Category B: State and Local Health Departments - Years of underfunding have weakened the United States (U.S.) public health (PH) system, leaving it with old data systems, a fractured infrastructure, a strained workforce, and insufficient communications capacity. (1,2) Analysis of the recent PH industry survey found nearly half of all employees in state and local PH agencies, including injury and violence prevention (IVP) professionals, left their jobs between 2017- 2021, leaving large gaps in knowledge and experience in these agencies across the US. (3) IVP is a critical segment of PH and addresses a range of PH priorities, including suicide, overdoses, and motor vehicle crashes. Despite the burden from deaths due to injury and violence – more than $4.2 trillion (4) in medical care and lost productivity each year – investments and support for prevention remain disproportionate, with an average $0.68 per capita in prevention resources.(5) To reduce the burden posed by injury and violence in the US, the IVP field needs to build organizational capacity and workforce competency in the key areas of innovative communications, enhanced partnerships, data systems able to capture equity and disparity measures, and policies addressing these inequities. Safe States, a membership organization comprised of over 800 IVP professionals representing all U.S. states and territories, proposes to utilize its 30 years of experience building IVP capacity in state health departments (SHD) and local health departments (LHD), hospitals/healthcare organizations, and other settings, as well as its extensive national partnership networks to conduct strategies in five areas: Organizational Capacity and Performance Improvement; Workforce; Data Modernization, Informatics, and Information Technology; Partnership Development and Engagement; and Policy and Programs. The driving force behind the activities in this proposal is to advance the IVP field through strengthening the IVP workforce and capacity of IVP programs as well as the advancement of IVP priorities through a broad partner network. Through the strategies and activities in this proposal, Safe States intends to achieve the following five outcomes among SHD and LHD IVP programs in all 50 states and 10 Health and Human Services regions: 1. Increased availability of and access to capacity-building assistance (CBA) services and products that address the strategic areas; 2. Increased awareness of best/promising practices and/or tools of CBA services and products; 3. Increased use of CBA services and products; 4. Increased awareness and understanding of recommended processes, policies, programs, and practices within the strategic areas; 5. Enhanced skill and ability to support decision-making towards processes, policies, programs, and practices within the strategic areas. These activities are expected to improve the essential, foundational capacity and performance of SHD and LHD IVP programs and staff and lead to an increased system-level capacity across PH to ultimately improve health outcomes and reduce health inequities. (1) Trust for America’s Health. The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations 2023, Washington, DC. https://www.tfah.org/report-details/funding-2023 Accessed February 22, 2024. (2)The Commonwealth Fund. Meeting America’s Public Health Challenge: Recommendations for Building a National Public Health System That Addresses Ongoing and Future Health Crises, Advances Equity, and Earns Trust (commonwealthfund.org) Accessed February 15, 2024. (3) de Beaumont Foundation. Public Health Turnover Threatens Community Health and Safety Accessed February 17, 2024. (4) Peterson C, Miller GF, Barnett SB, Florence C. Economic Cost of Injury — United States, 2019. MMWR Morb Mortal Wkly Rep 2021;70:1655–1659. DOI: http://dx.doi.org/10.15585/mmwr.mm7048a1. (5) State of the States: 2015 Report. (2016). Atlanta (GA): Safe States Alliance.
