Evolution in obesity and chronic disease prevention practice in California public health departments, 2010.

INTRODUCTION: Local health departments (LHDs) are dedicating resources and attention to preventing obesity and associated chronic diseases, thus expanding their work beyond traditional public health activities such as surveillance. This study investigated practices of local health departments in California to prevent obesity and chronic disease. METHODS: We conducted a web-based survey in 2010 with leaders in California's LHDs to obtain diverse perspectives on LHDs' practices to prevent obesity and chronic disease. The departmental response rate for the 2010 survey was 87% (53 of California's 61 LHDs). RESULTS: Although staff for preventing obesity and chronic disease decreased at 59% of LHDs and stayed the same at 26% of LHDs since 2006, LHDs still contributed the same (12%) or a higher (62%) level of effort in these areas. Factors contributing to internal changes to address obesity and chronic disease prevention included momentum in the field of obesity prevention, opportunities to learn from other health departments, participation in obesity and chronic disease prevention initiatives, and flexible funding streams for chronic disease prevention. LHDs that received foundation funding or had a lead person or organizational unit coordinating or taking the lead on activities related to obesity and chronic disease prevention were more likely than other LHDs to engage in some activities related to obesity prevention. CONCLUSION: California LHDs are increasing the intensity and breadth of obesity and chronic disease prevention. Findings provide a benchmark from which further changes in the activities and funding sources of LHD chronic disease prevention practice may be measured.

Reducing asthma disparities by addressing environmental inequities: a case study of regional asthma management and prevention's advocacy efforts.

Regional Asthma Management and Prevention describes its collaborative approach to address a social determinant of health--air quality--and the associated inequities that have led to asthma disparities impacting African American and Latino communities in the San Francisco Bay Area. The strategies, aimed at decreasing diesel pollution in disproportionately impacted communities, span the levels of the socioecological model, with an emphasis on policy outcomes. Regional Asthma Management and Prevention describes how this work fits within a larger comprehensive approach to address asthma disparities encompassing several components, ranging from clinical management to environmental protection.

Local public health departments in California: changing nutrition and physical activity environments for obesity prevention.

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.

Local health departments and the challenge of chronic disease: lessons from California.

The essential role local health departments have played in the control of infectious diseases has not been matched with an equivalent contribution in prevention of chronic diseases. Local health departments have attempted to define and build that capacity, but they have been confronted with budget cuts and competing public health priorities, most notably bioterrorism preparedness. This article is based on interviews with local health officials and describes some of the common ways local health departments in California have forged ahead to develop the capacity to engage in comprehensive approaches to chronic disease prevention in spite of the challenges. Additionally, the article highlights future considerations that need to be addressed if these promising trends in chronic disease prevention are to become more widespread.