Lessons Learned: The Varied Responses of Massachusetts' Local Health Departments During the COVID-19 Pandemic.
J Public Health Manag Pract
; 28(4): 344-352, 2022.
Article
in English
| MEDLINE | ID: covidwho-2051747
ABSTRACT
CONTEXT Massachusetts' decentralized public health model holds tightly to its founding principle of home rule and a board of health system established in 1799. Consequently, Massachusetts has more local health departments (n = 351) than any other state. During COVID-19, each health department, steeped in centuries of independence, launched its own response to the pandemic. OBJECTIVES:
To analyze local public health resources and responses to COVID-19.DESIGN:
Semistructured interviews and a survey gathered quantitative and qualitative information about communities' responses and resources before and during the pandemic. Municipality demographics (American Community Survey) served as a proxy for community health literacy. We tracked the frequency and content of local board of health meetings using minutes and agendas; we rated the quality of COVID-19 communications on town Web sites.SETTING:
The first 6 months of the COVID-19 pandemic in Massachusetts March-August 2020.PARTICIPANTS:
Health directors and agents in 10 south-central Massachusetts municipalities, identified as the point of contact by the Academic Public Health Corps. MAIN OUTCOMEMEASURES:
We measured municipality resources using self-reported budgets, staffing levels, and demographic-based estimates of community health literacy. We identified COVID-19 responses through communities' self-reported efforts, information on town Web sites, and meeting minutes and agendas.RESULTS:
Municipalities excelled in communicating with residents, local businesses, and neighboring towns but lacked the staffing and funding for an efficient and coordinated response. On average, municipal budgets ranged from $5 to $16 per capita, and COVID-19 consumed 75% of health department staff time. All respondents noted extreme workload increases. While municipal Web sites received high scores for Accurate Information, other categories (Navigability; Timeliness; Information Present) were less than 50%.CONCLUSIONS:
Increased support for regionalization and sustained public health funding would improve local health responses during complex emergencies in states with local public health administration.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
COVID-19
Type of study:
Observational study
/
Prognostic study
/
Qualitative research
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
J Public Health Manag Pract
Journal subject:
Public Health
/
Health Services
Year:
2022
Document Type:
Article
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