Prev Chronic Dis ;
References Heart disease, diabetes, cancer, arthritis, and other chronic diseases are the leading causes of death and disability and the leading drivers of health care costs in the United States 1.
Health disparities and inequalities exist across chronic diseases, behavioral risk factors, environmental exposures, social determinants, and health care access by sex, race and ethnicity, income, education, disability status, and other social characteristics 2.
Collecting, analyzing, interpreting, and disseminating data on chronic diseases and related risk factors is vital to understanding and raising awareness about morbidity, mortality, associated costs, and disparities.
These data are also vital inputs throughout the process of implementing evidence-based public health approaches to reduce the burden of chronic diseases in the United States. Chronic disease surveillance is changing, with new priorities that are more upstream, more clinical, more cross-cutting, and more granular than previous priorities; new data sources, such as electronic health records, to supplement traditional sources; and new technologies.
CDEs need to expand partnerships across multiple sectors to leverage data and resources to address social, environmental, and economic conditions that affect health and advance health equity. Timely and locally relevant data, metrics, and analytics are of utmost importance in this work to guide, focus, and assess the effect of prevention initiatives, including those targeting the social determinants of health and enhancing equity 4.
Concurrently, chronic disease surveillance is challenged by data gaps, limitations in data access and timeliness, increases in data collection costs, decreases in funding, and inadequate staffing. The public health structure varies across states, and many state public health agencies provide epidemiological technical assistance and resources to local public health agencies.
The size, resources, and other demands of local public health agencies might prohibit the hiring of dedicated CDEs or even the ability to have general epidemiologists perform chronic disease epidemiology and surveillance services. Inthe National Association of County and City Health Officials conducted a study on the funding, workforce, programs, and partnerships at local public health agencies; 1, local public agencies responded to the study survey 6.
Increasing the number of CDEs to build capacity and enhance expertise in surveillance, communication, and consultation is critically important.
Field assignees assist states by providing epidemiologic consultation and leadership for surveillance systems; offering expertise in designing epidemiological studies, analyzing data, evaluating chronic disease prevention and health promotion programs, and disseminating findings; providing data and identifying priority populations for public health program planning; and mentoring and training entry-level and mid-level CDEs and other staff members in epidemiologic methods and data interpretation.
Field assignees have served in their state position for up to 12 years.
Currently, the program has 4 field assignees; they are in Arizona, Colorado, Illinois, and Indiana. Field assignees serve as a liaison between the state or local public health agency and CDC. As a CDC employee, field assignees have access to CDC subject matter experts, training, data sets, analytic software, and an electronic library for broad access to the scientific literature, which can help supplement state resources and further contribute to statewide capacity in the practice of chronic disease epidemiology.
The program has benefited 36 states and New York City. In recent years, field assignees have focused on analyzing and disseminating state and local data on health disparities and improving data-informed decision-making processes to target public health interventions for chronic disease prevention and management.
This field assignee collaborated with a state chronic disease grant program to develop a new data-driven approach to scoring grant applications. This new approach was designed to increase the effect of grantee programs on health disparities by elevating scores of applications proposing to serve areas of greater need.
To develop the new approach, a county ranking was created by using a principal components analysis of county data on the burden of disease and the social determinants of health, and a new methodology was developed to apply the results of the county rankings to the scores of grant applicants.
The report informed targeted interventions and focused on health disparities. The field assignee is also leading efforts to assess feasibility of a statewide quality improvement collaborative.
Top Past, Present, and Future Capacity-Building Efforts Many other chronic disease epidemiology capacity-building efforts have occurred or are ongoing. These have been successful programs, but expanded efforts are needed.
Governmental agencies, foundations, universities, and others committed to chronic disease—related public health capacity building should collaborate with those working in other subject areas to build capacity on cross-cutting competencies.
Future efforts should build on past and current efforts, be informed by national assessment results, and target jurisdictions with subpar levels of chronic disease epidemiology capacity. Training efforts should be tailored to address changes occurring in public health and chronic disease surveillance.
To achieve excellence in chronic disease epidemiology and to build capacity, the following are needed: Strong commitment is vital to building and maintaining capacity-building efforts in chronic disease epidemiology and surveillance in state, territorial, local, and tribal public health agencies.
Throughout these capacity-building efforts and across all chronic disease epidemiology and surveillance efforts, the default view must be through a health equity lens.
Top Acknowledgments The authors recognize Paul Z.
Siegel, MD, Geraldine S. Croft, PhD, who provided information for this essay. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of CDC. No copyrighted material, survey, instrument, or tool was used. Top Author Information Corresponding Author:Logan County Commissioners, Logan County Family Court, Bellefontaine Mayor, Indian Lake School District, Chamber of Commerce, Business /Community Leader, Family & Children First Council, Job & Family Services, Community Health & Wellness Partners, each coalition and Continuum of Care/Homeless Coalition.
A Study and Implementation of a New Health Care Policy for Logan County PAGES 7.
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a high stress work environment. The goal of Logan Acres Nursing Home is to reduce the number of incidents involving patient lifting and improve the working and living conditions at their facility.
Solution: Logan Acres approached the problem of occupational injury by purchasing mechanical patient lift systems (Total Cost: $44,). The county must submit each revision of the attendance policy to the West Virginia Department of Education for approval.
Attendance Referral Procedure. 1.
The homeroom teacher or the first instructor must report the student’s absences to the principal or the designated attendance coordinator. Connect for Health Colorado will provide a wide selection of private health insurance plans offered by major carriers and new carriers who are entering the state to compete for business.
It will also provide access to new financial assistance, based on income, to reduce costs, making some eligible for zero-premium plans. collaborative effort to address and impact Logan County’s identified areas of risk and need. In addition, Mary Rutan Hospital developed an internal implementation plan that identifies the specific steps that Mary Rutan Hospital will take to maintain and improve the health of the Logan County.