Dearborn Mayor Michael A. Guido welcomed local health officials during the opening reception for the National Association of County and City Health Officials’ (NACCHO) annual conference that was held July 16-19 in his Michigan city. The theme this year, "Public Health at a Crossroads: Designing a Roadmap to 2010," focused the participants, many of whom where representing some of the nation’s largest cities, on the goal of examining and assessing where Local Health Departments specifically and public health in general, is headed in the next millennium.

Some of the top issues discussed were the state of technology capacity in public health agencies; environmental health; elimination of health disparities between minorities and the population at large, and collaboration at the local level. As public health agencies move into the new millennium, the focus on information technology and agencies’ readiness for the communication challenges, such as in the event of a biochemical attack, was a driving force in NACCHO’s efforts to conduct a study on the information technology capacity of public health agencies.

This study, Information Technology Capacity of Local Public Health Agencies, was released during the meeting in Dearborn. The survey builds upon prior research by NACCHO in the area of local public health infrastructure and information policy, asks questions about Internet e-mail, access to the world wide web, and broadcast fax capacities. It also asked about barriers to adopting Internet-based technologies.

Of the 656 surveys received the results showed that 80% of the responding health departments had the capacity to send and receive e-mail, and 83% indicated that they had staff who could search for and access public health information on the World Wide Web. However, "less than half (48%) of all respondents reported that their health director currently had continuous, high-speed access to the Internet at work." High-speed, continuous access to the Internet enables a health department to receive "real time" alerts, surveillance reports and instant messaging. Additionally, only 44% of all respondents indicated that they had broadcast fax capabilities (the ability to send faxes to multiple recipients at the same time).

The survey concludes that while disparities still exist between the information technology capacities of smaller and larger health departments with the larger health departments having greater access to technology, overall the health departments have shown great improvement in their access to information technology.

The issue of environmental health and responsibility was another key issue discussed at this year’s conference. In a panel discussion entitled, "Common Ground? : Environmental Health in HHS or EPA?" participants discussed the relevancy and existence of the gap between public health practices and environmental protection activities.

The common understanding is that this gap has been widening in the last twenty-five years; with the result being the development of distinct institutions to address each field separately: the Environmental Protection Agency and the Department of Health and Human Services. An unintended effect of this development, according to participants, is that neither entity takes direct responsibility for environmental health issues.

On group looking at this issue is The Pew Environmental Health Commission, a commission launched in May 1999 and funded by The Pew Charitable Trusts as a part of the Johns Hopkins School of Public Health. The Commission is mandated to convene for 18 months and has as its objective the provision of practical strategies and recommendations for improving the public health response to environmental threats; the creation of a vision for rebuilding the country’s public health capacity, and increasing public awareness of environmental health problems facing this country. The primary areas of investigation include children’s environmental health, health surveillance and right-to-know, and scientific and policy capacity building.

The Commission reported on the results of a study, Attitudes Toward Public Health — A Report by The Pew Charitable Trusts, which indicated that among those who responded to the survey (members of the registered voting public), almost all felt that insufficient resources are devoted to public health and that environmental factors are a major cause of health problems and disease.

Finally, on the policy front, NACCHO continues to pledge its full support of the Health Alert Network, a nationwide, integrated information and communications system serving as a platform for national disease surveillance, epidemiological investigation, electronic laboratory reporting and rapid communication. Last year Congress appropriated $28 million to the Health Alert Network system, this year NACCHO is asking Congress to designate $40 million in the FY 2000 appropriation for the Centers for Disease Control and Prevention. The Conference of Mayors has policy supporting the Health Alert Network.

NACCHO, a partner of the Conference of Mayors, is a nonprofit membership organization serving all of the nearly 3,000 local health departments in cities, counties, townships, and districts.