Adequacy of the National Public Health Performance Standards as a measure of the capacity of local environmental public health programs in Oklahoma

The National Public Health Performance Standards (NPHPS) assess the capacity of local public health systems to perform the ten essential services of public health. To date little has been undertaken to evaluate the extent to which the NPHPS reflect the capacity of local Environmental Public Health (EnvPH) programs to perform the Essential Environmental Public Health Services (EssEnvPHS). Local EnvPH programs with the capacity to perform the EssEnvPHS as defined by an accepted set of standards would be a significant benefit to the EnvPH system in its attempt to protect the health of the public. Three specific research questions were addressed and a means devised to obtain data that were appropriate and necessary to determine: (1) The capacity of environmental public health programs in Oklahoma counties to provide the essential environmental public health services; (2) Whether there was an association between the NPHPS and an accepted set of Environmental Public Health Performance Standards (EnvPHPS) and the significance and predictability of the association; (3) The barriers Oklahoma county environmental public health programs faced in developing the capacity to provide the essential environmental public health services.;EnvPHPS were developed and used to assess environmental public health capacity in the same 56 Oklahoma counties that completed the NPHPS in 2001. The EnvPHPS include ten standards, one for each of the ten EssEnvPHS. With the support of the Oklahoma State Department of Health, the EnvPHPS instrument was completed by each of the 56 counties during the summer of 2006. Results from the assessment were compared to the results from the NPHPS. Analysis of the results found weak correlation between the two instruments. Multiple linear regression analysis identified specific variables that influenced the outcome of eight of the ten standards. These variables were also barriers to meeting the standards and included lack of staff, training and funding were the barriers most frequently identified as influencing the outcome of the assessment. The results of the research support the need for a separate set of performance standards for environmental public health.