that complicate assuring safe water include aging infrastructure, emerging con- taminants, and balancing industrial and agri- cultural interests with public health. The capacity developed during the COVID- 19 pandemic to identify and respond might not be sustainable without ongoing funding (e.g., federal, state, local). Rapid urbanization and global travel pose challenges in control- ling pathogen spread, necessitating more robust surveillance and response systems. The eectiveness of local and state envi- ronmental health departments is often con- strained by limited resources, stang, and funding. Climate change exacerbates many environmental health issues, requiring adap- tive strategies and more resources. Further-
more, the need for intersectoral collaboration is critical, as environmental health is inter- twined with sectors like housing, urban plan- ning, and agriculture. The capacity and authority of local and state environmental public health agencies in the U.S. have faced challenges and reductions, particularly in responding to vector control issues, air quality, water quality, food safety, and nuisance conditions. Here are several key trends and examples that are of concern: • Workforce development and organiza- tional competencies: Many state public health agencies have identified workforce development as a critical area, focusing on training, education, recruitment, reten- tion, and rebuilding clinical and laboratory capacity. Additionally, organizational com- petencies—including funding strategies, resource management, and leadership— are priority areas for a majority of states. Are there opportunities to elevate environ- mental health practice as well? • Legal and policy challenges: These chal- lenges can take a variety of forms. Arizona, Florida, Georgia, Indiana, Kansas, Mon- tana, Ohio, and Texas have implemented policies that limit public health authority. These limitations include restrictions on quarantine, stripping local health depart- ments of emergency response authority, prohibiting vaccination requirements at state universities and hospitals, and shifting power to legislatures. Legal challenges in
states like California, Kentucky, Louisiana, and Virginia have also arisen, particularly around restrictions on religious gatherings and public health recommendations. These trends and examples illustrate the complex challenges facing local and state environmental public health agencies in the U.S. They reflect a combination of workforce, legal, policy, and funding issues, all of which impact the ability of these agencies to eec- tively respond to public health needs. On the brighter side of things, the inclu- sion of environmental health themes in improvement plans for local and state health departments across the U.S. reflects a grow- ing awareness of the essential role the envi- ronment plays in public health. By address- ing environmental factors, these plans aim to create healthier communities and a more sustainable future. I hope there are opportu- nities for environmental health practitioners to have active roles in this work.
tbutts@neha.org
Reference NPR. (2023, December 15). The U.S. is un- prepared for the growing threat of mosquito- and tick-borne viruses . https://www.npr.org/ sections/health-shots/2023/12/15/1219 478835/arboviruses-mosquito-tick-borne- viruses-tropical-disease
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