Citation
Wallace, Megan; Sharfstein, Joshua M.; & Lessler, Justin (2020). Performance and Priorities: A Cross-Sectional Study of Local Health Department Approaches to Essential Public Health Services. Public Health Reports, 135(1), 97-106. PMCID: PMC7119257Abstract
OBJECTIVES: Despite a push for increased local public health capacity, no clear baseline for performance of local health departments (LHDs) exists. The objectives of this study were to quantify the self-reported performance of LHDs on the 10 Essential Public Health Services (EPHSs) and describe the relationships between performance and characteristics of LHDs.METHODS: We used data on 2000 LHDs from the 2013 National Profile of Local Health Departments survey to develop principal components analysis-based scores to evaluate each LHD on the performance of EPHSs. Scores ranged from 0 to 100. LHDs that performed no activities within an EPHS had a score of 0, and LHDs that performed all activities within an EPHS had a score of 100. We explored the relationships between EPHS scores and LHD characteristics by using multivariate linear regression and cluster analysis.
RESULTS: Performance scores varied greatly by LHDs and EPHSs; however, LHDs typically scored <50, indicating that they performed fewer than half of the activities evaluated. LHDs that served larger populations (vs smaller populations) and LHDs that had higher per-capita funding (vs lower per-capita funding) had higher EPHS scores. We identified 6 EPHS performance score-based LHD clusters, which suggests similarities in which EPHSs LHDs focused on.
CONCLUSIONS: Our results suggest weaknesses in many LHDs' fulfillment of the EPHSs, particularly in low-population and low-funding settings. LHDs should be given the resources to increase capacity and ensure the EPHSs are met in communities.
URL
http://dx.doi.org/10.1177/0033354919890862Reference Type
Journal ArticleYear Published
2020Journal Title
Public Health ReportsAuthor(s)
Wallace, MeganSharfstein, Joshua M.
Lessler, Justin