Defining the Functions of Public Health Governance

Abstract

We conducted a literature review in 2011 to determine if accepted governance functions continue to reflect the role of public health governing entities. Reviewing literature and other source documents, as well as consulting with practitioners, resulted in an iterative process that identified 6 functions of public health governance and established definitions for each of these: policy development; resource stewardship; continuous improvement; partner engagement; legal authority; and oversight of a health department. These functions provided context for the role of governing entities in public health practice and aligned well with existing public health accreditation standards. Public health systems research can build from this work in future explorations of the contributions of governance to health department performance.

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

“…5,6,54–62 Theoretical principles of governing boards in other industries guided our conceptual framework. 5,55–62 Although 10 additional characteristics of LBoHs forming the seventh domain were included in the taxonomy, 6 governance functions as defined by Carlson et al 5 were the centerpiece. The 6 functions were

policy development,

resource stewardship,

legal authority,

partner engagement,

continuous improvement, and

oversight.

…”

“…Carlson et al 5 defined the 6 functions of public health governance (applicable to LBoHs) through a field-driven and collaborative project of NALBOH and Centers for Disease Control and Prevention. 55 NALBOH noted that all 6 functions were equally important.…”

“…55 NALBOH noted that all 6 functions were equally important. 55 Carlson et al 5 have provided definitions for these governance functions. These definitions were used to understand the scope and intent behind each of the 6 governance function domains and to inform the mapping of survey questions.…”

“…5 Hays et al proposed a 9-category taxonomy of LHD governance based on 3 concepts of governance. 6 These concepts were (1) the degree to which locus of authority was county government, state government, LBoH, or shared; (2) the extent to which the LBoH was empowered; and (3) whether the LBoH consisted of political appointees or health professionals.…”

“…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.…”