The program implications of administrative relationships between local health departments and state and local government.

Abstract

A typology of organizational arrangements between state and local public health agencies was used as a framework within which the organizational environment of the local health department was studied for its effects on program development and implementation by local public health departments. Data collected in a national sample of local health officers were used in measuring the effect of four different patterns of administrative relationships on the selected characteristics of local health department programs. Important differences were observed among the four organizational types with regard to constraints on programs and program priorities, and health officers' perceptions of the primary functions of local health departments and sources of local health department funding.In 1974, a group of researchers at the University of North Carolina surveyed the nation's local health officers. This survey compiled one of the few known sets of data within recent history on the organization, financing, functions, and staffing at local health departments as well as important personal and professional characteristics of local health officers. ' It now appears that the United States is entering a period of great change in the financing and organization of its public health system. The Reagan Administration has proposed that large block grants replace the present system of local and state health agencies appear to have on local health department program planning and development. These data provide a baseline from which to consider the possible impact of recent federal budgetary and health program policy development on the current patterns of intergovernmental relationships between local health departments and state and local governments and the consequences of these relationships for the funding and operation of local health department programs.

Evidence Links Increases In Public Health Spending To Declines In Preventable Deaths

“…Theory and previous studies indicate that these characteristics influence the ability and inclination of local public health agencies to secure external funding sources for their work. 15,35–37 …”

Understanding the Organization of Public Health Delivery Systems: An Empirical Typology

“…We define public health services as all the programs, policies, and activities designed to promote a population's health and prevent disease and injury, including activities that identify and investigate health threats, promote healthy lifestyles, prepare for emergencies and disasters, and ensure the quality of water, food, air and other resources necessary for good health (Baker et al 1994). We focus on those local delivery systems responsible for directly implementing public health services in most communities (DeFriese et al 1981; Halverson et al 1996).…”

From Measuring to Improving Public Health Practice

“…A series of studies by Miller and colleagues during the 1970s and 1980s (10,13,(24)(25)(26) provided new insights into the public health infrastructure and the effect of various forces on LHDs. Despite Hanlon's call, these studies largely supported the need for LHDs to provide personal health care services within their communities.…”