Local Public Health Departments in California

Abstract

The purpose of this research was to assess California public health departments capacity, practices, and resources for changing nutrition and physical activity environments for obesity prevention. The researchers surveyed key public health department personnel representing all 61 health departments in California using a Web-based survey tool. The response rate for the survey was 62 percent. This represented a 93 percent health department response rate. Analysis was conducted on the individual respondent and public health department levels and stratified by metropolitan statistical area and foundation-funded versus not foundation-funded. Public health departments are engaged in obesity prevention including environmental and policy change approaches. The majority of respondents stated that monitoring obesity rates and providing leadership for obesity prevention are important roles for public health. Health departments are involved in advocacy for healthier eating and/or physical activity in school environments and the development and monitoring of city/county policies to improve the food and/or physical activity environments. Funding and staff skill may influence the degree of public health department engagement in obesity prevention. A majority of respondents rate their staffing capacity for improving nutrition and physical activity environments as inadequate. Access to flexible foundation funding may influence how public health departments engage in obesity prevention.

Workforce capacity to address obesity: a Western Australian cross-sectional study identifies the gap between health priority and human resources needed

“…Managers estimated 152 % more specialist nutrition and 131 % more specialist physical activity workforce was required to achieve policy/program goals. The findings are consistent with research in California which found 70 % of local public health department managers rated their staff capacity for obesity prevention in NAPA environments as less than effective [33]. …”

Development and Application of a Framework to Assess Community Nutritionists' Use of Environmental Strategies to Prevent Obesity

“…5,6 This includes a spectrum of strategies such as making school menus healthier, establishing wellness policies in organizations, and increasing access to healthful foods and physical activity in communities. 5,6 While staff of public health and service agencies are familiar with working on the individual and interpersonal levels involving families, 7,8 they are being urged to mobilize their resources to promote changes on the organizational and community levels that can support healthy eating and physical activity to prevent obesity. 9–12 This study focused on actions to effect environmental changes, meaning changes that modify any contexts external to the individual, in organizations , e.g.…”

“…However, the application of the socio-ecological perspective to obesity prevention was not widespread until the early 2000’s 13 and this is still a new concept for many in public health 7 and community service work. For example, staff of the California public health system reported a lack of knowledge and skills to participate in environmental change work.…”

“…For example, staff of the California public health system reported a lack of knowledge and skills to participate in environmental change work. 7 Gantner and Olson identified a need for public health staff to have skills and knowledge to work beyond their traditional role of providing direct service and education, and to collaborate with partners with dissimilar goals, for example, local businesses and government officials, 8 who are in a position to effect environmental changes. Researchers have found that even when nutrition professionals believed that environment was heavily responsible for the rise in obesity, they still suggested direct nutrition education or methods aimed at changing individual-level behaviors as solutions.…”

“…Although comprehensive, the suggested strategies are often written as simple directives without regard for the inherent complexity of implementing the multiple components and sequential activities. The socio-ecological approach represents an expansion of perspectives and activities for many community health professionals, 7,8 and there is currently no framework to assess the extent practitioners are engaged in actions promoting environmental change for obesity prevention. A systematic method to understand the nature of environmental change-related tasks, monitor and assess their performance, and ultimately provide tools and support that facilitate professionals’ transition to performing the tasks is needed.…”