1. www.harriscountyhealth.com Research on Health Effects of Air Toxics Policy Perspective

2. Overview Principles of public health practice HCPHES responsibilities and activities Research Needs – Policy Perspective

3. What is Public Health?

4. Public Health is “what we as a society do collectively to assure the conditions in which people can be healthy” The Future of the Public’s Health in the 21 st Century, IOM 2003

5. Cornerstone of public health practice is a population health approach that considers the multiple determinants of health

6. Public Health Activities Assessment, e.g. ongoing monitoring of the community’s health status Policy Development and Education, e.g. informing and empowering the public, mobilizing community partnerships, developing policies and plans Assurance, e.g. enforcing laws and regulations, assuring a competent public health workforce

7. HCPHES Assessment Activities air quality ( ozone, toxics, bioterrorism agents ) water quality ( drinking water systems, public H 2 0 ways ) infectious diseases ( influenza, rabies, SARS, WNv ) chronic diseases (tobacco-related, obesity-related ) injuries ( child fatality review ) blood lead screening occupational safety hazards ( indoor air quality )

8. Public Health Activities Assessment, e.g. ongoing monitoring of the community’s health status Policy Development and Education, e.g. informing and empowering the public, mobilizing community partnerships, developing policies and plans Assurance, e.g. enforcing laws and regulations, assuring a competent public health workforce

9. HCPHES Policy Development Activities Inform, educate, and empower people about health issues (Public Health Communication System) Mobilize community partnerships (Steps to a Healthier Houston-Harris County Consortium) Develop policies and plans that support individual and community health efforts (pandemic influenza plan)

10. Public Health Activities Assessment, e.g. ongoing monitoring of the community’s health status Policy Development and Education, e.g. informing and empowering the public, mobilizing community partnerships, developing policies and plans Assurance, e.g. enforcing laws and regulations, assuring a competent public health workforce

11. HCPHES Assurance Activities air and water pollution regulations food safety inspection and enforcement animal vaccine regulations preventive clinical services ( immunizations, TB clinic, maternal child health ) vector control programs ( mosquito spraying ) referrals for primary care nuisance regulations and enforcement ( abandoned houses and pools, rubbish ) lead-based paint abatement

12. Research Needs from a Policy Perspective Assessment  Measurement tools for both air toxics and health status indicators must be: Accurate- are we measuring what we think we are? Reliable – do we get the same answer every time we measure?

13. Research Needs from a Policy Perspective Assessment  Study Design and Statistical Methods: Identify short term and/or long-term health outcomes Yield generalizable results – apply broadly to exposed populations Yield robust results – stand-up to scrutiny, e.g. to sensitivity analyses

14. Research Needs from a Policy Perspective Policy Development  Research that: Identifies sources of exposure Identifies and tests strategies to reduce exposure (primary prevention) Performs cost-effectiveness analyses of exposure-reducing strategies Identifies and tests strategies to reduce risk of adverse health outcome post-exposure (secondary prevention)

15. Research Needs from a Policy Perspective Assurance  Research that: Identifies relative risk of health effects associated with exposure  Acute and chronic health effects  Acute versus long-term exposure  Dose-response

16. Translational Research “From bench to bedside” From bench to community

17. Conclusion: Connecting the Dots Research that provides a sound scientific basis for public health policy Evidence-Based Policy  Assessment  Policy development  Assurance