Public Health "Every Where, Every Day, Every Body" The Three Core Functions of Public Health: The Job of the Local Board of Health In 1988, the Institute of Medicine issued The Future of Public Health report which stated that America’s public health system was in disarray. The Institute’s panel recommended new governmental functions at federal, state and local levels to strengthen our nation’s public health system. Localities, they said, should reestablish boards of health or “public health councils” to assess public health needs, develop public health policy, and assure that public health services are available. It is these three core functions – assess, address, and assure – that constitute the job of the local board of health. Assess: To scan, weigh and balance community needs, resources, statistics and politics. Address: To determine a course of action; to set targets, to allocate resources, to make policy and assign responsibility. Assure: To make certain that progress is made Adapted from Assess, Address, Assure: Manual for North Carolina’s Local Health Boards. Copyright 1993 – Association of North Carolina Boards of Health. The Ten Essential Public Health Services The 10 Essential Public Health Services provide a framework for public health to protect and promote the health of all people in all communities. To achieve equity, the Essential Public Health Services actively promote policies, systems, and overall community conditions that enable optimal health for all and seek to remove systemic and structural barriers that have resulted in health inequities. Such barriers include poverty, racism, gender discrimination, ableism, and other forms of oppression. Everyone should have a fair and just opportunity to achieve optimal health and well-being. Assess and monitor population health status, factors that influence health, and community needs and assets Investigate, diagnose, and address health problems and hazards affecting the population Communicate effectively to inform and educate people about health, factors that influence it, and how to improve it Strengthen, support, and mobilize communities and partnerships to improve health Create, champion, and implement policies, plans, and laws that impact health Utilize legal and regulatory actions designed to improve and protect the public’s health Assure an effective system that enables equitable access to the individual services and care needed to be healthy Build and support a diverse and skilled public health workforce Improve and innovate public health functions through ongoing evaluation, research, and continuous quality improvement Build and maintain a strong organizational infrastructure for public health References: 1. Website of Department of Health and Human Services – Centers for Disease Control and Prevention - https://www.cdc.gov/publichealthgateway/publichealthservices/essentialhealthservices.html 2. National Association of Local Boards of Health: Being an Effective Local Board of Health Member Ten Essential Public Health Services and How They Can Include Addressing Social Determinants of Health Inequities Conditions in the places where people live, learn, work, and play affect a wide range of health risks and outcomes. These social determinants of health and actions to address the resulting health inequities can be incorporated throughout all aspects of public health work. Learn more. History of Public Health in North Carolina The State Archives of North Carolina preserves and provides public access to historically significant archival materials related to North Carolina. Archived files trace the history of the Department of Health and Human Services beginning with a reference to “an act of the 1755 Assembly ordering quarantine on vessels" and concluding with the 1990s. As referenced in the The Eighteenth Biennial Report of the North Carolina State Board of Health : "In the seventies Dr. Thomas Fanning Wood of Wilmington, caught the vision of the possibilities of public health work to North Carolina. How fully he grasped the far-reaching consequences of his idea, how clearly he saw the ever-growing hosts of lives saved as a result of his vision and inspiration, we shall never know. We do know that the vision never left him, and that under its sway he worked, through the Medical Journal which he edited and through the North Carolina State Medical Society, until his influence reached the people of the State in their General Assembly of 1877, with the effect that on February 12, 1877, the North Carolina State Board of Health was born. Ours was the twelfth State board of health to be established". The county boards of health were composed of the affiliated county medical societies and were under the direction of the State Board of Health. The intent was to create a uniform system of health and sanitation throughout the state. But “the General Assembly appropriated only one hundred dollars to establish this health system; and the existence of the State Board of Health was nominal.” Additional excerpts from this history: “In 1899 the General Assembly passed additional legislation to protect public water supplies from contamination, and the State Board of Health was charged with instructing local health boards and water company inspectors on the procedures for sampling and inspection.” “… in 1911 the General Assembly recognized the State Board of Health as the state's medical adviser …. The state board was also required to issue bulletins statewide in the event of a dangerous outbreak of disease.” “In 1917 the General Assembly also charged the state board with responsibility for the sanitary conditions and the hygienic care of prisoners in state prisons, local jails, county prison camps, and all other places of confinement…. .” “In 1931 the dental care program was established as a separate Division of Oral Hygiene and expanded its efforts to educate the public preventive dental care. In the early 1930s the Division of Preventive Medicine took responsibility for school health services, health education and information, and maternal and child health services. Later in the decade, they initiated a nutrition program offering consultation services to local health departments, schools, and other institutions requesting services.” “… in 1945, the General Assembly instructed the state board to initiate a program related to the prevention and cure of cancer, with emphasis on the early detection and treatment of cancers. Under terms of the law, the board was to provide a system of financial aid for low-income cancer patients; establish minimum standards for cancer clinics or departments in general hospitals; collect information on cancer and sponsor an educational program for citizens; and compile and preserve statistical, clinical, and other records relating to cancer prevention and cure. … “In 1949 the last remaining county established a full-time health department." “In 1963 the General Assembly created a new Department of Mental Health, transferring to that department the services previously performed by the Division of Local Health and its Mental Health Section. Other laws during the same period significantly increased the state board's responsibilities. In 1961 the legislature provided for the licensing of nursing homes by the State Board of Health rather than by the Medical Care Commission and the State Board of Public Welfare. The 1963 General Assembly gave the state board responsibility for a program of air pollution control, although they failed to fund it. In 1965 Governor Dan K. Moore designated the State Board of Health as the official state agency to administer Title XVIII of U.S. Public Law 89-97, commonly referred to as Medicare. The Office of Chief Medical Examiner and a Division of Medical Examiner were created in 1967 …." “Under the 1973 act, the Commission for Health Services was granted the power and duty to adopt rules and regulations for the conduct of the state's public health programs, to protect and promote public health, and to control diseases and other health impairments. … Furthermore, the law stipulated that local health departments, when directed by the DHR, would enforce rules established by the Commission for Health Services and that DHR would supervise the local health departments." “New programs in place by the early 1990s included the Office of Chief Nurse, charged with coordinating public health nursing services with local health departments and statewide programs; the Office of Health Education, charged with providing various services and developing teaching strategies for environmental, community, and personal health programs; and the Office of Legislative Affairs to represent the department in the General Assembly and to monitor proposed legislation and the work of the legislative study and research committees." As it relates to Public Health, the State Archives collection includes links to a large searchable collection of digitized original documents , dated 1879 – 1973, including the Bulletin of the North Carolina Board of Health and Biennial Reports of the North Carolina State Board of Health. View the First Bulletin of the North Carolina Board of Health [1886-1887 : v.1, 1-12 plus Supplements] View the First Biennial Report of the North Carolina Board of Health [1879-1880] DOWNLOAD SELECT PUBLIC HEALTH STATUTES

DOWNLOAD EXAMPLE OF A LOCAL HEALTH DIRECTOR'S JOB DESCRIPTION

Newsletters of public health-related topics for Boards of Health and Health Directors ANCBH NEWSLETTERS Subscribe here to join the mail list to receive future editions. 2026 Fe bruary (Measles updates, Rural Health Transformation Funding, North Carolina HPV Stakeholder Meeting (Free)) April ( alcohol awareness month, national public health service week, a virtual training workshop on Finding and Reading the Law, the 2026 Public Health Preparedness and Response Symposium) June (National HIV Testing day, Hantavirus risk in NC, NC ROOTS Hub to Strengthen Rural Health Care, ANCBH recruiting for Board of Directors) August (2026 NC Budget Update, Cyclospora Update, Suicide Prevention Month) NEW! October (ANCBH Annual Meeting Recap, Ask the Expert, New QuitlineNC Provider Newsletter) 2025 December (2025–2030 North Carolina Cancer Plan, Radon Action Month, Medicare cost increases, QuitlineNC ) October (Tylenol-Autism, Tobacco control, nursing shortage, Helen recovery grants, trainings, Annual meeting) August (Federal legislation impact on NC, Hurricane season, Food recalls, Training opportunities) 2024 February ( Health Equity - Public Health and Pharmacy Partnerships , BOH liability, Pharmacist pres cribed contraceptives) June (PFAS and MNP (Forever Chemicals) in Today’s World, Cancer and cancer surveillance resources in NC) August (Ideas for sharing and BOH action: chronic disease prevention, gun violence, environmental health) October (Focus on immunizations, reporting animal rabies cases to the public, Zyn(TM)-an oral nicotine pouch) 2023 Janu ary (vie w 8 community-based action items for Board of Health Members plus FAQs about the BOH) June (North Carolinian, Dr. Mandy Co hen, Tapped for Leadership Position at CDC) Septem ber (PFOS/P FAS water advisory, firearms injuries and death: a public health issue, 2 023 A w ards, and more) November (Healthcare worker burnout, Triple viral threat, State Health Improvement Plan u pdated, BOH Chair network)

The legal organizational structure including Goals and Purpose, Membership and Dues, Officers, Directors, Meetings, Committees, Budget and Finance, Parliamentary Authority BYLAWS

Recognition ANCBH Board Members advocating for Public Health Watson S. Rankin Legacy Award 2022-2023 Barbara Ann Hughes, PhD, MPH, RDN, LDN, FADA, FAND was awarded the Rankin Legacy Award at the honors luncheon at the NCPHA Annual Conference in Wilmington. The Rankin Legacy Award is given to a NCPHA member in recognition of their outstanding contributions to public health in NC over the member's lifetime. Her many leadership roles in public health and nutrition organizations include being Past-President, National Association of Local Boards of Health and Past-House of Delegates, Academy of Nutrition & Dietetics Ham Stevens, MD Award 2022 Merle Green, MPH, MBA was presented with the Ham Stephens award, given to individuals who exemplify the qualities of a former health director and friend of public health, Ham Stevens, M.D. Dr. Stevens was largely responsible for bringing administrative health directors and medical health directors together to form the North Carolina Association of Local Health Directors (NCALHD). Merle was recognized for her many achievements in community-based health centers, health promotion, consensus building, volunteer service on community Boards, and leadership in public health. NCALHD also recognized Merle for her mentorship of young health professionals, faculty appointments at several colleges and universities in NC, and for her advocacy for population-based health services. National Association of Local Boards of Health ANCBH is providing leadership at the national level. At the Annual Business Meeting, held on August 2nd 2022 in conjunction with the NALBOH Annual Conference, Benjamin W. Tillett, RPh, PharmD serves as President of NALBOH. Dr. Tillett has provided outstanding leadership to the ANCBH Board as its President and is well qualified to lead NALBOH as they support local Boards of Health in their current and emerging public health challenges. Mary C. Egan Award 2022 Barbara Ann Hughes, PhD, MPH, RDN, LDN, FADA, FAND has received the 2022 Mary C. Egan Award from the APHA (American Public Health Association) Food and Nutrition Section. This national award recognizes the professional contributions and outstanding services of public health nutritionists. The services may include developing new approaches to public health nutrition, mentoring, nutrition education, and addressing special nutrition needs.

ANCBH Public Health Nursing Conference May 2, 2025 Concord, NC Program and Speaker Bios Presentations Speakers and Attendees 1/1

Local Boards of Health and Public Health Authority Boards A local board of health is the policy-making, rule-making, and adjudicatory body for public health in the county or counties in its jurisdiction. State statutes give boards of health specific powers and duties. Every type of local board may make local public health rules that apply throughout the board’s jurisdiction. Each board has limited authority to set fees for public health services. Each board also influences the day-to-day administration of the local public health agency. Public health authority boards have expanded powers and duties compared to county and district boards of health. Consolidated human services boards have all of the powers of county and district boards of health, except a consolidated human services board may not appoint the agency director (who is appointed instead by the county manager, with the advice and consent of the board). A consolidated human services board also plays a more active role in the development of the agency’s budget, and has additional powers and duties related to its oversight of other human services programs. North Carolina General Statutes defines both the responsibilities and the composition of local boards of health. The local board of health is charged with being “the policy-making, rule-making and adjudicatory body for a county health department.” And, with few exceptions, the typical board is composed of eleven members: one physician one dentist one optometrist one veterinarian one registered nurse one pharmacist one county commissioner one engineer four general public representatives The exceptions to the 11-member board include boards for a district health department, public health authority, and a consolidated human service agency or public hospital. S.L. 2012-126 (H 438) extends to all counties and creates new options to allow a board of county commissioners to assume the powers and duties of certain boards, create a consolidated human services agency, or take both actions. The options are: Assume direct control of certain boards by adopting a resolution abolishing the board(s) and transferring their powers and duties to the board of county commissioners; Create a consolidated human services agency (CHSA) governed by a consolidated human services board appointed by the county commissioners; or Create a CHSA governed directly by the county commissioners and appoint a health advisory committee. For a comparison of powers and duties by type of board, refer to the attached pdf from this UNC School of Government website: https://www.sog.unc.edu/resources/faqs/what-does-local-board-health-do DOWNLOAD COMPARISON OF BOH POWERS

Officers, Directors, Liaisons, and Directors Emeriti doing the work of ANCBH Orientation and Training Materials for New Board Members ANCBH New Board of Director Training Slides - July 2025

ANCBH Public Health Nursing Conference May 31, 2024 Raleigh, NC 1/1 Photos courtesy of Hannah Rodgers, MPH, ANCBH Board Member and Alecia Smith, Ph.D., Communications and Public Relations Manager Durham County Health Department

Recognizes outstanding public health workers, educators, and students. Provides financial support for members to attend conferences and meetings. Current and Past Award Recipients Robert L. Strother Award 2020: Warren County Health Department (Dr. Margaret Brake) and H.O.P.E Regional Medical Clinic (Demaura Russell) 2 020: Yadkin County Health Department (Jessica Wall) and Hands of Hope Medical Clinic (Marty Driver) 2023: Surry County Health and Nutrition Center and Mark Willis, Director of the Surry C ounty Office of Substance Abuse and Recovery 2024: Christie Sykes, RN, Alamance County Refugee Program 2025: Dr. Bahby Banks and Pillar Consulting Carl Durham Award 2020: Eva Brown (Warren County) 2023: Surry County Board of Health (Eddie Jordan, Chairman) 2024: Catawba County Environmental Health Team 2025: Rachel Royce, PhD, MPH (Orange County) Vaughn Upshaw Award 2020: Tanvi Shaw 2021: Aoife O'Connor 2022: Karina Gonzalez 2023: Karina Gonzalez 2024: N/A 2025: N/A Robert Blackburn Award 2020: Jessica Lynn Mrugala 2021: Megan DeMarco 2022: Samuel Elliott Krause 2023: Robert Zerniak 2024: N/A 2025: N/A Outstanding Board of Health Award 2023 : Stanly County’s Consolidated Health and Human Services Board 2024: Guilford County Board of Commissioners 2025: Madison County Board of Health ANCBH President's Award 2024: Dr. Benjamin W. Tillett (Person County) 2025: Ms Edna Hensey (Wake County)