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BACKGROUND: CSTE conducted the first Epidemiology Capacity Assessment (ECA) in 2001 to assess epidemiology capacity in state and territorial health departments. It is an assessment of self-reported capacity based on the 10 essential public health services in 8 different public health program areas. Information gathered from the ECA is used as a benchmark for measuring changes in epidemiology and surveillance capacity over time. In 2013, CSTE solicited additional data related to four epidemiologic program areas: environmental health, chronic disease, maternal and child health, and oral health. This presentation will highlight results from the environmental health capacity (EH ECA) module. It describes the current state of environmental epidemiology capacity and identifies areas needing improvement and expansion nationally. Several recommendations are provided with the goal of improving environmental epidemiology capacity in states.
METHODS: Questions for the EH ECA module were developed by CSTE National Office staff and members of the CSTE Environmental Health Subcommittee. Questions addressed: (1) environmental health epidemiology capacity and activities, (2) data access and support, (3) data collection and dissemination, (4) organizational structure and capacity, and (5) collaborations with internal and external partners and participation in national workgroups/meetings. All questions focus on state-level (rather than local-level) environmental epidemiology capacity. In August 2013, the EH ECA module was distributed to State Epidemiologists in 50 states, Washington DC and six territories.
RESULTS: Of the 49 respondents (86% of the 57 jurisdictions), 41 (84%) reported having at least one environmental epidemiologist on staff. The 41 respondents indicated a total of 219.3 full-time-equivalent (FTE) environmental epidemiologists, or an average 5.3 FTEs per jurisdiction, and estimated that a 37% increase in FTEs would be needed to reach full environmental epidemiology capacity. Generally, these 41 health departments reported adequate capacity to monitor and investigate environmentally-related exposures and health outcomes, but minimal capacity to evaluate environmental health services and to conduct research. Collaborations between environmental epidemiology programs and academic partners were common nationwide. Collaboration with other public health program areas, organizations and agencies was noted to be limited.
CONCLUSIONS: Based on EH ECA results, activities that should be undertaken by CSTE and public health leaders to enhance capacity for environmental epidemiology include identification of additional resources to increase state and tribal environmental epidemiology capacity, expansion of access to epidemiologic data, and strengthening of collaborations with other public health program areas. The 2013 EH ECA module was the first official assessment of national environmental epidemiology capacity and workforce needs in the US.