Local Health Departments' Engagement in Activities to Address Opioid Use and Abuse: The Influence of Surveillance Systems' Use

Abstract

Aims: To examine the extent to which local health departments (LHDs) conduct activities to address opioid use and abuse. To test the hypothesis that (i) LHDs' access to data from an electronic syndromic surveillance system is associated with conducting activities to address opioid use and abuse, and (ii) among those LHDs with access to syndromic surveillance data, the use of syndromic and other surveillance data on opioid-related events is associated with LHDs' report of conducting activities to address opioid use and abuse. Methods: Logistic regression was used to analyze data from the 2018 Forces of Change Survey of a statistically representative sample of 966 LHDs, of which 591 participated in the survey. Results: The LHDs' access to a syndromic surveillance system was significantly associated with their report of conducting activities to address opioid use and abuse. Compared with LHDs that had no surveillance systems, odds of participating in activities to address the opioid use or abuse were higher for LHDs that managed their own surveillance systems (adjusted odds ratio, AOR = 3.022, P = .03) and those who had but did not manage their own surveillance systems (AOR = 1.920, P < .01). The LHDs' use of syndromic surveillance systems (AOR = 2.98, P = .01) or other surveillance systems (AOR = 2.21, P = .03) was also associated with higher odds to participate in activities to address the opioid use or abuse (vs no such use). Conclusion:The LHDs are strategically well positioned to play their role in addressing this multifaceted epidemic. Access to data or information from electronic syndromic surveillance systems that use hospital emergency department data might significantly improve LHDs' engagement in conducting activities to address opioid use and abuse within their communities while building their capacity to face the next epidemic.

Association Between Interorganizational Collaboration in Opioid Response and Treatment Capacity for Opioid Use Disorder in Counties of Five States: A Cross-Sectional Study

“…Future work informing how local communities can better manage or overcome challenges associated with conflicting agendas of parties to collaborative opioid response, such as those of public health and police departments, 29 is also needed. Examining how more specific coordination alternatives, such as surveillance systems used by LHDs and EDs, 25 and cooperative arrangements, such as LHD-hospital collaboration in health planning, 26 relate to, or result in, other key outputs or outcomes of local opioid response efforts beyond treatment availability would also be informative.…”

“…24 To date, little is known about the impacts of local-level interorganizational collaborations on tackling, or building community capacity to address, the opioid overdose crisis. These collaborations take on myriad forms and objectives in practice such as sharing data and information between hospital emergency departments (EDs) and LHDs for engaging in opioid response, 25 requiring collaborations between non-profit hospitals and LHDs in local health planning, 26 using interagency collaborations between law enforcement/first responders and health providers to increase treatment referrals, 27 or engaging in cross-municipal collaboration in implementing postoverdose outreach programs operated by public health and safety providers. 28 In some cases, such as in collaborations between EDs and LHDs, joint organizational goals and activities may be more easily aligned around, for example, health and prevention improvement; in other cases, such as in collaborations involving police and public health, goal alignment and achievement can be more challenging with conflicting agendas on drug use that may undermine health outcomes and equity.…”

“…g SAR models(19)(20)(21)(22)(23)(24)(25)(26)(27)(28) include a spatial lag parameter, ρ , for the dependent variable. ***P < .01, **P < .05, *P < .10.…”

Assessing Public Health Workforce Informatics Competencies: A Study of 3 District Health Departments in Georgia

“…community engagement, and the provision of public health services. 1 Public health informatics (PHI) is "the systematic application of information and computer science technology to public health practice, research, and learning." 2(p67) The benefits of informatics include superior disease surveillance, enhanced provision of clinical services to underserved populations, and improved capacity to assess and address health needs and health inequities or disparities.…”

Gaining Ground in Opioid Surveillance

“…9 Opioid surveillance improvements are reflected in several studies in this issue. Nguyen and colleagues 13 provide national survey findings on local health departments' reported access to ED syndromic surveillance and use of that data for opioid-related surveillance. Scholl and colleagues 14 report the development and validation of a definition specific for heroin overdose to use with ED syndromic surveillance data.…”