Public Health Nurse

The local health department

A local health department (LHD) is an administrative or service unit of local or state government that acts to carry out responsibility for the health of a jurisdiction smaller than the state (NACCHO Profile of Local U.S. Health Departments, 1997). Each LHD is unique in structure and function.  Below is a list of a LHD’s responsibilities to the public as listed by NACCHO (National Association of County and City Health Officials).

A LHD’s responsibilities include:

  • Conducting a community assessment to identify the population it serves and to understand specific health issues and barriers to healthy activities.
  • Investigating health problems and health threats in the community.
  • Preventing, minimizing, and containing adverse health effects from communicable diseases, disease outbreaks from unsafe food and water, chronic diseases, environmental hazards, injuries, and risky health behaviors.
  • Leading planning and response activities for public health emergencies.
  • Implementing health promotion programs.
  • Developing partnerships with public and private healthcare providers and institutions, community based organizations, and other government agencies.

According to NACCHO data, the majority of the LHD’s across the U.S. listed communicable disease control, environmental health, and child health as top priorities in their community.  The core public health services and programs that LHD provide to their communities are:

  • Adult and childhood immunizations
  • Communicable disease control
  • Community assessment
  • Community outreach and education
  • Environmental health services
  • Epidemiology and surveillance programs
  • Food safety
  • Health education
  • Restaurant inspections
  • Tuberculosis testing

Less common programs developed and implemented by LHD include:

  • Cardiovascular disease, diabetes,  and glaucoma treatment
  • Behavioral and mental health services
  • Programs for the homeless
  • Substance abuse services
  • Veterinary public health

Interesting to note is NACCHO’s report that many LHD’s are reassessing and redefining their roles within the public health system.  “This has resulted in LHDs transitioning their direct delivery services to other providers, and refocusing resources on more population based services.”