New Hampshire was awarded a two-year planning grant in 1997 through Turning Point: Collaborating for a New Century in Public Health, a program of the Robert Wood Johnson (RWJ) and W.K. Kellogg Foundations. New Hampshire was one of fourteen states originally awarded a grant to transform and strengthen the public health infrastructure in the United States so that states, local communities, and their public health agencies may respond to the challenge to protect and improve the public's health in the 21st century.

Related Information
"Public Health Partnerships: A New Hampshire Dance"
Published in the Winter 2002 issue of "Transformations in Public Health", this article describes the role of the Turning Point initiative in the promotion of local, state, and non-governmental organization (NGO) partnerships to achieve shared social goals.

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A New Hampshire Dance
[PDF, 526 KB] With the leadership of the New Hampshire Public Health Association and the Community Health Institute (CHI), over 250 participants were engaged in the planning process representing state public health agencies, hospitals, health centers, networks and coalitions, schools and academic institutions, business, non-profit agencies, legislature, civic organizations, faith organizations and foundations. The final product of the planning process is a Public Health Improvement Plan [PDF, 324 KB] for the State of New Hampshire that outlines priority action areas for improvement of public health capacity.

The recommendations contained in the Public Health Improvement Plan include policy and operational changes intended to address systemic limitations that are barriers to optimal health improvement. A major finding of the assessment was the lack of an established local public health system. In most of New Hampshire's 234 towns, the only local public health resource is a health officer, often employed as a building inspector and with no training in health. By default, police, fire, school nurses and nonprofit health and human service providers fulfill roles more typically assigned to local pubic health officials. Unfortunately, no formal mechanism exists for coordinating the delivery of public health services at the local level among these diverse public health stakeholders.

A key recommendation of the planning process was the development of a community level public health capacity to protect and promote the public's health. The rationale supporting the development of a local public health capacity is that health improvement is best achieved at the local level because communities can identify health problems, galvanize a community response, and devise local solutions which build on available resources.

In response, the State of New Hampshire began funding community public health partnership in 2000 to develop models for improving local public health. These partnerships involve broad public health interests in a community (e.g., government, health care providers, social service agencies, schools, business and faith communities) working together to address complex public health issues. Four partnerships were funded in 2001 with implementation funds provided by the Robert Wood Johnson Foundation. These four community partnerships covered 39 towns and cities representing 15% of the State's population.

Following the tragic and historic events of September 11th and the Anthrax attacks along the east coast, Congress appropriated funds through the Public Health Threats and Emergencies Act to improve the readiness of public health agencies throughout the nation to respond to a bioterrorism attack and other public health emergencies. Funds are distributed through The Centers for Disease Control and Prevention (CDC) in the form of a cooperative agreement with the New Hampshire Department of Health and Human Services for public health preparedness and response for bioterrorism. Funds are intended to upgrade state and local public health jurisdictions' preparedness for and response to bioterrorism, other outbreaks of infectious disease, and other public health threats and emergencies.

The State of New Hampshire recognized the importance of a strong local public health infrastructure to effectively prepare for and respond to episodes of terrorism and other public health emergencies that may affect our state. In response, priority was given to appropriating a portion of the funding awarded to New Hampshire to expand the public health network to cover additional communities. With the funding provided by the Center's for Disease Control (CDC), the public health network partnerships were tasked with local infrastructure development including emergency preparedness planning.

With expanded funding provided by the CDC, the State of New Hampshire funds a total of fourteen partnerships representing nearly 50% of New Hampshire towns and 70% of New Hampshire residents. The ultimate goal is to develop effective and sustainable public health partnerships throughout New Hampshire that respect and accommodate local differences, seek to integrate public and private capacity for public health services and adequately protect the public's health.