The Importance of Local Health Departments in Combating HAIs and AMR
NACCHO’s CEO Lori Tremmel Freeman discusses efforts and emphasizes the need for federal support and coordination.
Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials (NACCHO), shared insights into the organization's ongoing work to combat healthcare-associated infections (HAIs) and antimicrobial resistance (AR), with a focus on the role of local health departments. NACCHO’s efforts aim to strengthen infection prevention and control (IPC) practices and improve surveillance.
Freeman emphasized the critical role of local health departments in tackling infectious diseases, "We are hoping that this work can continue and remain a priority focus. The world around us is there are no borders to the world anymore, and so diseases can kind of flow frequently and more easily from one country to the next. And I think that we'll continue to advocate for supports for this to continue and to grow, but the federal government has to make it a priority as well, in terms of its funding in Congress as well. We have to look at how they are supporting these efforts. But we are always here to support the work at the local health department level, because they're on the ground. They're working every day and dealing with everything that's coming their way."
Freeman pointed out that the COVID-19 pandemic highlighted the importance of local health departments in disease surveillance, antibiotic stewardship, and infection control. These departments are vital for enforcing policies and engaging communities in efforts to prevent and control infectious diseases.
NACCHO's advocacy efforts center around ensuring that local health departments have the resources they need to effectively address infection prevention and antimicrobial resistance. Freeman explained, "The COVID-19 pandemic really emphasized the importance of local health departments in disease surveillance, antibiotic stewardship, implementation and enforcement, community engagement, and infection control practices at large. Focused actions at the local level to reduce widespread antibiotic usage can really help contribute to the global reduction of resistance."
The CDC supports this approach, as their Vital Signs report underscores the importance of a coordinated response across healthcare facilities. According to Freeman, this collective effort is more effective than individual facility actions alone in preventing AR.
"Coordination among facilities will have a greater impact on preventing AR than independent individual facility efforts alone. Local health departments are in an ideal position to facilitate this coordination because it's been recognized and supported through CDC development of a local health department HAI and AR strategy."
Freeman highlighted that local health departments, particularly in smaller and rural areas, face unique challenges in combating infections and AR. She noted that two-thirds of the over 3,300 local health departments in the US serve populations of 50,000 or less, often in rural or frontier regions. These areas, Freeman said, "For our health departments that really sit in communities, you know, working every day, day in and day out on the ground, they play such a critical role in preventing and controlling healthcare-associated infections and AR, though their experiences can vary greatly by jurisdiction."
Despite the challenges, Freeman emphasized that local health departments are well-positioned to identify infection risk factors, make recommendations to reduce risk, and monitor compliance with infection control practices. With sufficient resources, these departments can improve awareness, develop programs, and collect vital data for local and regional surveillance.
"We have the capacity to do so and identify risk factors for infection during outbreaks and make recommendations to reduce risk and monitor compliance. So we're perfectly positioned to help do this work, and we're glad to help do it, because our whole goal is to make communities healthy and safe."
NACCHO’s efforts are focused on ensuring that local health departments have the support they need to continue their work in infection prevention, antibiotic stewardship, and disease control. Freeman’s vision for the future includes stronger collaboration between local, state, and federal entities, with a particular emphasis on the federal government making disease control and prevention a priority in its funding and legislative actions.
