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. 2014 Dec;104(12):e77-82.
doi: 10.2105/AJPH.2014.302281. Epub 2014 Oct 16.

Classifying local health departments on the basis of the constellation of services they provide

Betty Bekemeier  1 , Athena Pantazis, Matthew D Dunbar, Jerald R Herting
Affiliations

Classifying local health departments on the basis of the constellation of services they provide

Betty Bekemeier et al. Am J Public Health. 2014 Dec.

Abstract

Objectives: We explored service variation among local health departments (LHDs) nationally to allow systematic characterization of LHDs by patterns in the constellation of services they deliver.

Methods: We conducted latent class analysis by using categorical variables derived from LHD service data collected in 2008 for the National Profile of Local Health Departments Survey and before service changes resulting from the national financial crisis.

Results: A 3-class solution produced the best fit for this data set of 2294 LHDs. The 3 configurations of LHD services depicted an interrelated set of narrow or limited service provision (limited), a comprehensive (core) set of key services provided, and a third class of core and expanded services (core plus), which often included rare services. The classes demonstrated high geographic variability and were weakly associated with expenditure quintile and urban or rural location.

Conclusions: This empirically derived view of how LHDs organize their array of services is a unique approach to categorizing LHDs, providing an important tool for research and a gauge to monitor how changes in LHD service patterns occur.

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Figures

FIGURE 1—
FIGURE 1—
Probabilities that a low, medium, or high range of service provision in each service category (individual or population-focused and basic, expanded, or specialized) is offered by each of the 3 local health department classes (a) limited, (b) core, and (c) core plus: 2008 National Association of County and City Health Officials’ US National Profile of Local Health Departments.
FIGURE 2—
FIGURE 2—
Results of latent class analysis of local health department service provision from 2008 National Association of County and City Health Officials’ US National Profile of Local Health Departments, mapped to 2008 local health department jurisdictional boundaries. Note. LHD = local health department.
See this image and copyright information in PMC

References

    1. National Association of County and City Health Officials. Local health department job losses and program cuts: findings from the 2013 profile study. 2013. Available at: http://www.naccho.org/topics/infrastructure/lhdbudget/upload/Survey-Find.... Accessed January 20, 2014.
    1. Frieden TR. Asleep at the switch: local public health programs and chronic disease. Am J Public Health. 2004;94(12):2059–2061. - PMC - PubMed
    1. Policy and Environmental Change: New Directions for Public Health. Final Report. Atlanta, GA: Association of State and Territorial Directors of Health Promotion and Public Health Education and the Centers for Disease Control and Prevention (US); 2001.
    1. National Association of County and City Health Officials. Changes in local health department services and activities: longitudinal analysis of 2008 and 2010 profile data. 2012. Available at: http://www.naccho.org/topics/infrastructure/profile/resources/upload/Res.... Accessed December 5, 2013.
    1. Erwin PC. The performance of local health departments: a review of the literature. J Public Health Manag Pract. 2008;14(2):E9–E18. - PubMed

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