Uncovering Environmental Health: An Initial Assessment of the Profession's Health Department Workforce and Practice.

Environmental health (EH) professionals provide critical services and respond to complex and multifaceted public health threats. The role of these professionals is continually re-emphasized by emergencies requiring rapid and effective responses to address environmental issues and ensure protection of the public's health. Given the prominence of the EH profession within the public health framework, assessing the governmental health department workforce, practice, and current and future challenges is crucial to ensure EH professionals are fully equipped and prepared to protect the nation's health. Such an understanding of the EH profession is lacking; therefore, we initiated Understanding the Needs, Challenges, Opportunities, Vision, and Emerging Roles in Environmental Health (UNCOVER EH). Through a web-based survey, we identified EH professional demographics, characteristics, education, practice areas, and aspects of leadership and satisfaction. We distributed the survey to a convenience sample of EH professionals working in health departments, limiting the generalizability of results to the entire EH workforce. The results were strengthened, however, by purposive sampling strategies to represent varied professional and workforce characteristics in the respondent universe. The UNCOVER EH initiative provides a primary source of data to inform EH workforce development initiatives, improve the practice, and establish uniform benchmarks and professional competencies.

Public health implications of animals in retail food outlets.

Growing societal interest to permit animals into retail food outlets presents both risks and benefits to the dining public and consumers. This article summarizes a literature review that evaluated the associated potential public health issues related to this subject. Using the EBSCOhost research protocol and Google search engines between March 2010 and June 2011, the authors have compiled and synthesized scientific research articles, empirical scientific literature, and publicly available news media. While pets are known carriers of bacteria and parasites, among others, the relative risk associated with specific pet-human interactions in the dining public has yet to be established in a clear and consistent manner. Much of the available health-risk-factor evidence reflects pets in domestic conditions and interaction with farm animals. Special consideration is recommended for vulnerable populations such as children, asthmatics, the elderly, pregnant women, and the immunocompromised.

Building capacity for community disaster preparedness: a call for collaboration between public environmental health and emergency preparedness and response programs.

Partnerships among local public environmental health (EH), emergency preparedness and response (EPR) programs, and the communities they serve have great potential to build community environmental health emergency preparedness (EHEP) capacity. In the study described in this article, the beliefs and organizational practices pertaining to community EHEP outreach and capacity were explored through key informant (KI) interviews (N = 14) with a sample of governmental EH and EPR administrators and top-level managers from Riverside and San Bernardino counties in Southern California. The results indicate that KIs were highly confident in their workforces' efficacy, ability, willingness, and motivation to directly engage local communities in EHEP. Best practices to combat organizational and systematic barriers to community EHEP outreach were identified. Based on the authors' results, training in participatory methods is needed to bridge technical knowledge in emergency management to daily practice. The lessons learned will form the basis of future interventions aimed to prepare EH and EPR professions to implement community-focused emergency preparedness strategies.

Optimizing environmental health training outcomes: a case study of tribal and nontribal trainees.

Approximately 80 percent of the public health workforce lacks formal public health education, thus necessitating ongoing professional development training programs to ensure the delivery of essential environmental public health services. Unfortunately, there is a paucity of literature describing changes in workplace performance directly related to training program attendance. The purpose of the study reported here, which was conducted in the spirit of Essential Public Health Service 8 ("assure a competent workforce"), was to examine training style efficacy and changes in performance among Native Americans and non-Native Americans related to attendance at a two-day professional development course in March 2006. Pre- and post-training knowledge, skills, and abilities (KSA) surveys were administered to a subset of training program attendees. The pre-training survey mapped demographic information and assessed prior knowledge and practices associated with environmental health communications. The post-survey was administered three months after the program to measure changes in these key factors, as well as responses to workshop teaching styles. Data analysis suggests teaching styles did not have a significant impact on the transfer and retention of knowledge among Native Americans and non-Native Americans; however, Native Americans preferred a conversational approach, while non-Native Americans articulated a preference for visual, content-rich presentations. Non-native Americans reported using skills and techniques learned in the workshop more frequently than did their Native-American counterparts.

California's county and city environmental health services delivery system.

The purpose of the authors' research was to assess the current status of county and city environmental health service delivery in California with the aim of providing a foundation for informed decision making about environmental health service delivery. Standardized interviews were conducted from March 2005 to May 2005 with 55 (88 percent) of the 62 county and city directors of environmental health; their jurisdictions represented 90 percent of the state's population and 94 percent of the landmass. Relevant databases and other publicly available information germane to project goals were also evaluated. The directors who were interviewed reported a total of 2,477 professional environmental health staff employed in county and city agencies, complemented by 520 support personnel. Percentages of respondents reporting technical-training needs were greatest for Certified Unified Program Agency (CUPA) activities (60 percent), dairy programs (57 percent), and septic-system programs (55 percent), while nontechnical training was desired in conflict resolution (55 percent), written/oral communication (49 percent), and problem solving (49 percent). Sixty-seven percent (67 percent) of directors reported difficulty in recruiting qualified applicants. Fifty-six percent (56 percent) were familiar with the 10 essential services of environmental health, while only 11 percent collected and reported health outcome measures to demonstrate agency effectiveness. The study team concluded that at the local level, environmental health services are largely provided as a reflection of local need; however, this tendency toward customization leads to stakeholder confusion about the purpose and value of environmental health services. The authors offer seven recommendations for improving environmental health services in California. Many of these recommendations can be generalized to the nation at large.

A risk-based food inspection program.

The inspection of food facilities is a crucial public service designed to prevent foodborne illnesses among retail food consumers. To enhance the existing food inspection process in San Bernardino County, California, a risk-based food inspection program and assessment instrument has been developed and proposed. A literature review and interviews with health professionals were conducted to establish a baseline understanding of various inspection procedures currently being employed throughout the nation. San Bernardino subsequently developed an assessment instrument and attendant inspection schedules that reflect best practices. The proposed inspection model categorizes food facilities as high, moderate, or low risk according to food properties, service population characteristics, facility history, and predefined operational risks. The San Bernardino model supports health department decision making with respect to inspection resource allocation and also makes possible sliding permit fees that reflect the relative risk associated with each facility.