Strengthening the Nation’s Environmental Health Infrastructure and Improving Environmental Health Practice:

The Environmental Public Health Performance Standards Program

Sarah Kotchian

APHA and the Environment Section have repeatedly indicated support for strengthening the nation’s public health infrastructure and improving the practice of environmental health, and the CDC’s Environmental Public Health Performance Standards Program (EnvPHPS) offers a system for addressing those aims. The national Environmental Public Health Performance Standards have been under development for the past year after research determined the need for an environmental health companion module to the National Public Health Performance Standards. Through the implementation of these standards across the country at the state, tribal and local level, the CDC National Center for Environmental Health's Environmental Health Services Branch (EHSB) plans to build capacity, consistency and accountability within and across the nation’s environmental public health system. The Standards will be the primary tool to consistently and continuously assess the nation’s environmental public health capacity gaps in order to strengthen the nation’s environmental public health infrastructure. The CDC will also use the compiled capacity data from the assessments to build an accurate picture of the challenges facing the  nation’s environmental health services delivery system and to provide information to Congress, federal agencies, state agencies and foundations on where to focus resources.  In developing the Standards, the EHSB involved key public health partner groups, including APHA, in an April 2007 meeting and invited a number of jurisdictions to review and comment on the Standards from June-December 2007. The document is now being revised to incorporate this input, and the final draft document will go through federal clearance process early this year.  The EHSB expects the final version to be available later in 2008.

Listed below are a number of benefits of using the EnvPHPS.

• The EnvPHPS is designed to align with the familiar format of the NPHPS.
• Using both instruments can assist in building understanding and team work between environmental health and other public health programs.
• The EnvPHPS can be used separately from or concurrently with the NPHPS to:
  • Assess the capacity of a state, tribal or local jurisdiction to perform the essential environmental health services, and can be applied at the program, agency or system level;
  • Identify and prioritize gaps in the environmental health system to perform the essential environmental health services;
  • Develop an action plan to address the identified gaps and barriers to meeting the standards;
  • Educate and train new and existing staff, other public health officials, policy-makers and elected officials about the role of environmental health in preventing disease and reducing hazards; and
  • Provide credible evidence to demonstrate the value of environmental health service programs and to help justify the need for additional resources. 

Since the Standards have been developed nationally and are generally accepted, they provide a level of credibility and justification for improvement. They have brought external recognition of leadership to the departments that have used them, and have been used to demonstrate improvements in environmental health practice.  Developed with a perspective of the broad system of environmental health practice, they have application within virtually all environmental health and protection programs whether or not those programs reside in health departments.

The EnvPHPS program will be supported by a Web site with numerous online resources, including a tool kit for users.  The program will also include an evaluation component to assess the effectiveness of the tool in improving capacity, the environment and public health.

Those wishing to view and use the draft standards can visit the EHSB Web site for the latest draft version and a selection of online resources, including a free, online training offered by NEHA with CDC support.   http://www.cdc.gov/nceh/ehs/EnvPHPS/default.htm

CDC encourages all EH jurisdictions to become familiar with these new Standards and to actively promote their use.