Since 2001, many states have created regional structures in an effort to better coordinate/public health preparedness and response efforts, consolidate services, and supplement local government capacity. While several studies have identified specific benefits to regionalization, including enhanced networking, coordination, and communication, little research has examined the effect of regionalization on specific preparedness and response activities. To better understand the impact of regionalizing public health workforce assets in North Carolina, a survey aimed at documenting specific support and services that Public Health Regional Surveillance Teams(PHRSTs) provide to local health departments (LHDs) was developed and administered by the North Carolina Preparedness and Emergency Response Research Center, located at the North Carolina Institute for Public Health. Of80 potential types of assistance, 26 (33%) were received by 75% or more LHDs, including 9 related to communication and 7 related to exercises. There was significant variation by PHRST region in both the quantity and quality of support and services reported by LHDs. This variation could not be explained by county- or LHD-level variables. PHRST assistance to LHDs is largely focused on communication and liaison activities, regional exercises, and planning. On the basis of these findings, regionalization may provide North Carolina with benefits consistent with those found in other studies such as improved networking and coordination. However, further research is needed to identify whether regional variation is the result of varying capacity or priorities of the PHRSTs or LHDs and to determine how much variation is acceptable.
This article describes support and services provided by public health regional surveillance teams to local health departments in North Carolina.
Department of Epidemiology (Drs Horney and MacDonald), North Carolina Institute for Public Health (Dr Markiewicz), and Cecil G. Sheps Center for Health Services Research (Dr Meyer), University of North Carolina Gillings School of Global Public Health, Chapel Hill.
Correspondence: Jennifer A. Horney, PhD, MPH, CPH, Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, CB #8165, Chapel Hill, NC 27599 (firstname.lastname@example.org).
Disclaimer: The contents of the article are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.
The authors thank Jennifer Hegle, MPH, for editing the manuscript and Jessica Sage for assistance with data analysis and tables. This study was supported by Grant/Cooperative Agreement Number PO1 TP 000296-01 from the Centers for Disease Control and Prevention.