1. PACE EH Redefining Local Environmental Health PACE EH National Summit Louisville, Kentucky March 28-29, 2006 Trends Across PACE EH Sites

2. PACE EH – The Five Primary Challenges Data limitations Lack of consensus Scientific view v. public perception Authority Indicators

3. Data Limitations Not Existent Not Relevant Not Accessible

4. Lack of Consensus Proof that given environmental factor has human health impact

5. Science versus Perception Public health activities driven by science Interventions tend to be science-based Communal sense of health driven by perception Needs of community often not grounded in valid health science

6. Authority to Determine Environmental Health Agenda Disparate local agencies Distinction between public and environmental health State determined funding streams

7. Indicators Choice of indicators Rationale for indicators Viability of indicators

8. PACE EH Demonstration Sites Alexandria, Virginia Blount County, Tennessee Mahoning County, Ohio Multnomah County, Oregon Muskegon County, Michigan Polk County, Florida Rock County, Wisconsin San Juan Basin, Colorado

9. PACE EH Demonstration Sites: From January 2003 to May 2004 Demonstration SiteLast Task Report Completed Team Meeting Schedule/Hrs. Homework Alexandria, VirginiaTask 9Monthly / 1-2Yes Blount County, Tennessee Task 6Monthly / 1-2Yes Mahoning County, OhioTask 10Monthly / 1-2Yes Multnomah County, Oregon Task 5Bi-Monthly / 1-2Yes Muskegon County, Michigan Task 8Monthly / 1-2Yes Polk County, FloridaTask 7Monthly / 1-2Yes Rock County, WisconsinTask 10Monthly / 1-2Yes San Juan Basin, Colorado Task 13Monthly / 1-2Yes

10. CEHA Teams Demo Site# Health Dept Staff Staff is Lead # Total Members Alexandria, VA 1Yes15 Blount County, TN 5Yes42 Mahoning Co, OH 6Yes11 Multnomah Co, OR 2No6* Muskegon Co, MI 3Yes27 Polk County, FL 2Yes20 Rock County, WI 2Yes28 San Juan Basin, CO 2Yes24

11. Survey Tool and Analysis Site Surveys Distributed Surveys Analyzed Issue MenusOpen-Ended Questions A, VAUnknown475Yes B, TN2000252Yes M, OH423310Yes P, FL391114YesNo R, WI300 Yes SJ, COUnknown75Yes

12. Demonstration Site Challenges: Task 6 Building a Systems Framwork Of the seven sites reporting on Task 6, six of them described it as problematic. –Loss of momentum –Unnecessary –In need of modification

13. Demonstration Site Challenges: Task 7 Indicator Development Difficulties with Task 6 spilled over… –Demonstration sites did not focus their indicator development on the degree to which any chosen indicator served to complete a systems framework –All six demonstration sites that completed Task 7 developed logical and strategic local indicators, but none of the six used issue frameworks as a blueprint for identifying best potential indicators

14. Demonstration Site Challenges: Task 8 Selecting Standards Many sites employed existing standards from Healthy People 2010 –Lacking in environmental health standards related to urban sprawl and decreasing green spaces –the chosen standards largely are written in the professional language of health and environmental agencies

15. Demonstration Site Challenges: Task 9 Issue Profiles Most sites aggregated specific environmental health priorities under broad topic areas (e.g. air, land or water). One site chose to develop very specific issue profiles for each of the priority issues across a number of broader topical areas.

16. Priority Issues at PACE EH Demonstration Sites 1. Air Quality 2. Water Quality 3. Solid Waste 4. Land Use 5. Housing 6. Animal Vectors 7. Food Safety

17. PACE EH Contacts at NACCHO Jonathan Schwartz Senior Analyst Jschwartz@naccho.org (202) 783-5550 x250 Jennifer Li Program Manager Jli@naccho.org (202) 783-5550 x234 Grace Ibanga Program Assistant Gibanga@naccho.org (202) 783-5550 x249 Gea Jackson Program Associate Gjackson@naccho.org (202) 783-5550 x268