Local Public Health Agency Capacity and its Relationship to Public Health System Performance

Abstract

he study described in this article identifies local public health agency capacity characteristics that are related to their local public health systems' performance scores on the CDC's National Public Health Performance Standards Program assessment instrument. Public health system performance scores from a test version of the National Public Health Performance Standards instrument (5b) from county and city/county jurisdictions in three states were matched to organizational capacity data from the 1997 National Association of County and City Health Officials profile of health departments, resulting in a sample of 152 jurisdictions. Twenty-eight capacity variables from the profile and all 10 scores on the Essential Public Health Services plus the total performance score were analyzed in 11 separate multivariate regression models. Public health agency capacities in the areas of funding, organizational leadership, and certain nonprovider partnerships were found to be significantly related to public health system performance. Further study is needed to determine if these relationships between agency capacities and system performance are found, with data from other states now using the nationally released performance assessment instruments and with capacity measures that are more specific for evaluating public health 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.…”

Evidence-Based Public Health: A Fundamental Concept for Public Health Practice

“…In a survey of 152 city and county health departments in the United States, one of the main predictors of strong public health system performance was the attention of organizational leadership to the science base, quality, and performance (143). However, even public health leaders who understand and embrace EBPH have challenges in choosing and implementing innovative approaches.…”

“…As noted earlier, leadership is essential to promote adoption of EBPH as a core part of public health practice (143). This includes an expectation that decisions will be made on the basis of the best science, the needs of the target population, and what will work locally.…”

Recent Advances in Public Health Systems Research in the United States

“…These governmental organizations form the backbone of the public health system and interact with a wide array of other community partners to ensure the public's health. To accomplish these tasks, the public health system and its infrastructure rely on having adequate resources such as a competent workforce, financing, data and technology, efficient organization and structure, and governance (standards, policy, and law), each of which are interdependent and interacting, encompassing all levels of government, as well as both the public and private sectors (10,11,31,83).…”