Public health infrastructure provides the capacity to prevent disease, promote health, and prepare for and respond to both acute threats and chronic challenges to health. Infrastructure is the foundation for planning, delivering, evaluating, and improving public health.¹ As of 2023, NJ has 102 local health departments (LHDs) throughout the state, which comprise any municipal local health department, contracting local health department, regional health commission, or county health department, administered by a full-time licensed health officer.  Each local health department is responsible for the administration of public health services to the municipalities it serves, as described in N.J.A.C. 8:52, Public Health Practice Standards of Performance for Local Boards of Health in New Jersey.

2018-2023

Projects

• NJDOH’s Office of Local Public Health (OLPH) collaborated with local health departments (LHDs) and the New Jersey Association of City and County Health Officials (NJACCHO) on the Public Health Accreditation Board’s (PHAB) Public Health National Center for Innovations’ (PHNCI) Foundational Public Health Services Public Health Transformation work.
• NJDOH created the Office of Workforce Planning and Professional Development to establish both NJDOH and LHDs in New Jersey as destinations for top public health talent across the state.  OLPH is creating a Workforce Planning and Professional Development Unit that will further support local public health workforce training, continuing education opportunities, and develop a Health Officer mentoring program.
• OLPH is developing a Local Health Liaison Program in conjunction with LHDs to foster trust and collaboration with the local public health workforce and increase bidirectional communication between NJDOH and LHDs.
• Annual data are collected on LHD participation in county-wide community public health partnerships to assess compliance with N.J.A.C. 8:52, Public Health Practice Standards of Performance for Local Boards of Health in New Jersey. LHD on-site visits are conducted to confirm LHD participation in community public health partnerships.  If warranted, OLPH provides technical assistance to improve deficiencies identified during the on-site visit.

Outreach

• Through the OLPH Strengthening Local Public Health Capacity Program, outreach via multiple platforms to all local health departments took place to make them aware of their eligibility to apply for funding to support PHAB accreditation, reaccreditation, or pathways recognition.

Grants given by NJDOH

• Many of the OLPH grants that are awarded to the LHDs support public health infrastructure and county and local health department collaboration to serve at-risk populations.
• Enhancing Local Public Health Infrastructure Partner Organization Grant Program funding supports the development and/or expansion of public health infrastructure at local health departments to increase health equity for disproportionately affected populations.
• OLPH’s Strengthening Local Public Health Capacity grant includes funding for LHDs seeking voluntary national accreditation/reaccreditation through PHAB.  It also funds workforce positions that provide support to at-risk populations in preparing for and mitigating the effects of COVID-19 and other infectious diseases.
• OLPH COVID-19 Vaccination Supplemental Funding program provides funding to LHDs to support COVID-19 vaccination with an emphasis on populations disproportionally affected by COVID-19 and other infectious diseases.
• OLPH County Health Infrastructure Funding grant provides funding to support programs, public health infrastructure, staffing, and services in each county, with a focus on ensuring health equity among residents.  

Grants received by NJDOH

• CDC Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems Grant funding to improve critical public health infrastructure needs.  Key outcomes include increased hiring of diverse public health staff, improving organizational systems and processes, and increased availability and use of public health data.  
• CDC Public Health Infrastructure Grant funding to OLPH was sub-awarded to LHDs to support public health accreditation, reaccreditation, or pathways recognition activities.

Challenges

• Difficulty hiring positions and identifying sustainable funding to support the extensive PHAB accreditation process. NJDOH addressed this challenge by offering accreditation funding to LHDs.

Assets/resources

• Post-COVID-19 federal funding received by NJDOH supports the development and/or expansion of public health infrastructure at local health departments to increase health equity for disproportionately affected populations.

Disparities/inequities

• The currently accredited local health departments do not serve New Jersey’s highest priority municipalities in terms of social vulnerability because those in high need areas generally do not have the resources necessary to go through the accreditation process.

Final Assessment

One of three Public Health Infrastructure targets was achieved by 2020. 

1. Four (21%) of New Jersey's nineteen community colleges were offering public health or related associate degrees and/or certificate programs by 2015.  In 2017, that number increased to five (26%), thereby exceeding the target of 20 percent. 
2. Ninety-four percent of local health agencies were actively participating in county-wide community public health partnerships based on responses to the Health Education and Promotion Survey from 97 of the state's 103 local health departments^† in 2018.  The survey was not conducted in 2019 or 2020 because local health departments were fully engaged in response to the COVID-19 pandemic. 
3. Only four of the state's 99 local health departments^† had achieved voluntary national accreditation by 2020.  The accredited local health departments are Township of Bloomfield Department of Health and Human Services (accredited in 2015), Camden County Health Department (2017), Princeton Health Department (2018), and Montgomery Township Health Department (2020).  Monmouth County Regional Health Commission #1 became accredited in 2022 and Clifton Health Department in 2023.

^† The number of local health departments changes from time to time.

For more information, please refer to these resources:

• NJDOH Office of Local Public Health
• NJ Public Health Associations
• CDC Center for State, Tribal, Local, and Territorial Support
• Inventory of Degree and Certificate Program Offerings at New Jersey Institutions of Higher Education
• Public Health Accreditation Board
• Region 2 Public Health Training Center
• Healthy People 2030

Reference:

1. Public Health Infrastructure.  Healthy People 2020.  5/27/21