Local health departments and the challenge of chronic disease: lessons from California.
The essential role local health departments have played in the control of infectious diseases has not been matched with an equivalent contribution in prevention of chronic diseases. Local health departments have attempted to define and build that capacity, but they have been confronted with budget cuts and competing public health priorities, most notably bioterrorism preparedness. This article is based on interviews with local health officials and describes some of the common ways local health departments in California have forged ahead to develop the capacity to engage in comprehensive approaches to chronic disease prevention in spite of the challenges. Additionally, the article highlights future considerations that need to be addressed if these promising trends in chronic disease prevention are to become more widespread.
Prentice
Bob
B
Public Health Institute, 180 Grand Avenue, Suite 750, Oakland, CA 94612, USA. bprentice@phi.org
Flores
George
G
D002140:California; D002908:Chronic Disease / Q000517:prevention & control*; D018672:Community Health Planning / Q000458:organization & administration*; D003153:Community Health Services / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D015980:Public Health Practice