Frontiers in Public Health Services and Systems Research is an open-access, rapid-response, peer-reviewed online journal offering brief, preliminary PHSSR findings from ongoing or recently completed empirical studies or quality improvement projects. Journal articles answer questions of importance regarding the organization, financing, and delivery of public health services; the structure, operation, and management of public health delivery systems; the application of quality improvement methods in public health settings; and/or the impact of these endeavors on population health. Findings must have the potential to guide future public health practice, health policy, and research. Frontiers is intended to provide quick access to actionable public health infrastructure research to improve public health practice at the state and local levels. It is of use to practitioners, policy makers and researchers.

October 6, 2016
Brian E. Dixon et al.

Background: Community health assessments assist health departments in identifying health needs as well as disparities, and they enable linking of needs with available interventions. Electronic health record (EHR) systems possess growing volumes of clinical and administrative data, making them a valuable source of data for ongoing community health assessment.

October 6, 2016
Danielle M. Varda et al.

Background: Health care reform has resulted in changes throughout the health system, including the Affordable Care Act (ACA) and IRS requirements that nonprofit hospitals conduct community health needs assessments and develop implementation plans to guide greater investment in their respective communities. This has led to questions of which factors influence hospital interaction and investment in PH systems.

October 6, 2016
Julie M. Kapp et al.

Background: The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program was created by the 2010 Patient Protection and Affordable Care Act. MIECHV provides comprehensive services to at-risk families through evidence-based home visiting programs.

Purpose: The following question is addressed: Does the Missouri MIECHV system meet the definition of a complex adaptive system (CAS)?

October 6, 2016
Beth C. Truesdale et al.

Many researchers and advocates believe that income inequality affects individual health, but empirical evidence has been inconclusive. A large body of research has found that income inequality is negatively correlated with average life expectancy, partly because a transfer of income from the poor to the rich is likely to harm the health of the poor more than it improves the health of the rich. A smaller body of work has investigated socioeconomic disparities in life expectancy, which widened in many countries after 1980, at the same time that income inequality was increasing.

October 6, 2016
Heather Wipfli et al.

This paper focuses on the first century of the global tobacco epidemic and its current status, reviewing the current and projected future of the global tobacco epidemic and the steps that are in progress to end it. In the United States and many countries of western Europe, tobacco consumption peaked during the 1960s and 1970s and declined as tobacco control programs were initiated, motivated by the evidence indicting smoking as a leading cause of disease.

October 6, 2016
Joan A. Casey et al.

Adoption of electronic health records (EHRs) by clinical practices and hospitals in the US has increased substantially since 2009, and offers opportunities for population health researchers to access rich structured and unstructured clinical data on large, diverse, and geographically distributed populations. However, because EHRs are intended for clinical and administrative use, the data must be curated for effective use in research.

October 6, 2016
Gina Solomon et al.

Communities located near multiple sources of pollution, including current and former industrial sites, major roadways, and agricultural operations, are often predominantly low-income, with a large percentage of minorities and non-English speakers. These communities face additional challenges that can affect the health of their residents, including limited access to health care, a shortage of grocery stores, poor housing quality, and a lack of parks and open spaces. Research is now showing that environmental exposures can interact with social stressors, thereby worsening health outcomes.

October 6, 2016
Kate E. Beatty et al.

Rural residents in the U.S. face significant health challenges, including higher rates of risky health behaviors and worse health outcomes than many other groups. Rural communities are also typically served by local health departments (LHDs) that have fewer human and financial resources than their suburban and urban peers. As a result of history and need, rural LHDs are more likely than urban LHDs to provide direct health services, which may result in limited resources for population-based activities.

September 19, 2016
Whitney Webber et al.

Studies that exist on quality improvement efforts within local health departments indicate that there needs to be clearer approaches for achieving a culture of quality. This study describes how a local health department used the National Association of County and City Health Officials (NACCHO’s) Roadmap to an Organizational Culture of Quality Improvement (QI Roadmap) to successfully build a quality culture on its journey to becoming accredited, as reflected in results from a February 2016 survey.

September 14, 2016
Simone Singh et al.

Background: More than half of all local health departments (LHDs) in the U.S. are involved in collaborations with nonprofit hospitals on a community health needs assessment (CHNA), yet little is known about the role that LHDs play in hospitals’ implementation plans.

Purpose: This study aims to explore the current state of hospital–LHD collaborations around the implementation plan using data from a survey of LHDs across the country.