Composition and Duties of Local Boards of Health

Jones, Jeff; Fenton, Ginger D.

doi:10.1097/phh.0b013e31825fba97

Journal of Public Health Management and Practice

2012

DOI: 10.1097/phh.0b013e31825fba97

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Composition and Duties of Local Boards of Health

Jeff Jones

Ginger D. Fenton

Abstract: LBOH members and chairs are more similar in demographics to the top executives at local health departments than the general population or the public health workforce. Most LBOH chairs, however, lack experience in public health, and a quarter or more of LBOHs do not use their powers to set or recommend health priorities as a mechanism to leverage better community health outcomes.

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Cited by 9 publications

(21 citation statements)

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“…3 The National Association of Local Boards of Health (NALBOH) defines an LBoH as

a legally designated body whose members are appointed or elected to provide advisory functions and/or governing oversight for the primary governmental public health agency, and/or public health activities (assessment, assurance, and/or policy development), for the protection and promotion of health in its community. 4(p609)

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confidence: 99%

“…In some cases, LBoHs are nominal bodies without much impact or engagement, whereas other LBoHs have significant impact and recognition for their contributions. 4,7 …”

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confidence: 99%

“…7 A relatively scant body of research literature focuses on detailed functions and responsibilities of LBoHs as governing bodies, 4,8 which might be attributable to a general lack of detailed data in this area. 8 Surveys of LBoHs have experienced a number of challenges, including lack of funding to conduct surveys on regular basis between the 1997 National Profile of Local Boards of Health and the 2008 National Association of Local Boards of Health Survey, both conducted by NALBOH.…”

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confidence: 99%

“…7 Other limitations, including low response rates (27% in 2008) and issues with the sampling frame in the 2011 NALBOH survey of LBoHs, have further deterred useful inquiries based on these data sets. 4,8 Because of the lack of detailed data on LBoHs, numerous studies extracted data about LBoHs from surveys not specifically designed for describing LBoHs. Profile surveys of LHDs conducted in 2005, 2008, 2010, and 2013 by the National Association of County and City Health Officials (NACCHO) are examples of such studies containing a small number of questions about LBoHs.…”

mentioning

confidence: 99%

“…Attempts to classify the spheres of LBoH influence are limited and narrow in scope. 4,7 Boulton et al stated that taxonomy “is the practice of classifying concepts within hierarchic categories that help organize it in meaningful ways.” 52(p315) Our study offers operational definitions for a taxonomy of LBoHs to provide a coherent framework for describing LBoH variation, thus filling important gaps. 5,53 The study also uses primary data collected by NACCHO in 2015 from a nationally representative sample of LHDs to provide an empirical assessment of LBoH performance across various domains of the typology, and to describe variation in such performance by relevant LHD characteristics.…”

mentioning

confidence: 99%

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Creating a Taxonomy of Local Boards of Health Based on Local Health Departments’ Perspectives

et al. 2017

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Objectives-To develop a local board of health (LBoH) classification scheme and empirical definitions to provide a coherent framework for describing variation in the LBoHs.Methods-This study is based on data from the 2015 Local Board of Health Survey, conducted among a nationally representative sample of local health department administrators, with 394 responses. The classification development consisted of the following steps: (1) theoretically guided initial domain development, (2) mapping of the survey variables to the proposed domains, (3) data reduction using principal component analysis and group consensus, and (4) scale development and testing for internal consistency.Results-The final classification scheme included 60 items across 6 governance function domains and an additional domain-LBoH characteristics and strengths, such as meeting frequency, composition, and diversity of information sources. Application of this classification strongly supports the premise that LBoHs differ in their performance of governance functions and in other characteristics.Reprints can be ordered at http://www.ajph.org by clicking the "Reprints" link.Correspondence should be sent to Gulzar H. Shah, Georgia Southern University, PO Box 8015, Statesboro, GA 30460 (gshah@georgiasouthern.edu). CONTRIBUTORS G. H. Shah coordinated the development of the article, performed statistical analyses, and participated in writing. G. H. Shah and S. Sotnikov prepared the analysis design for the article. All authors participated in writing various sections, editing and improving the entire article, and outlining content in this article through discussions and consensus. HUMAN PARTICIPANT PROTECTIONHuman participant protection was not required because this research used secondary data. HHS Public AccessAuthor manuscript Am J Public Health. Author manuscript; available in PMC 2017 October 10. Conclusions-TheLBoH taxonomy provides an empirically tested standardized tool for classifying LBoHs from the viewpoint of local health department administrators. Future studies can use this taxonomy to better characterize the impact of LBoHs.Local boards of health (LBoHs), a fundamental component of the public health governance structure, have guided public health interventions since the 19th century. 1 Like many other governing bodies, an LBoH is vested with the authority to make decisions, "formulate the policy and direct the affairs of an institution in partnership with the managers … on a voluntary or part-time basis." 2 LBoHs have evolved with the changing public health landscape to address emerging public health threats. 1 Currently, LBoHs govern 7 out of 10 local health departments (LHDs) of all sizes in the United States. 3 The National Association of Local Boards of Health (NALBOH) defines an LBoH as a legally designated body whose members are appointed or elected to provide advisory functions and/or governing oversight for the primary governmental public health agency, and/or public health activities (assessment, assurance, and/or policy dev...

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“…3 The National Association of Local Boards of Health (NALBOH) defines an LBoH as

…”

mentioning

confidence: 99%

“…In some cases, LBoHs are nominal bodies without much impact or engagement, whereas other LBoHs have significant impact and recognition for their contributions. 4,7 …”

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Creating a Taxonomy of Local Boards of Health Based on Local Health Departments’ Perspectives

et al. 2017

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Patterns and trends in local health departments’ efforts to promote access to care in local communities throughout the United States: The contributions of governance structures

Hearld

Tafili

Kelly

2023

Health Planning & Management

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Public health agencies like local health departments (LHDs) play an important role in addressing healthcare access disparities and service delivery gaps in local communities throughout the United States. Previous research has provided important snapshots into specific access issues confronted by LHDs; however, the literature lacks a more comprehensive view of LHDs' efforts to ensure broad access to care, how these have evolved over time more recently, and whether certain types of LHDs governance structures are more likely to engage in activities to ensure access to care. The purpose of this study was to address these gaps in the literature by exploring the prevalence of different activities to ensure access to care, describing how the prevalence of these activities have evolved over time, and examining whether the prevalence of these activities varied as a function of different governance structures. Using pooled, cross‐sectional survey data from four waves of a survey (2009, 2013, 2016, 2019) of LHDs in the United States, the univariate and bivariate analysis revealed that, over time, LHDs have generally increased their efforts to assess gaps in access to healthcare services and across all healthcare categories (i.e., medical, dental, behavioural health) but especially for behavioural health. Poisson regression models showed that LHDs with a more decentralised decision‐making structure were associated with more activities to ensure access to care, as compared to more centralised structures. Collectively, our findings indicate that despite growth in the number and percentage of LHDs assessing and addressing gaps in services, opportunities still exist to enhance access to healthcare services in local communities, particularly in the areas of dental and behavioural health. Our findings also suggest that stakeholders interested in improving LHDs’ efforts to ensure access to care in local communities may want to pay close attention to governance features of LHDs.

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Association Between Local Boards of Health Authority Over Budgets and PHAB Accreditation Standard Score

et al. 2023

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Composition and Duties of Local Boards of Health

Cited by 9 publications

References 8 publications

Creating a Taxonomy of Local Boards of Health Based on Local Health Departments’ Perspectives

Creating a Taxonomy of Local Boards of Health Based on Local Health Departments’ Perspectives

Patterns and trends in local health departments’ efforts to promote access to care in local communities throughout the United States: The contributions of governance structures

Association Between Local Boards of Health Authority Over Budgets and PHAB Accreditation Standard Score

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