Local Boards of Health: A NewPublicHealth Q&A With Marie Fallon
Next week, hundreds of public health officials will meet in Idaho for the annual meeting of the National Association of Local Boards of Health. NewPublicHealth spoke with Marie Fallon, NALBOH’s chief executive officer, about the role of local boards of health and about the highlights of this year’s conference.
NewPublicHealth: What is the role of local boards of health in keeping their communities healthy?
Marie Fallon: Local, state, tribal and territorial boards of health work as trustees of governmental health departments in almost every state in the nation. Members of boards of health are appointed or elected to oversee, guide and set policy for health departments.
The roles of boards of health vary by state as does their authority to carry out their responsibilities. Some boards can enact rules and regulations, while others (the minority) may advise or make recommendations to the governing body for public health, such as a county commission.
As community representatives, board of health member roles include advocating – being the voice from the community to the health department and from the health department to the community and other community representatives, such as elected officials; aligning community need with programs through community health assessments and strategic planning; program oversight, follow-up and assessment; and fiscal oversight to ensure taxpayer dollars are being used as effectively and efficiently as possible.
All boards of health, regardless of the extent of their legal authority, are obligated to enact or recommend policies that serve the interest of public health in the communities they serve.
NPH: How do boards of health and health departments work together?
Marie Fallon: Boards of health and key staff provide the leadership team of the health department. They work together, collaborating to develop a strategic plan and establish priorities, doing outreach in the community and soliciting community input to ensure the ten essential services of public health are being carried out and there are no gaps in service to community members.
Boards of health can also often act as a buffer for health directors on some controversial issues.
NPH: What is the focus of this year’s NALBOH conference and what are some of the key topics being addressed?
Marie Fallon: NALBOH’s 19th annual conference theme is “Public Health: Effective Governance, Strong Leadership, and Engaged Citizens.” This theme was chosen because of NALBOH’s fundamental belief in the importance of citizen engagement for successful public health outcomes. We can have the best science and professionals in the world, but unless we are translating those tools to something meaningful that the community members understand and value, we will make little progress. Key topics include accreditation and quality improvement, with the launch of national, voluntary public health accreditation occurring later this month. Our board orientation workshop is always a huge success, as most of the board of health members do not receive an official orientation or regular board development. Also, we have a wonderful opportunity for a field trip to the Bunker Hill superfund site – the second largest superfund site in the country. Attendees will learn how a board of health, health department and local officials worked together to clean up contamination from a shuttered lead smelter plant.
NPH: What are some key ways that boards of health help health departments develop and implement strategies to improve people’s health?
Marie Fallon: Working together on community health assessments, strategic planning, health improvement plans, assessment and quality improvement. Agency accreditation will help to strengthen and improve these efforts. The other key area is policy development and implementation. The majority of boards have the authority to develop and implement policy and the health department staff is responsible for carrying it out. One example is the New York City Board of Health, which started the initiative for restaurant menu labeling.
NPH: What are some examples of areas where boards of health are making great strides in improving community health?
Marie Fallon: Tobacco control is definitely a success story we keep going back to and trying to replicate in other areas that can benefit from policy and grass root efforts, such as obesity. Environmental health-related policies and efforts also are making strides to improve community health.
We are working to educate boards of health about evidence-based decision-making and using the tools that are out in the field, such as the CDC’s Community Guide, to make the best decisions for their communities. Boards of health need to be strong advocates for prevention-related activities in order to help this country shift from just a focus on health care to a wider focus on health.