Comparative risk (CR) methods and PACE-EH are processes in which environmental problems are identified and compared with each other.
The PACE-EH work in Delaware County has been built on the suggested PACE-EH protocol, the experience and technical support of accessible and free consultants provided by NACCHO, and the Ohio Comparative Risk Project.
Thus, the PACE-EH process can identify common environmental concerns, such as water and air pollution, across regions or political boundaries.
The major constraint of PACE-EH is that it requires considerable allocations of time, financial and human resources, and technical support - both from the health departments and from all parties involved.
Another important challenge Delaware County experienced with the PACE-EH process was the lack of a system for collecting and managing specific data on important environmental health indicators.
Two other critical considerations with PACE-EH are the need for public involvement throughout the process, and the need for active media and public relations efforts.
The draft PACE-EH guidance document developed by NACCHO has provided valuable insight into the process (3).
The Delaware County experience suggests that additional consideration should be given to blending the CR methods traditionally used by environmental agencies with the PACE-EH protocols that are to be marketed to local environmental health divisions.
Finally, the PACE-EH draft document describes the difficulties experienced by the NACCHO work group in deciding the relative order of the eight steps in the process - and the philosophy behind those steps.
In particular, there is pressing need for environmental management programs, such as PACE-EH, that incorporate a strong community-based approach.
Nevertheless, even when time and resources are limited, the PACE-EH process can be implemented.
The PACE-EH process can provide a clear picture of a community's environmental concerns.