PACE EHRedefining Local Environmental

Health

PACE EH National SummitLouisville, KentuckyMarch 28-29, 2006

The PACE EH Methodology

Protocol for Assessing Community Excellence in Environmental Health

A tool offering local health officials

guidance in conducting a

community-based environmental health

assessment and creating an accurate

profile of a community’s

environmental health status

PACE EH was produced by:

The Community Environmental Health Assessment Program at NACCHO

Funded through a cooperative agreement between NACCHO and the National Center

for Environmental Health, CDC

Question:

What is the cornerstone of “good” science?

Key Objectives of PACE EH

• Evaluate Environmental Health Conditions

• Target Populations at Risk

• Set Priorities

• Support Health Equity and Social Justice

What Are Not the Key Objectives of PACE EH

• Does not define the parameters of “Environmental Health”

• Does not provide a menu of issues or indicators

• Does not provide pre-designed action plans

• Does not require a health equity focus

Benefits Across PACE EH Sites

Fosters confidence

“Clients” to “Partners”

Database development

Community ownership of EH

Improved EH

Leadership role

Bridge-building

New work skills

New professional partnerships

The Thirteen Tasks of PACE EH

Task 1: Determine Community Capacity

Task 2: Define/Characterize the Community

Task 3: Assemble a CEHA Team

Task 4: Define the Goals, Objectives and Scope

Task 5: Generate List of EH Issues

Task 6: Analyze Issues w/ Systems Framework

Task 7: Develop Indicators Task 8: Select StandardsTask 9: Create Issue

ProfilesTask 10: Rank IssuesTask 11: Set Priorities for

ActionTask 12: Develop Action

Plan(s)Task 13: Evaluate Progress

and Plan for the Future

Tasks 1- 3 Prepare for the Process

1.) Facilitators examine potential for a CEHA

2.) Facilitators “map” the target community

3.) Invite key community/staff members

Tasks 4 - 6 Locate the Issues

4.) Define Goals & Scope of Assessment

5.) Generate List of Local EH Issues

6.) Describe the Context of the Issues

Tasks 7 - 9 Quantify and Qualify the Issues

7.) Develop Local Indicators

8.) Select Relevant Standards

9.) Create Issue Profiles

Tasks 10 - 13 Set the Stage for Action

10.) Rank the Issues

11.) Set Priorities for Action

12.) Develop Action Plans

13.) Evaluate Progress

PACE EH – The Five Primary Challenges

Data limitationsLack of consensusScientific view v.

public perception

AuthorityIndicators

Obstacles to meeting the challenges of PACE EH

• Extensive community outreach

• Translating between perception and science

• Rearranging work methods and priorities

• Promotion of CEHA efforts

Environmental Health at Schools of Public Health

• 28-30 Graduate Schools of Public Health• 11 offer advanced degrees in EH

– 85-90% of all core classes are “hard science” and issue specific

– Little to no Social Sciences– No community outreach, no media

strategies• Approximately 75% of PH graduate

students do NOT become employees of local public health agencies

The Public Health Workforce

• About 500,000 public health workers• Of those, only 44% have formal, academic

training in public health; most do not have a public health credential (e.g., an MPH).

• Median local public health agency staff size is 13 FTEs

• Local public health agencies struggle to fill workforce with technically proficient staff, other proficiencies deemed secondary

Environmental Health Workforce Development

Current Status:• Less than 50% coming out of schools of public health• Those that do, not prepared for community

collaboration• Too few employees, and too many specific funding

streams, in most local public health agencies to support discrete skill specialization

• Maryland health directors claim it takes approximately five years to fully train a new employee

What can PACE EH do?

Undertaking the PACE EH methodology builds competency:

• Extensive community outreach• Translating between perception and science• Rearranging work methods and priorities• Promotion of agency efforts