The Value of the National The Value of the National Environmental Health Environmental Health Performance Standards to Performance Standards to EH Programs EH Programs

Volusia CountyVolusia County

FloridaFlorida

Existing ToolsExisting Tools

MAPPMAPP

State/Programmatic AuditsState/Programmatic Audits

Internal ReviewsInternal Reviews

EH RenaissanceEH Renaissance

10 Essential Services10 Essential Services National EH Performance StandardsNational EH Performance Standards Geographic Information SystemsGeographic Information Systems Assessment, MonitoringAssessment, Monitoring Smart GrowthSmart Growth Health Impact AssessmentHealth Impact Assessment Cause/Effect Exposure/Disease OutcomesCause/Effect Exposure/Disease Outcomes

Population Based EHPopulation Based EH

Requires a strategic focus on the societal Requires a strategic focus on the societal causes of ill healthcauses of ill health

Societal or “Social Determinants of Health” Societal or “Social Determinants of Health” are broadare broad

Changes in structural conditions can affect Changes in structural conditions can affect many individuals simultaneously and have many individuals simultaneously and have broad and diverse impacts on multiple broad and diverse impacts on multiple health outcomeshealth outcomes

Cost effectiveCost effective

Levels of Determinants of Levels of Determinants of Behavior & DiseaseBehavior & Disease

Individual

Family

Neighborhood

Community

Society

How this tool is used…How this tool is used…

Build agency capacity for essential Build agency capacity for essential servicesservices

Build community accountabilityBuild community accountability Consistent servicesConsistent services Provide support for GR programsProvide support for GR programs Teach EH, local BOH, Health Teach EH, local BOH, Health

department directors, state level department directors, state level program, & stakeholdersprogram, & stakeholders

50%50% 25%25% 150%150%Vulnerable – Possible Vulnerable – Possible

scenarioscenario

TanningTanning – Privatized – Privatized

Mobile Home ParksMobile Home Parks – – gone or to other agencygone or to other agency

Small wellsSmall wells – gone – gone

S/T S/T - Privatized or - Privatized or building dept.building dept.

PoolsPools – Privatized – Privatized

SDWASDWA – Other agency – Other agency

All in column 1 outAll in column 1 out

In:In:

Rabies ConsultingRabies Consulting

SLE ConsultingSLE Consulting

FBI InvestigationFBI Investigation

Infectious disease Infectious disease investigationinvestigation

Adding PHAdding PH Priority Priority Programs:Programs:

Safety/InjurySafety/Injury

Sanitary NuisanceSanitary Nuisance

Public Relations & Public Relations & MarketingMarketing

Tox risk assessment Tox risk assessment and OHand OH

Minimum HousingMinimum Housing

Health AssessmentHealth Assessment

Reuse water regulationReuse water regulation

Surface waterSurface water

Future of Volusia County EH

Financial Disaster Plan

Social Conscience / FiduciaryOutbreak Response

+

Health Assessment

Community Assessment

Toxicological Risk Assessment

Figure EHF 1-b

Addition to Health Addition to Health DepartmentDepartment

Director

Assistant Director for

Public Health Programs

Office of Assessment

Staff CommentsStaff Comments

““Since I was a young man of 19 I was Since I was a young man of 19 I was attending EH classes. If you asked me back attending EH classes. If you asked me back then what I would have been doing in an EH then what I would have been doing in an EH HD setting, I would have responded with #1 HD setting, I would have responded with #1 and #2. My response now would be #6and #2. My response now would be #6.”.”

““I find #3 particularly important. The public I find #3 particularly important. The public should be made to be EH professionalsshould be made to be EH professionals.”.”

““We do #8 very wellWe do #8 very well.”.”