Urban-Rural Status and Other Characteristics of Local Health Departments Associated with Their Environmental Health Activities Related to Unused Pharmaceutical Collection and Water Quality

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Background: Pharmaceuticals are one of the main pollutants in our water bodies, causing ecological and potential public health concerns. The role of local health departments (LHDs) addressing these public health issues is unknown.

Purpose: This study assesses engagement of LHDs in environmental health activities related to water. Specifically, five areas of environmental health activities related to water protection and quality were examined.

Study Questions: (1) What is the extent to which LHDs are engaged in environmental health activities related to collection of unused pharmaceuticals and water quality? (2) Are LHDs located in metropolitan areas more likely to be engaged in these activities? (3) What other characteristics of the LHDs are associated with their performance of these environmental health activities?

Methods: Data from 2000 LHD (79% responded) responding to the 2013 National Profile of LHDs was used. Descriptive statistics, bivariate analysis and five separate logistic regression models were developed for each of the five dichotomous outcome variables of interest. Independent variables included infrastructural capacity, financial capacity, and other characteristics theoretically associated with performance of environmental health activities.

Results: Collection of unused pharmaceuticals was a rare activity among LHDs (16.4 %). Ground water and surface water protection was conducted by 40.5 32.9 percent of LHD respectively. Regulations and inspection of public and private drinking water were conducted by 33.0 percent and 55.7 percent of LHDs. Metropolitan LHD jurisdiction, larger size of LHD jurisdiction, MD degree of the top executive and higher per capita expenditures (being well funded) were significantly associated with LHDs environmental activities related to water quality and protection (p,0.05).

Conclusions: There is a significant variation within the LHDs performing water source protection and regulation A systematic regulatory program involving the majority of the LHDs is needed to prevent pharmaceutical pollution in surface and groundwater across the country.


American Public Health Association Annual Meeting (APHA)


Chicago, IL