TY - JOUR
T1 - Performance and Priorities
T2 - A Cross-sectional Study of Local Health Department Approaches to Essential Public Health Services
AU - Wallace, Megan
AU - Sharfstein, Joshua
AU - Lessler, Justin
N1 - Funding Information:
The authors acknowledge the National Association of County and City Health Officials (NACCHO) for its data contributions to this project and Tom Burke and Carla Zelaya for their contributions to the conceptualization of this study. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The 2013 NACCHO Profile of Local Health Departments Survey was funded by the Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation. The authors received no financial support for the research, authorship, and/or publication of this article.
Funding Information:
The authors acknowledge the National Association of County and City Health Officials (NACCHO) for its data contributions to this project and Tom Burke and Carla Zelaya for their contributions to the conceptualization of this study. Declaration of Conflicting Interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The 2013 NACCHO Profile of Local Health Departments Survey was funded by the Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation. The authors received no financial support for the research, authorship, and/or publication of this article. ORCID iD Megan Wallace, DrPH https://orcid.org/0000-0003-4331-5785 Supplemental Material Supplemental material for this article is available online.
Publisher Copyright:
© 2019, Association of Schools and Programs of Public Health.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Objectives: Despite a push for increased local public health capacity, no clear baseline for performance of local health departments (LHDs) exists. The objectives of this study were to quantify the self-reported performance of LHDs on the 10 Essential Public Health Services (EPHSs) and describe the relationships between performance and characteristics of LHDs. Methods: We used data on 2000 LHDs from the 2013 National Profile of Local Health Departments survey to develop principal components analysis–based scores to evaluate each LHD on the performance of EPHSs. Scores ranged from 0 to 100. LHDs that performed no activities within an EPHS had a score of 0, and LHDs that performed all activities within an EPHS had a score of 100. We explored the relationships between EPHS scores and LHD characteristics by using multivariate linear regression and cluster analysis. Results: Performance scores varied greatly by LHDs and EPHSs; however, LHDs typically scored <50, indicating that they performed fewer than half of the activities evaluated. LHDs that served larger populations (vs smaller populations) and LHDs that had higher per-capita funding (vs lower per-capita funding) had higher EPHS scores. We identified 6 EPHS performance score–based LHD clusters, which suggests similarities in which EPHSs LHDs focused on. Conclusions: Our results suggest weaknesses in many LHDs’ fulfillment of the EPHSs, particularly in low-population and low-funding settings. LHDs should be given the resources to increase capacity and ensure the EPHSs are met in communities.
AB - Objectives: Despite a push for increased local public health capacity, no clear baseline for performance of local health departments (LHDs) exists. The objectives of this study were to quantify the self-reported performance of LHDs on the 10 Essential Public Health Services (EPHSs) and describe the relationships between performance and characteristics of LHDs. Methods: We used data on 2000 LHDs from the 2013 National Profile of Local Health Departments survey to develop principal components analysis–based scores to evaluate each LHD on the performance of EPHSs. Scores ranged from 0 to 100. LHDs that performed no activities within an EPHS had a score of 0, and LHDs that performed all activities within an EPHS had a score of 100. We explored the relationships between EPHS scores and LHD characteristics by using multivariate linear regression and cluster analysis. Results: Performance scores varied greatly by LHDs and EPHSs; however, LHDs typically scored <50, indicating that they performed fewer than half of the activities evaluated. LHDs that served larger populations (vs smaller populations) and LHDs that had higher per-capita funding (vs lower per-capita funding) had higher EPHS scores. We identified 6 EPHS performance score–based LHD clusters, which suggests similarities in which EPHSs LHDs focused on. Conclusions: Our results suggest weaknesses in many LHDs’ fulfillment of the EPHSs, particularly in low-population and low-funding settings. LHDs should be given the resources to increase capacity and ensure the EPHSs are met in communities.
KW - Essential Public Health Services
KW - local public health
KW - principal components analysis
KW - public health practice
UR - http://www.scopus.com/inward/record.url?scp=85076532253&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85076532253&partnerID=8YFLogxK
U2 - 10.1177/0033354919890862
DO - 10.1177/0033354919890862
M3 - Article
C2 - 31835008
AN - SCOPUS:85076532253
SN - 0033-3549
VL - 135
SP - 97
EP - 106
JO - Public Health Reports
JF - Public Health Reports
IS - 1
ER -