Healthy Behaviors and Choices (e.g. Fitness, Tobacco, Opioids, Nutrition)
Sharing Session - 60 Minutes
Injury and violence prevention (IVP) is an important public health priority due to its high potential costs to communities resulting from premature death, disability, poor mental health, medical expenses, and productivity. Traditionally, accidental deaths, community safety, community violence, and substance abuse all reside under the IVP umbrella. Today, IVP is moving to the forefront of public health because of pervasive opioid misuse and the rise in community violence such as school shootings. Local health departments (LHDs) have a responsibility to their communities to assist in intervening in these epidemics. Data from the 2013 National Profile of Local Health Departments (Profile) and 2016 Profile studies indicate LHDs are conducting more activities related to IVP. This case study aims to provide a picture in time of LHD capacity to address IVP.
This case study intends to demonstrate the capacity of LHDs in Ohio to address IVP within their communities. NACCHO and Safe State Alliance developed the Local Injury and Violence Prevention Capacity Assessment Tool to gauge individual LHD’s ability to respond to IVP; this tool includes 12 standards, each with suggested indicators to measure capacity. The author modified the tool to reflect limited access to data, turning 17 of the indicators within 8 of the standards into binary variables where data is publicly available. Data was gathered from NACCHO’s 2016 Profile and 2018 Forces of Change studies to determine whether an LHD met the indicators. Data was then augmented by the author who continued to gather data points from publicly available LHD and state health department websites. The author selected Ohio as the location for the case study due to the Ohio Health Department’s prioritization of injury and violence prevention as a public health demonstrated by their commitment to preventing opioid misuse. Additionally, Ohio has mandated that all LHDs pursue PHAB accreditation by 2020; PHAB accreditation includes metrics on partnerships and policy advocacy, both of which were indicators in the assessment tool. The sample was 119 LHDs located in Ohio, which shrank to 90 LHDs that completed the 2016 Profile study. LHDs were from three population-served categories as defined by NACCHO’s Profile study: small (<50,000), medium (50,000-499,999), and large (500,000+). The LHDs were scored using the tool. The relationship between the LHDs’ scores and data on drug deaths, violent deaths, suicide deaths, and homicide deaths were assessed for correlation.
Some limitations include access to data to measure the assessment indicators, gaps in the availability of data, and self-selection bias in survey response.
LHDs must rise to the needs of their communities. They must understand what their current capacity to address IVP issues are so they can implement change where necessary and measure their success. IVP continues to be a significant public health area, only increasing in importance for local agencies continue to navigate the opioid epidemic and the increase in community violence.
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) Fatal Injury Data. (2017)
Healthy People 2020. (2018). Injury and Violence Prevention. October 2018. https://www.healthypeople.gov/2020/topics-objectives/topic/injury-and-violence-prevention
Corso, P., Finkelstein, E., Miller, T., Fiebelkorn, I., & Zaloshnja, E. (2006). Incidence and lifetime costs of injuries in the United States. Injury Prevention, 12(4), 212–218. https://doi.org/10.1136/ip.2005.010983
National Association of County and City Health Officials. 2016 National Profile of Local Health Departments. November 2018. http://nacchoprofilestudy.org/.
National Association of County and City Health Officials. 2018 Forces of Change. November 2018. http://nacchoprofilestudy.org/.
National Association of County and City Health Officials & Safe States. Local Health Department IVP Standards and Indicators - Safe States Alliance. (2011). Retrieved October 5, 2018, from https://www.safestates.org/page/LocalHealthIVP