Where We're Starting
- Health First Indiana
- Current: Where We're Starting
Introduction and Overall Summary
In collaboration with the CDC Foundation, local health departments were surveyed in October 2023 regarding current activities related to each of the core public health services and priorities for offering or expanding core services. In total, 92 of 95 local health departments responded. These data provide vital information for local health departments to share ideas and collaborate with each other for core public health service delivery. In addition, survey data are helpful for Indiana Department of Health divisions to determine how best to support local health departments with core public health service delivery. This survey will be conducted annually to further inform ideas and partnerships and describe progress.
92
Complete
3
Incomplete
97% of Indiana local health departments (LHDs) answered the Health First Indiana survey administered from 9/26/2023 – 10/30/2023.
Tobacco and Vaping Prevention and Cessation
Infectious Disease Surveillance and Prevention
Access to and Linkage to Clinical Care
Chronic Disease Prevention
Lead Case Management
Trauma and Injury Prevention
Food Protection
Fatality Review
Maternal and Child Health
School Health Liaison
Health-Related Areas during Emergencies/Disasters
Immunizations
Environmental Public Health
Tuberculosis Prevention and Case Management
Vital Records
Incomplete surveys: Starke County, Warrick County, Wells County
Note that LHDs can fit into multiple groups depending on how they described their program. What is mentioned in section textboxes are items explicitly shared in qualitative write ups and may not be a comprehensive list of existing programming.
Note that all percentages have been rounded up to the nearest whole number to account for the unit of ‘whole health department’ as measured by this survey.
Access to and Linkage to Clinical Care
Does your LHD partner with local and state health partners to address gaps and barriers to health services in your community?
72
Yes
20
No
3
No Answer
76% of Indiana LHDs work with local and state partners to address gaps and barriers to health services.
Out of those that partner, 63 provide referrals to clinical care for a range of services.
LHDs were asked to describe who they partner with to address gaps and barriers
- Hospitals and health systems (28 LHDs)
- Organizations in the community providing connections to healthcare (22 LHDs)
- Indiana Department of Health (16 LHDs)
- University health systems (IU or Purdue) (4 LHDs)
- Community-based shelters (abuse, homeless, etc.) (2 LHDs)
- Churches (3 LHDs)
- In-county coalitions (such as for tobacco, etc.) (3 LHDs)
- Other Indiana county health departments (3 LHDs)
- Schools (3 LHDs)
- WIC (3 LHDs)
- Mobile units (2 LHDs)
- Law enforcement (2 LHDs) and EMS services (1 LHD)
- CDC (1 LHD)
*City LHDs are not included in the map: Fishers and Gary City are included in ‘yes,’ East Chicago is included in ‘no.’
Chronic Disease Prevention
Does your LHD have a comprehensive, evidence-based program and/or promising practices to address obesity and obesity-related disease prevention within your local health department?
14
Yes
79
No
2
No Answer
15% of Indiana LHDs currently have a program addressing obesity or obesity-related disease prevention.
*City LHDs are not included in the map: Fishers, East Chicago and Gary City are included in ‘no.’
Summary of obesity and related disease prevention program descriptions
- Provided services explicitly mentioned
- Education provided (6 LHDs)
- Wellness checks provided for blood sugar, blood pressure, weight, etc. (6 LHDs)
- Referrals and resources provided (3 LHDs)
- Healthy living promotions (2 LHDs)
- Data monitoring (1 LHD)
- Food provision programs (1 LHD)
2 LHDs mentioned they were in the initial stages of programming, while 1 explicitly mentioned they have plans for expansion of existing programs. 1 LHD mentioned they have general programming for diabetes prevention and did not provide specifics.
- Partners explicitly mentioned
- WIC (3 LHDs)
- Schools (3 LHDs)
- Community partners (2 LHDs)
- Diabetes prevention program partnership (1 LHD)
- SNAP (1 LHD)
- Purdue Extension (1 LHD)
- Hospitals (1 LHD)
- YMCA (1 LHD)
- CDC funding (1 LHD)
- LHDs current partnership mechanisms
Below are the ways in which LHDs described their partnership with hospital(s) or healthcare system(s)/partners:
- 19 LHDs are currently discussing partnership opportunities with their health systems on chronic disease prevention, and some are discussion HFI funding for this partnership
- 12 LHDs engage with their health systems in referral systems or education provision
- 7 LHDs mentioned that generally they engage in partnership with their local health systems
- 4 LHDs are forming or currently active on committees or coalitions regarding chronic disease
- 3 LHDs attend regular meetings
- 3 LHDs engage in data and information sharing
- 3 LHDs did not elaborate on the ways in which they engage in their partnership
- 2 LHDs engage in a partnership that covers payments for certain fees provided by the health systems
- 1 LHD engages in community outreach for their health systems
- 4 LHDs work with their health systems on developing community initiatives
53% (50/95) LHDs have been in conversation with the hospital(s) or healthcare system(s)/partners concerning chronic disease prevention.
- 42 of those 50 do not currently have an active program for preventing obesity or obesity-related disease.
Other KPIs addressed in chronic disease prevention programming:
- Maternal and child health (3 LHDs)
Environmental Public Health
Does your LHD have an ordinance governing any portion of environmental health (onsite sewage systems, public swimming pools, minimum housing, wells, vector control)?
| Onsite sewage systems | 77 |
| Public/semi-public swimming pools | 49 |
| Vector control | 37 |
| Minimum housing | 23 |
| Other | 11 |
*Does not include those that did not complete the survey. 3 LHDs did not complete the survey.
No LHDs chose that they had an ordinance governing ‘none of the above.’
Out of the 11 that checked ‘other’, below are the ordinances that were listed:
| Allen County | Lodging Inspection program |
| Clark County | Disposal of Solid Waste and Hazardous Refuse, Potable Water, Solid Waste |
| Delaware County | Tattoo and Body Piercing |
| Elkhart County | Ground Water Protection, Private Well Water |
| Hendricks County | Tattoo and Body Piercing, Temporary Campground, Lodging (pests), Solid Waste, Illegal Dumping, Private Well Water |
| Howard County | Tattoo and Body Piercing |
| LaPorte County | Drinking Water Well permitting and testing of water after initial drilling, Tattoo and Body Piercing, and Outdoor Hydronic Heater. |
| Marion County | Solid waste, Well-field protection, Tattoo and Body Piercing, and Hazardous Materials |
| Porter County | Tattoo and Body Piercing |
| Vanderburgh County | Tattoo and Body Piercing |
| Vigo County | Tattoo and Body Piercing |
Does your LHD have an onsite sewage system/septic system inspection program?
92
Yes
1
No
3
No Answer
97% of LHDs have an onsite sewage system/septic system inspection program.
Out of those that answered ‘yes’:
- 93% (86) of LHDs answered that it was a proactive permitting and inspection program. 5 LHDs did not answer.
- 15% (14) of LHDs said it was a complaint-based program only without permitting and routine proactive inspections. 70 LHDs said it was not, and 7 LHDs did not answer.
*City LHDs are not included in the map: Fishers and East Chicago are included in ‘yes,’ and Gary City is included in ‘no.’
Does your LHD have a public/semi-public swimming pool inspection program?
69
Yes
23
No
3
No Answer
73% of LHDs have a public/semi-public swimming pool inspection program.
Out of those that answered ‘yes’:
- 87% (60) of LHDs answered that it was a proactive permitting and inspection program. 4 LHDs did not answer.
- 13% (9) of LHDs said it was a complaint-based program only without permitting and routine proactive inspections. 56 LHDs said it was not, and 4 LHDs did not answer.
*City LHDs are not included in the map: Fishers is included in ‘yes,’ and East Chicago and Gary City are included in ‘no.’
Does your LHD have a Housing Complaint Inspection Program (such as for pests, hoarding, trash/garbage, unsanitary living conditions like no running water, etc.)?
82
Yes
10
No
3
No Answer
87% of LHDs have a housing complaint inspection program.
Out of those that answered ‘yes’:
- 94% (77) of LHDs answered that it was a complaint-based program. 4 LHDs did not answer.
*City LHDs are not included in the map: Fishers, East Chicago, and Gary City are included in ‘yes.’
Does your LHD have a vector control (pests, rodents) program?
67
Yes
25
No
3
No Answer
71% of LHDs have a vector control program.
Out of the 67 LHDs with a vector control program:
- 28 shared that they have a rodent-related program. (34 do not, 5 LHDs did not answer)
- 93% (26) of rodent-related programs are complaint based.
- 42% of LHDs with a vector control program have a rodent-related program.
Out of the 56 LHDs that have a mosquito-related program: (7 do not, 4 did not answer)
- 84% of LHDs with a vector control program have a mosquito related program.
- 99% of the 56 (55) respond to standing water complaints.
- 70% of the 56 (39) spray larvicide on standing water.
- 59% of the 56 (33) spray for mosquitos through adulticide.
- 56% of the 56 (31) engage in mosquito trapping and identification – of which 7 test for West Nile Virus, and 21 send mosquitos to IDOH for testing of West Nile Virus.
- 9% (5) of the 56 LHDs provide mosquitofish to the public for mosquito control.
*City LHDs are not included in the map: Fishers, East Chicago, and Gary City are included in ‘yes.’
Does your LHD have a tattoo & body piercing inspection program?
68
Yes
24
No
3
No Answer
72% of LHDs have a tattoo and body piercing program.
Out of those that answered ‘yes’:
- 87% (59) of LHDs answered that it was a proactive permitting and inspection program. 3 LHDs did not answer.
- 73% (49) of these programs address permanent makeup.
- 20% (13) programs are complaint-based programs only.
LHDs were asked to choose which of the following fits their status regarding the recent changes to the Indiana Code for inspections of and education for eyelash extension services provided in the community.
| Educated staff on statutory change and conduct only complain-based inspections | 55 |
| Don't yet have a process in place, but are working toward it | 37 |
Fatality Review
Has your LHD implemented an evidence-based or promising prevention program for a leading cause of fatality in your community?
29
Yes
63
No
3
No Answer
31% of Indiana LHDs currently have a program addressing a leading cause of fatality.
*City LHDs are not included in the map: Fishers and East Chicago are included in ‘yes’ and Gary City is included in ‘no.’
- Leading causes of fatality mentioned
- Infant sleep-related deaths (13 LHDs)
- Overdose (10 LHDs)
- Cardiovascular conditions (3 LHDs)
- Injury prevention (3 LHDs)
- Motor vehicle accidents (3 LHDs)
- Suicide (2 LHDs)
- Firearm related deaths (2 LHDs)
- Drowning (1 LHD)
- Homicide (1 LHD)
- Maternal mortality (1 LHD)
- Obesity (1 LHD)
- Sexually transmitted infections (1 LHD)
- Smoking (1 LHD)
Out of the 63 LHDs that do not have a fatality-related program, 31 LHDs mentioned they have identified a leading cause of death to implement programming for in the future – 26 LHDs provided specifics:
- Overdose (10 LHDs)
- Suicide (5 LHDs)
- Heart disease (5 LHDs)
- Infant sleep related deaths (3 LHDs)
- Cancer (2 LHDs)
- Motor vehicle accidents (2 LHDs)
- Injury and falls (2 LHDs)
- Drowning (1 LHD)
- Firearm related deaths (1 LHD)
- Provided services explicitly mentioned
- Safe sleep programs (11 LHDs)
- Overdose prevention programs (8 LHDs)
- General programming (did not provide specifics) (6 LHDs)
- Mental health campaigns (3 LHDs)
- Car seat safety programs (3 LHDs)
- Data tracking and mapping (2 LHDs)
- Gun safety programs (2 LHDs)
- Helmet provision (2 LHDs)
- AED machine distribution (1 LHD)
- Autopsy reviews (1 LHD)
- Driver safety campaigns related to texting and driving (1 LHD)
- Car safety technician training (1 LHD)
- Community outreach (1 LHD)
- Obesity-related programming (1 LHD)
- STI screening (1 LHD)
- Swimming lessons (1 LHD)
- Vaccinations (1 LHD)
Does your LHD participate in the following? (All ‘yes’ responses are counted below).
| Child Fatality Review | 63 |
| Fetal and Infant Mortality Review (FIMR) Team | 45 |
| Suicide and Overdose Fatality Review (SOFR) Team | 37 |
| Non of the above | 16 |
*These numbers do NOT include those that did not complete the survey. 3 LHDs did not answer these questions.
Are there barriers preventing you from engaging with the fatality review teams that you did not check?
| No | 45 |
| Yes | 24 |
| Engages with all teams | 21 |
| No answer | 5 |
Below is the summary of barriers identified from the 24 LHDs that shared:
- The teams do not exist, or are in development and are not yet engaging individuals (16 LHDs)
- There are not enough resources (5 LHDs), staff (6 LHDs), funding (3 LHDs) or time (1 LHD) to establish or engage in these teams
- There is a lack of partner interest in setting up such teams (2 LHDs)
- There is a need to understand more about when the teams meet (1 LHD) or who their point of contact is to get involved (1 LHD)
- Team inclusion is by invite only (1 LHD) or they are not accepting new members (1 LHD)
- The representative involved (coroner) does not feel the need to engage in the teams (1 LHD)
Does your LHD provide the following certificates to local fatality review teams?
| Death certificates | 69 |
| Birth certificates | 53 |
| Stillbirth certificates | 51 |
| None of the above | 23 |
*These numbers do NOT include those that did not complete the survey. 3 LHDs did not answer these questions.
Are there barriers preventing you from providing the certificates unchecked above to fatality review teams?
| Provides all certificates | 46 |
| No | 39 |
| Yes | 6 |
| No answer | 4 |
*These numbers do NOT include those that did not complete the survey. 3 LHDs did not answer this question.
Below is the summary of barriers identified from the 6 LHDs that shared:
- “The system only allows the data to be exported once and the report is due before the COD is returned. This [delay in MCPHD providing COD in the report in a timely manner] causes poor documentation on the vital records and interferes with timely accurate reports… The missing information is not complete for the abstracting of medical records.” – Marion County
- The local hospital does not know who the POC is to send these certificates to. – Jefferson County
- Vital records will not allow Bartholomew County to attend meetings due to HIPPA restrictions.
- Martin County does not have a hospital so most deaths are not occurring or monitored in this county.
- Blackford County’s vital records team has not requested certificates to the office. Appears review team is not on the list of candidates that are able to receive certificates.
- Miami County only provides certificates for infant mortality.
Food Protection
Does your LHD have a written policy for a food inspection program?
73
Yes
19
No
3
No Answer
37% of LHDs have a written policy for a food inspection program.
Out of the 73 LHDs with a written policy for food inspection:
60 shared it is a risk-based food inspection program.
- (7 are not risk-based, and 6 did not answer.)
- 83% of LHDs that have a food inspection program
56 LHDs shared it has a mechanism to assess inspection frequency that is being followed based on the menu type of retail food establishments.
- (11 do not, 6 did not answer)
- 77% of LHDs that have a food inspection program
70 LHDs shared they conduct follow up inspections based on complaints, outbreaks and code violations.
- This was 100% of LHDs that answered this question. (3 did not answer)
- 100% of LHDs that have a food inspection program
All 92 LHDs that completed the survey shared that they have at least one individual trained in the role of food inspector.
*City LHDs are not included in the map: Fishers is included in ‘no,’ and East Chicago and Gary City are included in ‘yes.’
Health-Related Areas During Emergencies/Disasters
Does your LHD have an updated Emergency Operations Plan?
"Updated” is defined as conducting research on latest national and state best practices, incorporation of lessons learned and areas of improvement from real world events and exercises, and inclusion of preparedness and response partners in content validation.
75
Yes
17
No
3
No Answer
78% of Indiana LHDs have an updated Emergency Operations Plan.
*City LHDs are not included in the map: Fishers, Gary City and East Chicago are included in ‘yes.’
Do you engage with community partners on exercising current emergency response plans?
71
Yes
1
No
2
No Answer
Out of the LHDs that have an updated Emergency Operations Plan, 96% engage with community partners on exercising those plans.
- Partners listed
- EMA (38 LHDs)
- Fire (36 LHDs)
- Police (34 LHDs)
- EMS (29 LHDs)
- Hospitals (22 LHDs)
- School or university groups (18 LHDs)
- Local government (16 LHDs)
- Local Emergency Planning Committees (LEPC) (14 LHDs)
- District emergency preparedness (13 LHDs)
- Long term care (shelters, nursing homes) (8 LHDs)
- Sherriff’s office (8 LHDs)
- IDOH (7 LHDs)
- Red Cross (7 LHDs)
- Utility departments (6 LHDs)
- Faith-based organizations (6 LHDs)
- Health Care Coalitions (6 LHDs)
- ESF-8 / FEMA (4 LHDs)
- Local businesses (4 LHDs)
- Coroner (4 LHDs)
- County Commissioners (4 LHDs)
- Department of Homeland Security (4 LHDs)
- Community organizations (3 LHDs)
- EOC (3 LHDs)
- Local healthcare (2 LHDs)
- Mental health (2 LHDs)
- Neighborhood associations (1 LHD)
- Other volunteer organizations (1 LHD)
- Regional preparedness personnel (1 LHD)
- Search and rescue (1 LHD)
- Department of transportation (1 LHD)
- County emergency management (1 LHD)
- Animal shelter (1 LHD)
Immunizations
Does your LHD offer immunizations to all ages in your jurisdiction?
89
Yes
3
No
3
No Answer
94% of Indiana LHDs provide immunizations to all ages in their jurisdiction.
*City LHDs are not included in the map: Fishers, East Chicago and Gary City are included in ‘yes.’
Does your LHD offer immunizations to all ages in your jurisdiction regardless of insurance status?
78
Yes
11
No
6
No Answer
Barriers to providing immunizations regardless of insurance status
Out of 8 that shared, barriers include:
- Limitations in billing capabilities/unable to take private insurance (5)
- Only able to take 317 patients (3)
- Limited requests for adult vaccinations (2)
- Only able to take VFC patients (1)
Does your LHD have extended hours for vaccination services?
71
Yes
15
No
6
No Answer
Barriers to providing extended hours
Out of the 13 that shared, barriers included:
- Staff and time limitations (6)
- Security issues (being housed in a building that locks at 5pm, etc.) (4)
- Plan is in progress (3)
- Clients do not attend after hours (2)
- Not identified as a need (1)
- List of immunizations provided by LHDs
Numbers on each bar refer to the number of LHDs that provide that vaccination out of a total of 92 LHDs that completed the survey. The numbers do not include those that did not complete the survey - 3 LHDs did not answer these questions.
Varicella 90 Seasonal influenza 90 School vaccinations (K-12) 90 MMR 89 Hepatitis B 89 Hepatitis A 89 Dtap/Tdap 89 School vaccinations (college/university) 88 Pneumococcal 86 COVID-19 adult 79 COVID-19 pediatric 76 Other 26
Infectious Disease Prevention and Control
Can your LHD rapidly conduct investigations for all immediately reportable conditions?
81
Yes
11
No
3
No Answer
85% of LHDs can rapidly conduct investigations for immediately reportable conditions.
100% of LHDs that reported barriers (9 LHDs) shared that staff limitations prevent them from conducting investigations for immediately reportable conditions.
*City LHDs are not included in the map: Fishers, East Chicago and Gary City are included in ‘yes.’
Can your LHD complete investigations for all non-immediately reportable conditions?
85
Yes
7
No
3
No Answer
89% of LHDs can rapidly conduct investigations for non-immediately reportable conditions.
100% of LHDs that reported barriers (4 LHDs) shared that staff limitations prevent them from conducting investigations for all non-immediately reportable conditions.
*City LHDs are not included in the map: Fishers, East Chicago and Gary City are included in ‘yes.’
Lead Case Management
Can your LHD readily conduct timely case management for children with elevated blood lead levels?
85
Yes
7
No
3
No Answer
89% of Indiana LHDs are able to readily conduct timely case management for children with elevated blood lead levels.
*City LHDs are not included in the map: Fishers, East Chicago and Gary City are included in ‘yes.’
Does your LHD currently have the staff (permanent or contractor) to conduct your own lead risk assessments for children with elevated blood lead levels?
48
Yes
44
No
3
No Answer
51% of Indiana LHDs have the staff available to conduct lead risk assessments for children with elevated blood lead levels.
37 of those that do not have the staff still conduct timely case management for children with elevated blood levels. Those that do not conduct timely case management for children, and do not have the staff to support, include Miami County, LaGrange County, Orange County, Clinton County, Jefferson County, Posey County, Fountain County.
LHDs were asked whether they were currently offering blood lead testing as a service at least weekly:
64
Yes
28
No
3
No Answer
67% of Indiana LHDs are offering blood lead testing as a service at least weekly.
Maternal and Child Health
Has your LHD implemented an evidence-based or promising program or activity to improve birth outcomes in your community?
28
Yes
64
No
3
No Answer
30% of Indiana LHDs currently have a program addressing birth outcomes in their community.
*City LHDs are not included in the map: Fishers, East Chicago and Gary City are included in ‘no.’
- Provided services explicitly mentioned
- Safe sleep programs (8 LHDs)
- Prenatal care (5 LHDs)
- Referrals to services (5 LHDs)
- Resources provided (5 LHDs)
- Hospital partnerships (4 LHDs)
- Community partnerships (4 LHDs)
- Early childhood education programs (3 LHDs)
- Education programs for mothers and families (3 LHDs)
- Fatality review (3 LHDs)
- Home visits (3 LHDs)
- Pregnancy tests (2 LHDs)
- Car seat safety (1 LHD)
- Doula care (1 LHD)
- Immunizations (1 LHD)
- Insurance navigation (1 LHD)
- Pregnancy Mobile Clinic Care Unit (1 LHD)
- Transportation services provided (1 LHD)
3 LHDs mentioned they have recent programs in development and did not provide specifics.
Local health departments were asked whether they identified disparities in birth outcome data:
21
Yes
71
No
3
No Answer
- Disparities identified
- Race/Ethnicity (8 LHDs)
- Access and linkage to care (4 LHDs)
- Insurance status (4 LHDs)
- Language (3 LHDs)
- Age (1 LHD)
- Education level (3 LHDs)
- Smoking status (2 LHDs)
- Transportation access (2 LHDs)
- Income level (2 LHD)
- Citizenship status (1 LHD)
- Housing access (1 LHDs)
- Sex/Gender (1 LHD)
10 out of those 21 LHDs have implemented specific programs to address identified disparities.
- Provided services explicitly mentioned
- Hiring staff (4 LHDs)
- Translated resources or translation services (2 LHDs)
- Education (2 LHDs)
- Transportation services (2 LHDs)
- Community outreach (1 LHD)
- Data monitoring (1 LHD)
- Implementing home visits (1 LHD)
- Promoting existing partnerships (1 LHD)
- Providing referrals (1 LHD)
- Offering therapies for identified conditions (1 LHD)
9 LHDs identified they do not currently have a program addressing disparities but shared plans to implement programs to address disparities.
- Plans explicitly mentioned
- Leverage partners in the community (3 LHDs)
- Hire staff (2 LHDs)
- Coordinate with IDOH (1 LHD)
- Data sharing (1 LHD)
- Reduce language barriers (1 LHD)
- Support expanded programming (1 LHD)
Two LHDs mentioned they are still evaluating ways to address disparities.
Does your LHD have a documented process to refer families to the following:
| WIC | 62 |
| Substance use disorder treatment | 53 |
| Prenatal care | 52 |
| Contraceptive care | 50 |
| OB/pediatric care | 48 |
| Insurance navigation | 45 |
| Home visiting | 38 |
| Other related services | 25 |
| None of the above | 27 |
*These numbers do NOT include those that did not complete the survey. 3 LHDs did not answer this question.
- Referral methods utilized
- Partnership with community/health organizations (18 LHDs)
- Phone (16 LHDs) or multiple language call lines (1 LHD)
- Healthcare staff or client advocates (16 LHDs)
- Making direct contact with those that need referring (11 LHDs)
- Referral guide (10 LHDs)
- Setting up appointments for identified individuals (6 LHDs) or warm handoffs (8 LHDs)
- Online resources (3 LHD), pamphlets or flyers (3 LHDs)
- Self-referral strategies (5 LHDs)
- Email referrals (3 LHDs)
- Outreach in communities (2 LHDs)
- Insurance screening (2 LHDs)
- Health-related platform (2 LHDs)
- Family member referrals (1 LHD)
- Mobile clinics (1 LHD)
7 LHDs mentioned that referrals are provided but did not provide specifics. 7 LHDs mentioned that referrals are provided but did not provide specifics.
- Identified barriers to providing referrals
- Lack of services in-county (12 LHDs)
- No documented process (8 LHDs)
- Staffing constraints (7 LHDs)
- No need for referrals to these services (3 LHDs)
- Lack of patient agency (3 LHDs)
- Language (3 LHDs)
- Financial constraints (2 LHD)
- Transportation (2 LHD)
- Lack of knowledge of these services (1 LHD)
- Lack of expertise in department (1 LHD)
- Insurance restrictions (1 LHD)
- Financial constraints (2 LHD)
- Finding needs prior to issues arising (1 LHD)
- Agency changes (1 LHD)
- Transportation (2 LHD)
- Language (3 LHDs)
- Establishing partnerships (1 LHD)
- Time (1 LHD)
6 LHDs mentioned they need more time to develop these programs and intend to do so with HFI funding. 13 LHDs mentioned no barriers keeping them from referral implementation.
School Health Liaison
Did your county participate in IDOH-CDC school liaison grant funding beginning in 2021 until now?
60
Yes
32
No
3
No Answer
64% of Indiana LHDs engage with the school liaison grant funding.
*City LHDs are not included in the map: Fishers and Gary City are included in ‘yes’ and East Chicago is included in ‘no.’
- Current activities within the LHD and school partnerships
- Provide vaccinations (26 LHDs)
- Hearing, vision, and/or dental screenings (15 LHDs)
- Training hosted for CPR or STB (14 LHDs)
- Resource provision (such as emergency medications, STB kits, AEDs, etc.) (12 LHDs)
- Education provided to students and/or families (10 LHDs)
- Host health clinics (8 LHDs)
- Tobacco related education (7 LHDs)
- Hygiene supplies provided (8 LHDs)
- Mental health resources (4 LHDs)
- Dental programming (4 LHDs)
- Communicable disease education (3 LHDs)
- Data collection (3 LHDs)
- Lice kits provided to families (2 LHDs)
- Physical activity programs (2 LHDs)
- Air quality monitoring (1 LHD)
- Community outreach (1 LHD)
- Handwashing specific education (1 LHD)
- Emergency preparedness training (1 LHD)
- Food pantry (1 LHD)
- Policy development (1 LHD)
- Referral program (1 LHD)
20 LHDs with ongoing partnership did not provide specifics.
Tobacco and Vaping Prevention and Cessation
Does your local health department (LHD) currently have a tobacco prevention and cessation program to address tobacco and addictive nicotine prevention?
32
Yes
61
No
2
No Answer
34% of Indiana LHDs currently have a tobacco prevention and cessation program.
*City LHDs are not included in the map: Fishers is included in ‘yes,’ and East Chicago and Gary City are included in ‘no.’
Summary of tobacco prevention and cessation program descriptions
- Programs explicitly mentioned
- Quit Now (1-800-QUIT-NOW) Quitline (8 LHDs)
- Catch my Breath Program (3 LHDs)
- Breathe Easy Indiana (1 LHD)
- Freedom from Smoking Program (1 LHD)
- Mommy and Me Tobacco Free Program (1 LHD)
- Provided services explicitly mentioned
- Education provided (18 LHDs)
- Vaping component (6 LHDs)
- Utilizes grant funding for TPC programming (such as IDHO-TPC grant) (5 LHDs)
- Has a staff representative (4 LHDs)
- Referrals provided (4 LHDs)
- Resources provided, such as patches, lozenges, etc. (4 LHDs)
- Community outreach (3 LHDs)
- Nicotine replacement therapy (2 LHDs)
1 LHD mentioned they were in the initial stages of programming, and 2 LHDs mentioned that they engage in general tobacco prevention and cessation programming and did not specify further.
- LHDs current youth-focused programming
25 of the 32 (78%) Indiana LHDs that have a tobacco prevention and cessation program designated that they have a youth-focused component embedded.
LHDs current youth-focused programming:
- Education provided in schools (14 LHDs)
- Vaping component (5 LHDs)
- School health liaison involved (5 LHDs)
- Training provided to schools (5 LHDs)
- Community outreach (2 LHDs)
- Marketing analysis of products (1 LHD)
- Resources provided to schools (1 LHD)
Out of the 6 LHDs that have a tobacco prevention and cessation program but do not have an embedded youth component, future plans to engage youth include:
- Utilizing the school health liaison (4 LHDs)
- Leverage existing partnerships (3 LHDs)
- Implement a Tobacco Free Coalition (1 LHD)
- Implement community outreach (1 LHD)
- Encourage partnership with schools (1 LHD)
- LHDs current partnership mechanisms
46% (or 44) of Indiana LHDs currently engage with the local Tobacco Free Coalition.
25 of those 44 do not have an active tobacco prevention and cessation program.
LHDs current partnership mechanisms:
- Attend meetings (13 LHDs)
- Funded or plan to fund (7 LHDs)
- Partnership in school programs (7 LHDs)
- Partnership in providing referrals, including to the quit line (6 LHDs)
- Resource sharing (5 LHDs)
- Community outreach (3 LHDs)
- Established an MOU (2 LHDs)
18 LHDs mentioned they engage in the local Tobacco Free Coalition but did not provide specifics regarding partnership mechanisms.
- Other KPIs
Other KPIs addressed in tobacco prevention and cessation programming
- Maternal and child health (4 LHDs)
- School health liaison (3 LHDs)
- Chronic disease (1 LHD)
- Environmental health (1 LHD)
- Vital Records (1 LHD)
- Other partnerships explicitly identified
- Schools (10 LHDs)
- County-level groups (5 LHDs)
- Tobacco Free Coalition (3 LHDs)
- Local hospital (4 LHDs)
- Health fairs and events (1 LHD)
- Mobile unit (1 LHD)
- Other partners not specified (1 LHD)
Trauma and Injury Prevention
Has your LHD implemented a comprehensive, evidence-based program(s) for a leading cause of trauma-related injury or death?
30
Yes
62
No
3
No Answer
32% of Indiana LHDs currently have a program addressing a leading cause of trauma-related injury or death.
*City LHDs are not included in the map: Fishers, East Chicago and Gary City are included in ‘no.’
Summary of trauma-related injury and death prevention program descriptions shared
- Leading causes of trauma-related injury and death addressed
- Harm reduction and overdose (18 LHDs)
- Motor vehicle accidents (13 LHDs)
- Self-inflicted injury/suicide (6 LHDs)
- Infant sleep-related death (6 LHDs)
- Fall and other injuries (5 LHDs)
- Choking (2 LHDs)
- Drowning (1 LHD)
- Firearm-related injuries (2 LHDs)
- General trauma-related incidents (not specified) (1 LHD)
- Provided services explicitly mentioned
- Harm reduction/overdose-related programming (15 LHDs)
- Car seat programs (12 LHDs) and car safety technician certifications (7 LHDs)
- Narcan accessibility (10 LHDs)
- Safe sleep programs (7 LHDs)
- CPR/First Aid/AED training (3 LHDs)
- Helmet provision (3 LHDs)
- Choking prevention trainings (2 LHDs)
- Community outreach (2 LHDs)
- Fall prevention programs (2 LHDs)
- Gun safety (1 LHD) and stop the bleed kit distribution (1 LHD)
- Swimming lessons (1 LHD)
1 LHD mentioned they were generally working to address identified trauma-related issues, and 1 LHD mentioned that program implementation is in discussion.
Out of the 62 LHDs that do not have a program addressing trauma-related injury or death, 30 LHDs mentioned they have identified a leading cause of trauma-related injury or death. 27 of these LHDs provided plans to implement programs to address the identified issues.
Tuberculosis Prevention and Case Management
Does your LHD have community partnerships for the following to assist in case management services for patients with TB and latent TB infection?
| Interpretation services | 52 |
| Food security | 44 |
| Housing | 31 |
| None of the above | 35 |
*These numbers do NOT include those that did not complete the survey. 3 LHDs did not answer this question.
Has your LHD identified community partners to help provide TB clinical services?
| Testing | 77 |
| Ability to serve patients who are uninsured | 68 |
| Chest x-rays | 65 |
*These numbers do NOT include those that did not complete the survey. 3 LHDs did not answer this question. Note that ‘none of the above’ was not an option for this set of questions.
Vital Records
Does your LHD have a plan in place to offer Vital Records services without disruption to business continuity during natural disasters/emergencies?
64
Yes
27
No
4
No Answer
68% of LHDs have a plan in place to offer Vital Records services without disruption during emergencies.
*City LHDs are not included in the map: Fishers is included in ‘no,’ and East Chicago and Gary City are included in ‘yes.’
Components of plans described for continuing Vital Records services without disruption during an emergency
- Technology and equipment prepared (12 LHDs)
- Off-site location is prepared (12 LHDs)
- Access to remote services (7 LHDs)
- Staff are cross trained and prepared to act (6 LHDs)
- Backup generator prepared (6 LHDs)
- Preparations to partner with other departments or counties (4 LHDs)
- Paper records prepared (4 LHDs)
- Use of DRIVE (4 LHDs)
- Partnership with COOP (4 LHDs)
- Go bag prepared with equipment for records if necessary to move (3 LHDs)
- Mobile units prepared (3 LHDs)
- Hot spots prepared (2 LHDs)
- Working on a plan (2 LHDs)
- MOUs in place to use other locations if necessary (2 LHDs)
- Mail in system prepared (1 LHD)
- Plans in progress to extend hours (1 LHD), hand enter info (1 LHD), purchase technology (1 LHD) or generally continue services (1 LHD)
- A supply of certificates is ready in case of mass casualty event (1 LHD)
- Use another program other than DRIVE as a backup (1 LHD)
- Works with EMA on a plan (1 LHD)