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Understanding Emerging Environmental Health Concerns and Environmental Public Health–Tracking Priorities Among State and Local Professionals in Colorado

Murphy, Jacquelyn A. DrPH, MPH; Peel, Jennifer L. PhD, MPH; Butts, Tom MSc, REHS; McKenzie, Lisa M. PhD, MPH; Litt, Jill S. PhD

Journal of Public Health Management and Practice: June 04, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHH.0000000000001010
Research Full Report: PDF Only

Context: Colorado is experiencing dramatic changes related to population growth, climate change, and expanded industrial activity. Local and state public health professionals are trying to address a growing array of unique public health issues with stagnant or limited resources.

Objectives: To understand, through perspectives from local and state public health professionals, the alignment of contemporary environmental and community health issues with state and local capacity and state environmental public health–tracking priorities.

Design: During 2014-2015, we conducted semistructured interviews which informed the development of a statewide survey of Colorado's professionals from public health, emergency management, forestry, and transportation.

Setting: This work took place in Colorado.

Participants: Fifteen professionals from public (n = 9), academic (n = 4), and private (n = 2) sectors were interviewed. Forty-seven professionals, representing 34 counties and 40 public agencies, completed the 25-minute online survey.

Main Outcome Measures: Environmental and community health concerns; contributing factors to environmental concerns; strengths and limitations of capacity to respond to issues; and frequency of community engagement activities.

Results: Top environmental health concerns were indoor air pollution (eg, radon), outdoor air pollution, and waste management. Transportation, extreme weather (eg, wildfires), and oil and gas development were most frequently reported as major contributing factors to concerns. Obesity, physical inactivity, and mental illness were the top community health concerns. To remain prepared for emerging challenges, professionals cited a need for more spatiotemporal-refined data related to their top concerns in the environmental public health–tracking database, and support from local, state, and federal agencies, in addition to personnel and funding. To address concerns, participants reported frequently working with government officials, advisory committees, and media outlets.

Conclusions: This project illuminates opportunities to strengthen connections between the state's environmental public health–tracking priorities and local-level capacity related to professionals' top concerns. It also suggests reinforcing and broadening partnerships to improve data infrastructure and inform environmental public health priorities.

Environmental and Occupational Health Department, Colorado School of Public Health, Aurora, Colorado (Drs Murphy and McKenzie); Department of Environmental and Radiological Sciences, Colorado School of Public Health, Colorado State University, Fort Collins, Colorado (Dr Peel); Environmental Health Division; Tri-County Health Department, Greenwood Village, Colorado (Mr Butts); and Environmental Studies Department, University of Colorado-Boulder, Boulder, Colorado (Dr Litt).

Correspondence: Jill S. Litt, PhD, Sustainability, Energy and Environment Complex (SEEC), MacAllister Building Suite S214, 4001 Discovery Drive, Boulder, CO 80303 (

The authors acknowledge their colleagues for their contributions to this project and preparation of this manuscript: Dr Christopher Weible, Dr Tanya Heikkila, Mr Chris Adams, Dr John Adgate, Dr Mary Dinger, and Dr Mike Van Dyke. In addition, the authors acknowledge graduate students who contributed to this project: Jessica Moore, MPH, and Jolene Rohde, MPH.

This study was supported by NIH/NCATS Colorado CTSA grant number UL1 TR001082. Contents are the authors' sole responsibility and do not necessarily represent official NIH views. “Changing industries, landscapes, and environments: Implications for the public's health in Colorado” funded by Colorado Clinical and Translational Sciences Institute (CCTSI) CSU-CU Pilot Collaboration Award (Litt and Peel, Co-PIs).

The authors declare no conflicts of interest.

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