Developing a local public health infrastructure: the Maine Turning Point experience

Area of Science:

• Public Health
• Health Services Research
• Community Health

Background:

• Limited local public health infrastructure in Maine prior to 1999.
• Only two city health departments existed, with one having minimal capacity.
• The Robert Wood Johnson Foundation's Turning Point project aimed to enhance local capacity.

Purpose of the Study:

• To describe the organizational efforts, challenges, successes, and failures of developing local public health capacity in Maine.
• To evaluate the impact of the Turning Point project and subsequent initiatives.
• To assess the sustainability of public health networks in Maine.

Main Methods:

• Qualitative analysis of the Turning Point project from the perspective of key stakeholders.
• Description of the establishment of a new network of community-based partnerships.
• Review of public health outcomes and challenges in Maine.

Main Results:

• Over 200 individuals from diverse organizations engaged in the Turning Point project.
• A new network of state-financed partnerships focused on chronic disease risk factors was established.
• Tobacco use decreased, but significant challenges remain in addressing obesity, mental illness, and substance abuse.
• A sustainable statewide network for essential public health services remains an elusive goal.

Conclusions:

• The Turning Point project initiated efforts to build local public health capacity in Maine.
• New partnerships show political resilience and have achieved some success, such as reduced tobacco use.
• Despite progress, a comprehensive and sustainable statewide local public health system is yet to be fully realized in Maine.