Describing Local Boards of Health: Insights from the 2008 National Association of Local Boards of Health Survey

Patton, Dana; Moon, Charles E.; Jones, Jeff

doi:10.1177/003335491112600315

Cited by 9 publications

(13 citation statements)

References 5 publications

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“…We independently reviewed the materials and developed a list of themes, and then discussed the findings to further refine the thematic categories and identify key elements to include in the definitions. We identified 6 strong themes that concerned the roles and responsibilities of governing boards: policy development (addressed in 86% of articles reviewed, or n = 38) 18,24–26,30–63 ; resource stewardship (50%, or n = 22)18,24,26,30–32,37,38,40,41,44,45,47,48,50,54,56,57,59,60,63,64; partner engagement (50%, or n = 22)18,24–26,30–34,37,38,40,44,45,48,49,53,55,59,60,62,65; continuous improvement (73%, or n = 32)18,24–26,30–33,35,36,38,40–43,45,46,48,49,51,54–61,63,66–68; legal authority (25%, or n = 11) 18,24,26,38,39,41,52,57,60,61,67 ; and oversight (57%, or n = 25) 18,24,26,31,32,34,38,39,41,43–45,50,52,…”

Section: Resultsmentioning

confidence: 99%

Defining the Functions of Public Health Governance

et al. 2015

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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.

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Section: Resultsmentioning

confidence: 99%

Defining the Functions of Public Health Governance

et al. 2015

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“…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%

“…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. 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.…”

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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.…”

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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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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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Describing Local Boards of Health: Insights from the 2008 National Association of Local Boards of Health Survey

Cited by 9 publications

References 5 publications

Defining the Functions of Public Health Governance

Defining the Functions of Public Health Governance

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

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