Public health leaders are increasingly being asked to address adaptive challenges in the context ... more Public health leaders are increasingly being asked to address adaptive challenges in the context of finite and often limited resources. Budgets and their associated resources create the financial framework within which public health agencies and organizations must operate. Yet, many public health professionals expected to undertake roles requiring this foundational knowledge and skills are not trained in the fundamentals of public finance and are ill-equipped for managing and monitoring funds. Graduate courses in schools of public health most often are focused on health care management and finance or private sector finance. To meet the needs of future public health leaders, it is critical that academic content builds capacity in management and finance focused on public health practice. This paper describes the development of a Doctor of Public Health program management and finance course designed to prepare future public health leaders. The course aims to build the knowledge and ski...
The COVID-19 pandemic has had a significant effect on the opioid epidemic, which has been increas... more The COVID-19 pandemic has had a significant effect on the opioid epidemic, which has been increasing over the past decade. The increase in opioid-involved deaths have coincided with fentanyl use, and a combination of drugs. Since the beginning of the COVID-19 pandemic opioid-involved deaths have increased greater than 30% in the U.S. The COVID-19 mandates, including stay-at-home orders, has had a detrimental impact on opioid and drug abuse, and association mortality.This paper describes a statewide study of the impact of the COVID-19 pandemic and opioid and drug-involved deaths. Data was acquired from the Louisiana Department of Health for 2018, 2019, and 2020. The percent increase statewide in opioid-involved deaths was 115.9% from 2018 through 2020. When the data is stratified by race, non-Hispanic Blacks had a 163.6% increase in opioid-involved deaths, which was 15% higher than in non-Hispanic Whites. The increase in opioid-involved deaths was similar in males and females. Statew...
Journal of Public Health Issues and Practices, 2021
Early in the COVID-19 pandemic, minorities experienced the greatest burden of infection and death... more Early in the COVID-19 pandemic, minorities experienced the greatest burden of infection and death. These disparities were studied and related to the disproportionate distribution of comorbidities among minority, especially diabetes and obesity in non-Hispanic Blacks. Additionally, health equity has been linked to health disparities of chronic disease and COVID-19 infection. The same effect of the social determinants of health on chronic diseases in minorities is now seen in the COVID-19 pandemic. This study, which is a follow-up of research in the early stages of the pandemic, is focused on determining if the disparity in mortality is still present in the second year of the COVID-19 pandemic. Data were collected for state health departments in Georgia, Louisiana, Michigan and Mississippi on mortality due to COVID-19 infection. Mortality and case-fatality rates were collected for each state and selected counties in the study states. Mortality and case-fatality rates were determined a...
Science-Based Approaches to Respond to COVID and Other Public Health Threats, 2021
Public health emergencies are becoming more commonplace every year. Naturally occurring public he... more Public health emergencies are becoming more commonplace every year. Naturally occurring public health emergencies, such as hurricanes, typhoons, tsunamis, and floods cause significant devastation to property and people. Although these emergencies are becoming more and more common, response is still very challenging. A root cause of failed response is a lack of coordination between national, regional, and local public health agencies. These failed and unsuccessful responses are seen with naturally occurring public health emergencies, including pandemics. This chapter addresses coordination, its barriers and challenges, with a focus on the role of leadership in response to public health emergencies. Coordination leadership is a critical aspect of successful and effective response to emergencies. Leadership styles will be discussed and examples of effective leadership. Lessons learned will be presented, as well as research findings. Examples discussed include Hurricane Katrina, the tsu...
Accreditation of governmental public health agencies is a relatively new concept that began in 20... more Accreditation of governmental public health agencies is a relatively new concept that began in 2006. The accreditation program strives to advance improvements in quality and performance in state and local governmental public health agencies across the nation. Standards and measures are the traditional assessment criteria in accreditation systems used to evaluate that acceptable levels of quality are present and aligned with industry-specific goals for quality. In this study, an examination was conducted to assess the reliability of standards and measures for evaluating the effectiveness of public health agency financial management systems. The higher education system for accreditation of college and universities was selected for comparison purposes. The rationale for higher education was based in part on the relationship of colleges and universities to federal agencies which is very similar to that of governmental public health agencies. Also considered were the maturity of the high...
Journal of Public Health Issues and Practices, 2021
Objectives: Opioid overdose death rates in the United States has been increasing over the past se... more Objectives: Opioid overdose death rates in the United States has been increasing over the past several years. This increasing trend has been seen in states across the country. Previous studies have highlighted that opioid-involved deaths have occurred mostly in non-Hispanic Whites. The objectives of this study were to (1) compare opioid deaths death trends in U.S. to a state, Louisiana, (2) compare opioid death trends in Louisiana urban and suburban areas, and (3) evaluate changes in the overall trends, as well as across race and gender, that may affect public health policy and practice. Methods: Data were abstracted from secondary data sources, including the Louisiana Opioid Data and Surveillance System. Trends in opioid-involved deaths, drug-induced deaths, and opioid prescription by prescriber location were determined in the U.S. and Louisiana. Results: The increasing trends in age-adjusted rate of opioid involved deaths in Louisiana has mimicked what has occurred in the United S...
ObjectiveTo describe the development of an evaluation framework thatallows quantification of surv... more ObjectiveTo describe the development of an evaluation framework thatallows quantification of surveillance functions and subsequentaggregation towards an overall score for biosurveillance systemperformance.IntroductionEvaluation and strengthening of biosurveillance systems is acomplex process that involves sequential decision steps, numerousstakeholders, and requires accommodating multiple and conflictingobjectives. Biosurveillance evaluation, the initiating step towardsbiosurveillance strengthening, is a multi-dimensional decisionproblem that can be properly addressed via multi-criteria-decisionmodels.Existing evaluation frameworks tend to focus on “hard” technicalattributes (e.g. sensitivity) while ignoring other “soft” criteria(e.g. transparency) of difficult measurement and aggregation. Asa result, biosurveillance value, a multi-dimensional entity, is notproperly defined or assessed. Not addressing the entire range of criterialeads to partial evaluations that may fail to convene ...
The missions of public health and community colleges bind them intimately to their service areas.... more The missions of public health and community colleges bind them intimately to their service areas. Programs delivered by both members are influenced by the health and educational needs in the communities they serve. This alignment of missions supports a vision for greater cross-sectoral collaborations between public health and community colleges to advance improvements in health and education. Doing so has mutual benefits for both sectors while also supporting the achievement of national goals. A particular area ripe for exploration is on strengthening the public health workforce through the expansion of U.S. community college offerings in this discipline. Enhanced public health workforce skills increase the probability of achieving population health improvement goals of the Affordable Care Act as well as for strengthening community capacity so urgently needed to stimulate thriving communities across the United States.
The new journal Frontiers in Public Health Services and Systems Research provides a platform for ... more The new journal Frontiers in Public Health Services and Systems Research provides a platform for rapidly and widely communicating emerging findings and lessons learned from studies of public health services and delivery systems.
Since 9/11 federal funds directed toward public health departments for training in disaster prepa... more Since 9/11 federal funds directed toward public health departments for training in disaster preparedness has dramatically increased resulting in changing expectations of public health workers roles in responding to disasters. In order to better understand the roles and functions of public health workers in disaster we conducted an oral history of the public health response to Hurricane Katrina with support from the Robert Wood Johnson Foundation. In depth interviews were conducted in the summer of 2006 with over 50 state and local public health officials at all levels of the organization in the City of New Orleans, the states of Louisiana and Mississippi. A thematic analysis of the transcribed interviews revealed differences in understanding of the public health workers role as first responders and challenges in balancing traditional responsibilities with new demands. While leadership in public health agencies have embraced the new role in responding to disaster, not all staff have ...
Journal of public health management and practice : JPHMP
For optimal effectiveness, assessments of public health agency and system performance should incl... more For optimal effectiveness, assessments of public health agency and system performance should include analysis to measure the amount of financial resources consumed to achieve performance levels. This pilot study was conducted to test a methodology in a state health department for comparing financial resources consumed to performance scores in each of the 10 Essential Public Health Services categories. An additional feature was to quantify the percentage of total agency expenditures utilized for administrative functions as well. The allocation of all fiscal year 2004 expenditures to the 10 Essential Public Health Services and administration categories was based on assessments of employee job functions and scope of services performed under agency contracts. Performance scores were obtained through a 2-month process of completing self-assessment surveys with system partners using the National Public Health Performance Standards Program Assessment Instrument. Investigators found no clea...
Public health leaders are increasingly being asked to address adaptive challenges in the context ... more Public health leaders are increasingly being asked to address adaptive challenges in the context of finite and often limited resources. Budgets and their associated resources create the financial framework within which public health agencies and organizations must operate. Yet, many public health professionals expected to undertake roles requiring this foundational knowledge and skills are not trained in the fundamentals of public finance and are ill-equipped for managing and monitoring funds. Graduate courses in schools of public health most often are focused on health care management and finance or private sector finance. To meet the needs of future public health leaders, it is critical that academic content builds capacity in management and finance focused on public health practice. This paper describes the development of a Doctor of Public Health program management and finance course designed to prepare future public health leaders. The course aims to build the knowledge and ski...
The COVID-19 pandemic has had a significant effect on the opioid epidemic, which has been increas... more The COVID-19 pandemic has had a significant effect on the opioid epidemic, which has been increasing over the past decade. The increase in opioid-involved deaths have coincided with fentanyl use, and a combination of drugs. Since the beginning of the COVID-19 pandemic opioid-involved deaths have increased greater than 30% in the U.S. The COVID-19 mandates, including stay-at-home orders, has had a detrimental impact on opioid and drug abuse, and association mortality.This paper describes a statewide study of the impact of the COVID-19 pandemic and opioid and drug-involved deaths. Data was acquired from the Louisiana Department of Health for 2018, 2019, and 2020. The percent increase statewide in opioid-involved deaths was 115.9% from 2018 through 2020. When the data is stratified by race, non-Hispanic Blacks had a 163.6% increase in opioid-involved deaths, which was 15% higher than in non-Hispanic Whites. The increase in opioid-involved deaths was similar in males and females. Statew...
Journal of Public Health Issues and Practices, 2021
Early in the COVID-19 pandemic, minorities experienced the greatest burden of infection and death... more Early in the COVID-19 pandemic, minorities experienced the greatest burden of infection and death. These disparities were studied and related to the disproportionate distribution of comorbidities among minority, especially diabetes and obesity in non-Hispanic Blacks. Additionally, health equity has been linked to health disparities of chronic disease and COVID-19 infection. The same effect of the social determinants of health on chronic diseases in minorities is now seen in the COVID-19 pandemic. This study, which is a follow-up of research in the early stages of the pandemic, is focused on determining if the disparity in mortality is still present in the second year of the COVID-19 pandemic. Data were collected for state health departments in Georgia, Louisiana, Michigan and Mississippi on mortality due to COVID-19 infection. Mortality and case-fatality rates were collected for each state and selected counties in the study states. Mortality and case-fatality rates were determined a...
Science-Based Approaches to Respond to COVID and Other Public Health Threats, 2021
Public health emergencies are becoming more commonplace every year. Naturally occurring public he... more Public health emergencies are becoming more commonplace every year. Naturally occurring public health emergencies, such as hurricanes, typhoons, tsunamis, and floods cause significant devastation to property and people. Although these emergencies are becoming more and more common, response is still very challenging. A root cause of failed response is a lack of coordination between national, regional, and local public health agencies. These failed and unsuccessful responses are seen with naturally occurring public health emergencies, including pandemics. This chapter addresses coordination, its barriers and challenges, with a focus on the role of leadership in response to public health emergencies. Coordination leadership is a critical aspect of successful and effective response to emergencies. Leadership styles will be discussed and examples of effective leadership. Lessons learned will be presented, as well as research findings. Examples discussed include Hurricane Katrina, the tsu...
Accreditation of governmental public health agencies is a relatively new concept that began in 20... more Accreditation of governmental public health agencies is a relatively new concept that began in 2006. The accreditation program strives to advance improvements in quality and performance in state and local governmental public health agencies across the nation. Standards and measures are the traditional assessment criteria in accreditation systems used to evaluate that acceptable levels of quality are present and aligned with industry-specific goals for quality. In this study, an examination was conducted to assess the reliability of standards and measures for evaluating the effectiveness of public health agency financial management systems. The higher education system for accreditation of college and universities was selected for comparison purposes. The rationale for higher education was based in part on the relationship of colleges and universities to federal agencies which is very similar to that of governmental public health agencies. Also considered were the maturity of the high...
Journal of Public Health Issues and Practices, 2021
Objectives: Opioid overdose death rates in the United States has been increasing over the past se... more Objectives: Opioid overdose death rates in the United States has been increasing over the past several years. This increasing trend has been seen in states across the country. Previous studies have highlighted that opioid-involved deaths have occurred mostly in non-Hispanic Whites. The objectives of this study were to (1) compare opioid deaths death trends in U.S. to a state, Louisiana, (2) compare opioid death trends in Louisiana urban and suburban areas, and (3) evaluate changes in the overall trends, as well as across race and gender, that may affect public health policy and practice. Methods: Data were abstracted from secondary data sources, including the Louisiana Opioid Data and Surveillance System. Trends in opioid-involved deaths, drug-induced deaths, and opioid prescription by prescriber location were determined in the U.S. and Louisiana. Results: The increasing trends in age-adjusted rate of opioid involved deaths in Louisiana has mimicked what has occurred in the United S...
ObjectiveTo describe the development of an evaluation framework thatallows quantification of surv... more ObjectiveTo describe the development of an evaluation framework thatallows quantification of surveillance functions and subsequentaggregation towards an overall score for biosurveillance systemperformance.IntroductionEvaluation and strengthening of biosurveillance systems is acomplex process that involves sequential decision steps, numerousstakeholders, and requires accommodating multiple and conflictingobjectives. Biosurveillance evaluation, the initiating step towardsbiosurveillance strengthening, is a multi-dimensional decisionproblem that can be properly addressed via multi-criteria-decisionmodels.Existing evaluation frameworks tend to focus on “hard” technicalattributes (e.g. sensitivity) while ignoring other “soft” criteria(e.g. transparency) of difficult measurement and aggregation. Asa result, biosurveillance value, a multi-dimensional entity, is notproperly defined or assessed. Not addressing the entire range of criterialeads to partial evaluations that may fail to convene ...
The missions of public health and community colleges bind them intimately to their service areas.... more The missions of public health and community colleges bind them intimately to their service areas. Programs delivered by both members are influenced by the health and educational needs in the communities they serve. This alignment of missions supports a vision for greater cross-sectoral collaborations between public health and community colleges to advance improvements in health and education. Doing so has mutual benefits for both sectors while also supporting the achievement of national goals. A particular area ripe for exploration is on strengthening the public health workforce through the expansion of U.S. community college offerings in this discipline. Enhanced public health workforce skills increase the probability of achieving population health improvement goals of the Affordable Care Act as well as for strengthening community capacity so urgently needed to stimulate thriving communities across the United States.
The new journal Frontiers in Public Health Services and Systems Research provides a platform for ... more The new journal Frontiers in Public Health Services and Systems Research provides a platform for rapidly and widely communicating emerging findings and lessons learned from studies of public health services and delivery systems.
Since 9/11 federal funds directed toward public health departments for training in disaster prepa... more Since 9/11 federal funds directed toward public health departments for training in disaster preparedness has dramatically increased resulting in changing expectations of public health workers roles in responding to disasters. In order to better understand the roles and functions of public health workers in disaster we conducted an oral history of the public health response to Hurricane Katrina with support from the Robert Wood Johnson Foundation. In depth interviews were conducted in the summer of 2006 with over 50 state and local public health officials at all levels of the organization in the City of New Orleans, the states of Louisiana and Mississippi. A thematic analysis of the transcribed interviews revealed differences in understanding of the public health workers role as first responders and challenges in balancing traditional responsibilities with new demands. While leadership in public health agencies have embraced the new role in responding to disaster, not all staff have ...
Journal of public health management and practice : JPHMP
For optimal effectiveness, assessments of public health agency and system performance should incl... more For optimal effectiveness, assessments of public health agency and system performance should include analysis to measure the amount of financial resources consumed to achieve performance levels. This pilot study was conducted to test a methodology in a state health department for comparing financial resources consumed to performance scores in each of the 10 Essential Public Health Services categories. An additional feature was to quantify the percentage of total agency expenditures utilized for administrative functions as well. The allocation of all fiscal year 2004 expenditures to the 10 Essential Public Health Services and administration categories was based on assessments of employee job functions and scope of services performed under agency contracts. Performance scores were obtained through a 2-month process of completing self-assessment surveys with system partners using the National Public Health Performance Standards Program Assessment Instrument. Investigators found no clea...
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Papers by Peggy Honore