New Data, Same Story? Revisiting Studies on the Relationship of Local Public Health Systems Characteristics to Public Health Performance

Abstract

This study examined the relationship between community and system characteristics of 353 local public health agencies and local public health system performance by revisiting previous research by Mays et al and Scutchfield et al. More recent and coterminous data were used. Local public health agency characteristics were obtained from the National Association of City and County Health Officials' 2005 National Profile of Local Public Health Departments and performance data were obtained from version 1 of the National Public Health Performance Standards Program local performance assessment instrument. Descriptive analyses and multivariate analyses similar to the two previous studies were employed. Population size, presence of a local board of health and whether the board makes policy, educational background of the local public health agency's top executive, and jurisdiction type were found to be important predictors of local public health performance. These findings support some of the earlier findings but do not support all the findings of the earlier studies. Variances are discussed. This study provides researchers and practitioners with an evidence base from which to make suggestions regarding characteristics, many changeable, which may influence system performance.

The Double Disparity Facing Rural Local Health Departments

“…Another study found that larger population size significantly associated with higher performance of seven essential services (86) but not with performance of essential services 6, 7, or 8. In 2013, Bhandari replicated an earlier study (117) and found that population size positively and significantly associated with performance of essential services 1, 2, 5, 6, and 10 compared with just service 6 in the original study (21). Bhandari also retested a model published in 2006 (86) and found a positive and significant association between population size and performance of essential services 1, 2, 6, and 10 compared with services 1 through 6 in the earlier study.…”

“…Formal training of leadership also varies by size; the larger the population served, the more likely it is that the top executive holds a college degree in public health (41). LHDs serving smaller populations had proportionally fewer MDs in the top executive role (41), whereas smaller LHDs are up to three times more likely to be led by someone with a nursing degree (17,21,24).…”

Governance's Role in Local Health Departments' Information System and Technology Usage

“…However, that cannot be certain because previous research on LHD executive leadership training has demonstrated inconsistencies in relation to departmental performance. 23 Lastly, the presence of IS employees within the LHD was positively associated with both extent of IT and IS utilization. Specialized IS/IT employees are an indicator of an organization's technological capacity to adopt and implement technology.…”

Diabetes-Related Services and Programs in Small Local Public Health Departments, 2009-2010

“…Previous studies have found that a large population size is one of the most consistent predictors of public health performance (7-10). Some large metropolitan LHDs, such as those in New York City and Los Angeles County, have demonstrated their exceptional capacity to assess local diabetes burden and implement unique programs to address disparities in diabetes care (11-13).…”