Environmental Health Practice Challenges and Research Needs for U.S. Health Departments

Abstract

Background: Environmental health (EH) professionals, one of the largest segments of the public health workforce, are responsible for delivery of essential environmental public health services. The challenges facing these professionals and research needs to improve EH practice are not fully understood, but 26% of EH professionals working in health departments of the United States plan to retire in 5 y, while only 6% of public health students are currently pursuing EH concentrations.

Objectives: A groundbreaking initiative was recently launched to understand EH practice in health departments of the United States. This commentary article aims to identify priority EH practice challenges and related research needs for health departments.

Methods: A horizon scanning approach was conducted in which challenges facing EH professionals were provided by 1,736 respondents working at health departments who responded to a web-based survey fielded in November 2017. Thematic analyses of the responses and determining the frequency at which respondents reported specific issues and opportunities identified primary EH topic areas. These topic areas and related issues informed focus group discussions at an in-person workshop held in Anaheim, California. The purpose of the in-person workshop was to engage each of the topic areas and issues, through facilitated focus groups, leading to the formation of four to five related problem statements for each EH topic.

Discussion: EH professionals are strategically positioned to diagnose, intervene, and prevent public health threats. Focus group engagement resulted in 29 priority problem statements partitioned among 6 EH topic areas: a) drinking water quality, b) wastewater management, c) healthy homes, d) food safety, e) vectors and public health pests, and f) emerging issues. This commentary article identifies priority challenges and related research needs to catalyze effective delivery of essential environmental public health services for common EH program areas in health departments. An unprecedented initiative to revitalize EH practice with timely and strategic recommendations for student and professional training, nontraditional partnerships, and basic and translational research activities is recommended. https://doi.org/10.1289/EHP5161.

Figure 1.

Percentage of environmental health professionals delivering specific programs in health departments of the United States. The web-based survey allowed environmental health professionals multiple responses to indicate the various programs in which they worked. Note: A, food safety and protection; B, public swimming pools; C, emergency preparedness and response; D, schools; E, onsite wastewater (e.g., septic systems); F, private or onsite drinking water; G, hotels/motels; H, vector control; I, body art (e.g., tattoo); J, day care/early childhood development facilities; K, special events/mass gatherings; L, campgrounds and RVs; M, public drinking water systems; N, lead prevention; O, solid waste; P, smoke-free ordinances; Q, children’s camps; R, indoor air quality; S, other recreational water (e.g., beaches); T, healthy homes; U, other; V, mobile homes; W, radon control; X, animal control; Y, land-use planning; Z, hazardous waste disposal; AA, pollution prevention; BB, health-related facilities; CC, outdoor air quality; DD, hazmat response; EE, tobacco retailers; FF, noise pollution; GG, cosmetology businesses; HH, collection of unused pharmaceuticals; II, radiation control; JJ, injury prevention; KK, toxicology; LL, occupational health; MM, milk processing; and NN, poison control ($n=\mathrm{1,736}$) (adapted from Gerding et al. 2019).

Figure 2.

Number of different environmental health programs delivered by percent of respondent professionals working in health departments of the United States ($n=\mathrm{1,736}$).

Figure 3.

Environmental health practice recommendations.