The Effects On Population Health Status of Using Dedicated Property Taxes To Fund Local Public Health Agencies

Background: In the United States, a dedicated property tax describes the legal authority given to a local jurisdiction to levy and collect a tax for a specific purpose. We investigated for an association of locally dedicated property taxes to fund local public health agencies and improved health status in the eight states designated as the Mississippi Delta Region. Methods: We analyzed the difference in health outcomes of counties with and without a dedicated public health tax after adjusting for a set of control variables using regression models for county level data from 720 counties of the Mississippi Delta Region. Results: Levying a dedicated public health tax for counties with per capita income above $28,000 is associated with improved health outcomes of those counties when compared to counties without a dedicated property tax for public health. Alternatively, levying a dedicated property tax in counties with lower per capita income is associated with poor health outcomes. Conclusions: There are both positive and negative consequences of using dedicated property taxes to fund public health. Policymakers should carefully examine both the positive association of improved health outcomes and negative impact of taxation on poor populations before authorizing the use of dedicated local property tax levies to fund public health agencies

Coordination of Public Health Response: The Role of Leadership in Responding to Public Health Emergencies

Public health emergencies are becoming more commonplace every year. Naturally occurring public health emergencies, such as hurricanes, typhoons, tsunamis, and floods cause significant devastation to property and people. Although these emergencies are becoming more and more common, response is still very challenging. A root cause of failed response is a lack of coordination between national, regional, and local public health agencies. These failed and unsuccessful responses are seen with naturally occurring public health emergencies, including pandemics. This chapter addresses coordination, its barriers and challenges, with a focus on the role of leadership in response to public health emergencies. Coordination leadership is a critical aspect of successful and effective response to emergencies. Leadership styles will be discussed and examples of effective leadership. Lessons learned will be presented, as well as research findings. Examples discussed include Hurricane Katrina, the tsunami of 2004 in Thailand, the COVID-19 pandemic, and the Sendai Framework for Disaster Risk Reduction, Sustainable Development Goals

Emergency Response and Public Health in Hurricane Katrina: What Does it Mean to Be a Public Health Emergency Responder?

Since 9/11, federal funds directed toward public health departments for training in disaster preparedness have dramatically increased, resulting in changing expectations of public health workers’ roles in emergency response. This article explores the public health emergency responder role through data collected as part of an oral history conducted with the 3 health departments that responded to Hurricane Katrina in Mississippi and Louisiana. The data reveals a significant change in public health emergency response capacity as a result of federal funding. The role is still evolving, and many challenges remain, in particular, a clear articulation of the public health role in emergency response, the integration of the public health and emergency responder cultures, identification of the scope of training needs and strategies to maintain new public health emergency response skills, and closer collaboration with emergency response agencies

The effects on population health status of using dedicated property taxes to fund local public health agencies

<p>Abstract</p> <p>Background</p> <p>In the United States, a dedicated property tax describes the legal authority given to a local jurisdiction to levy and collect a tax for a specific purpose. We investigated for an association of locally dedicated property taxes to fund local public health agencies and improved health status in the eight states designated as the Mississippi Delta Region.</p> <p>Methods</p> <p>We analyzed the difference in health outcomes of counties with and without a dedicated public health tax after adjusting for a set of control variables using regression models for county level data from 720 counties of the Mississippi Delta Region.</p> <p>Results</p> <p>Levying a dedicated public health tax for counties with per capita income above $28,000 is associated with improved health outcomes of those counties when compared to counties without a dedicated property tax for public health. Alternatively, levying a dedicated property tax in counties with lower per capita income is associated with poor health outcomes.</p> <p>Conclusions</p> <p>There are both positive and negative consequences of using dedicated property taxes to fund public health. Policymakers should carefully examine both the positive association of improved health outcomes and negative impact of taxation on poor populations before authorizing the use of dedicated local property tax levies to fund public health agencies.</p

Public Health Financial Management Competencies

The absence of appropriate financial management competencies has impeded progress in advancing the field of public health finance. It also inhibits the ability to professionalize this sector of the workforce. Financial managers should play a critical role by providing information relevant to decision making. The lack of fundamental financial management knowledge and skills is a barrier to fulfilling this role. A national expert committee was convened to examine this issue. The committee reviewed standards related to financial and business management practices within public health and closely related areas. Alignments were made with national standards such as those established for government chief financial officers. On the basis of this analysis, a comprehensive set of public health financial management competencies was identified and examined further by a review panel. At a minimum, the competencies can be used to define job descriptions, assess job performance, identify critical gaps in financial analysis, create career paths, and design educational programs

Disease Surveillance and Achieving Synergy In Public Health Quality Improvement

Efforts to describe and improve quality in public health are closely tied to disease surveillance systems and capabilities. This roundtable will engage participants around how a new national framework for public health quality relates to their work in surveillance. The audience will be invited to provide examples, from their experience, of feasible and practical variables to measure the priority public health aims; data sources; and gaps that are impeding progress in quality improvement. This roundtable will inform a new initiative to develop measures that resonate with the roles of public health at the local, state, federal and global levels

Disease Surveillance and Achieving Synergy In Public Health Quality Improvement

OBJECTIVE: To examine disease surveillance in the context of a new national framework for public health quality and to solicit input from practitioners, researchers, and other stakeholders to identify potential metrics, pivotal research questions, and actions for achieving synergy between surveillance practice and public health quality. INTRODUCTION: National efforts to improve quality in public health are closely tied to advancing capabilities in disease surveillance. Measures of public health quality provide data to demonstrate how public health programs, services, policies, and research achieve desired health outcomes and impact population health. They also reveal opportunities for innovations and improvements. Similar quality improvement efforts in the health care system are beginning to bear fruit. There has been a need, however, for a framework for assessing public health quality that provides a standard, yet is flexible and relevant to agencies at all levels. The U.S. Health and Human Services (HHS) Office of the Assistant Secretary for Health, working with stakeholders, recently developed and released a Consensus Statement on Quality in the Public Health System that introduces a novel evaluation framework. They identified nine aims that are fundamental to public health quality improvement efforts and six cross-cutting priority areas for improvement, including population health metrics and information technology; workforce development; and evidence-based practices (1). Applying the HHS framework to surveillance expands measures for surveillance quality beyond typical variables (e.g., data quality and analytic capabilities) to desired characteristics of a quality public health system. The question becomes: How can disease surveillance help public health services to be more population centered, equitable, proactive, health-promoting, risk-reducing, vigilant, transparent, effective, and efficient—the desired features of a quality public health system? Any agency with a public health mission, or even a partial public health mission (e.g., tax-exempt hospitals), can use these measures to develop strategies that improve both the quality of the surveillance enterprise and public health systems, overall. At this time, input from stakeholders is needed to identify valid and feasible ways to measure how surveillance systems and practices advance public health quality. What exists now and where are the gaps? METHODS: Improving public health by applying quality measures to disease surveillance will require innovation and collaboration among stakeholders. This roundtable will begin a community dialogue to spark this process. The first goal will be to achieve a common focus by defining the nine quality aims identified in the HHS Consensus Statement. Attendees will draw from their experience to discuss how surveillance practice advances the public health aims and improves public health. We will also identify key research questions needed to provide evidence to inform decision-making. RESULTS: —How is surveillance used to identify and address health disparities and, thereby, make public health more equitable? What are the data sources? Are there targets? How can research and evaluation help to enhance this surveillance capability and direct action? —How do we identify and address factors that inhibit quality improvement in surveillance? What are the gaps in knowledge, skills, systems, and resources? —Where can standardization play a positive role in the evaluation of quality in public health surveillance? —How can we leverage resources by aligning national, state, and local goals? —What are the key research questions and the quality improvement projects that can be implemented using recognized models for improvement? —How can syndromic surveillance, specifically, advance the priority aims? The roundtable will conclude with a list of next steps to develop metrics that resonate with the business practices of public health at all levels

Anatomy of a Public Health Agency Turnaround: The Case of the General Health District in Mahoning County

A turnaround describes an organization\u27s ability to recover from successive periods of decline. Current and projected declines in US economic conditions continue to place local public health departments at risk of fiscal exigency. This examination focused on turnaround methodologies used by a local public health department to reverse successive periods of operational and financial declines. Illustrations are provided on the value added by implementing financial ratio and trend analysis in addition to using evidence-based private sector turnaround strategies of retrenchment, repositioning, and reorganization. Evidence has shown how the financial analysis and strategies aided in identifying operational weakness and set in motion corrective measures. The Public Health Uniform Data System is introduced along with a list of standards offered for mainstreaming these and other routine stewardship practices to diagnose, predict, and prevent agency declines