Forming an Academic Health Department: A Case Example

Local Health Departments' Engagement in Addressing Health Disparities: The Effect of Health Informatics

CONTEXT

Health disparities and health inequities can lead to poor health outcomes. However, health disparities continue to persist in communities across the United States, presenting a crucial public health challenge. Persisting budget cuts and workforce challenges tend to hinder local health departments' (LHDs') ability to assess and address health disparities.

OBJECTIVES

To examine the extent to which LHDs' use of informatics effects their engagement in strategies and activities addressing health disparities.

METHODS

Data from the 2016 Profile of LHDs were used in examining the association of informatics with 9 activities addressing health disparities/inequities.

RESULTS

Fifty-nine percent of LHDs used data and described health disparities in their jurisdiction, and 12% conducted original research to link health disparities to differences in social or environmental conditions. Less than 40% of LHDs prioritized resources for the reduction of health disparities. LHDs that implemented information systems had increased odds of describing the disparities in their jurisdiction (P < .01) and having prioritized resources for the reduction of disparities (P < .01). Per capita expenditures, participation in a national accreditation program process, and a larger LHD population were also positively associated with 7 of 9 activities for addressing health disparities/inequities.

CONCLUSIONS

As LHDs advance efforts to reduce health disparities and inequities, leadership will find informatics a useful strategy. National initiatives aimed to boost LHDs' engagement in the reduction of disparities might benefit from our findings, positing a positive influence of informatics.

A Population Health Driver Diagram to Address Neonatal Abstinence Syndrome

This article describes the process for developing a population health driver diagram to address a priority health issue in East Tennessee: neonatal abstinence syndrome (NAS). Population health driver diagrams are used in quality improvement processes for determining and aligning actions that a community can take to achieve a specified outcome. The Tennessee Department of Health contracted with the University of Tennessee's Department of Public Health to conduct a community participatory process to contribute to a statewide health improvement plan. Colleagues in local public health practice identified NAS as the leading perinatal health issue, and community engagement was achieved by involving community health councils. Qualitative and quantitative data were collected, analyzed, and provided to these councils. A region-wide stakeholders' meeting resulted in the development of a population health driver diagram to address NAS. We describe this process and provide lessons learned that can be valuable in other settings. Population health diagrams have important implications for practice because of their use as a framework for community action, especially in the context of a community health assessment.

Development of a Research Agenda Focused on Academic Health Departments

An academic health department (AHD) is a formal partnership between an academic institution and a governmental public health agency. Case studies have described the value of individual AHDs in the areas of student engagement, practice-based research, workforce development, and service. With growing interest in AHDs and the increasing importance of academic-practice linkages in both academic programs' and public health agencies' accreditation processes, articulating a research agenda focused on the AHD model can be useful for stimulating the research and practice fields to further develop the evidence base for AHDs. We provide a research agenda, developed through an iterative process involving academicians, practitioners, and others interested in academic-practice linkages.

Successful Academic-Public Health Practice Collaboration: What Works From the Public Health Workforce's Perspective

CONTEXT

Public health departments and academic institutions engage in a range of cooperative activities that can greatly benefit a public health department and can often be mutually beneficial. Yet, little is known regarding practitioners' views of successful academic collaborations.

OBJECTIVE

The purpose of this study was to explore predictors and correlates of beneficial academic collaboration from the perspective of those on the front lines--the practitioners constituting the public health workforce.

DESIGN

Analysis of the Public Health Workforce Interests and Needs Survey (PH WINS), a cross-sectional survey of state health department practitioners, conducted in 2014.

PARTICIPANTS

PH WINS is a nationally representative survey of state health department practitioners. Data were available for a total of 8718 respondents in 37 states.

MAIN OUTCOME MEASURES

Two main outcome measures were used--(a) whether a respondent reported collaborating with an academic entity (including faculty/staff/students) in the past year, and (b) when collaboration did occur, the success of the collaboration insofar as the respondent perceived the engagement as very helpful.

RESULTS

Health department practitioners (27.2%) reported participating in an academic-practice collaboration. Factors associated with partnering included respondents' supervisory status, positional duties, and public health background. Of these respondents, 46.6% reported a successful collaboration. Factors associated with a successful collaboration included respondents' self-reported job skills and public health background.

CONCLUSION

While characteristics related to a public health practitioner's position are most significant in predicting whether a collaboration will occur, characteristics of the individual him- or herself are more relevant in predicting whether a collaboration will be successful. Public health managers interested in fostering an environment that promotes a successful academic-practice collaboration may benefit from ensuring that the public health practitioners involved in such collaborations are themselves trained in public health.

The Academic Health Department: the process of maturation

The Academic Health Department (AHD) involves an arrangement between a governmental health agency and an academic institution, which provides mutual benefits in teaching, service, research, and practice. From its initial development in the mid-1980s as the public health equivalent of the relationship between a teaching hospital and a medical school, the AHD concept has evolved to include multiple levels of governmental public health agencies (local, state, and federal) as well as multiple academic institutions (public health, medicine, and primary care medical residencies). Throughout the decade of the 2000s, multiple influences have impacted both the quality and quantity of AHDs, leading to an expansion of AHDs through the Council on Linkages' AHD Learning Community. The value of the AHD--as described from prior studies as well as the AHD case examples in this current special issue--is evident in its impact on the quality of educational experiences and workforce development, agency and academic accreditation, practice-based research, and the potential to influence health reform.

A Logic Model for Evaluating the Academic Health Department

Academic Health Departments (AHDs) are collaborative partnerships between academic programs and practice settings. While case studies have informed our understanding of the development and activities of AHDs, there has been no formal published evaluation of AHDs, either singularly or collectively. Developing a framework for evaluating AHDs has potential to further aid our understanding of how these relationships may matter. In this article, we present a general theory of change, in the form of a logic model, for how AHDs impact public health at the community level. We then present a specific example of how the logic model has been customized for a specific AHD. Finally, we end with potential research questions on the AHD based on these concepts. We conclude that logic models are valuable tools, which can be used to assess the value and ultimate impact of the AHD.