The double disparity facing rural local health departments: A short report

Rural residents in the U.S. face significant health challenges, including higher rates of risky health behaviors and worse health outcomes than many other groups. Rural communities are also typically served by local health departments (LHDs) that have fewer human and financial resources than their suburban and urban peers. As a result of history and need, rural LHDs are more likely than urban LHDs to provide direct health services, which may result in limited resources for population-based activities. This review examines the double disparity facing rural LHDs and their constituents: pervasively poorer health behaviors and outcomes and a historical lack of investment by local, state, and federal public health entities

A Qualitative Analysis of the Status, Benefits, and Barriers of Electronic Health Record Implementation in Local Health Departments

Background: Electronic Health Records (EHRs) are changing the operations within local health departments (LHDs). The collection of EHRs allow for information analysis, reporting, sharing, transmission, and processing. The barriers in implementing EHRs can prevent and challenge LHDs in experiencing the benefits and efficiency of their use. Research Objective: Analyze the status, benefits, barriers, and ways of overcoming challenges of implementing EHRs in LHDs. Methods: This project used primary, key-informant interview based study design of 50 leaders from local health departments across the United States. These qualitative interviews were about current practices, capacities, and needs in the realm of public health informatics in the fall of 2014. Qualitative data analysis focused on major drivers of EHR implementation, or lack of implementation. Principal Findings: Preliminary results exhibit variability in implementation status, benefits, and barriers of EHRs in LHDs. Implementation status varied from fully implemented in clinical settings, investigated or planning to implement, and no implementation but use of electronic medical records (EMRs). The barriers included costs, low capacity, lack of trained staff, staff resistance, complexities in current systems, and concerns about past investments in technology. Benefits were acknowledged by LHDs that have implemented and those who had not implemented EHRs as the ability to pull and have accurate records, ease of reading records, ability to share with partners, ease of searching, time saving, simplicity of budgeting and estimating revenues, staff satisfaction, and HIPAA compliance. Conclusions and Implications: Despite financial, capacity, and operational constraints, leaders interviewed as part of this project were optimistic about the future of EHRs in local health departments. Implementation of EHRs tends to be easier to implement with resources, staff buy-in, and leadership involvement. EHRs have multiple benefits that impact the operations and delivery of care in LHDs, affecting the health of the populations they serve

Gaps in Public Health Workers\u27 Awareness of Emerging Public Health Trends

Public health practice is evolving in response to new and varying threats and demands on population health. Out of these complexities have emerged new approaches and concepts shaping public health practice

Understanding the Dynamics of Diversity in the Public Health Workforce

The US population has become increasingly diverse; during 1965-2015, the proportion of non-Hispanic whites decreased from 84% to 62%, concurrent with a population increase among Hispanics and Asians. According to the US Census Bureau, in 2017, 50% of children younger than 5 years belonged to racial or ethnic minority groups; by 2044, minority groups—that is, African Americans, Asians and Pacific Islanders, Hispanic/Latinos, American Indians, and Alaskan natives, and individuals who are 2 or more races—are estimated to constitute 50% of the US population.1 Although health indicators, including life expectancy and infant mortality, have improved for most Americans, disparities in health and health care exist, with minority groups being at disproportionate risk of experiencing worse health outcomes from preventable and treatable conditions.2 A diverse public health workforce is better equipped to address public health disparities than a nondiverse workforce and therefore to implement population-based approaches aimed to improve health in communities.3 However, the public health workforce is not representative of the population it serves. Overall, only 42% of the governmental public health workforce is people of color.1,