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

Abstract

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.

Conclusions: The LBoH 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.

FIGURE 1—

Steps Involved in Creation and Application of Taxonomy of Local Boards of Health, Their Sequence and Purposes Note. LBoH = local board of health.

FIGURE 2—

Conceptual Framework for Local Board of Health Taxonomy, Proposed Theoretically and Guided by Empirical Analyses: United States, 2015 Note. LBoH = local board of health. This taxonomy and the scores are proposed for studies that use the variables (and questions) used in this study. Studies using different survey items may follow our methodology to develop revised taxonomy scores. “Superior” is defined as an individual domain score greater than the arithmetic mean for that domain. ^aStrengths of LBoHs reflect composition and member qualifications, diversity of information sources, and meeting frequency of the LBoH.