Skip Navigation LinksHome > March/April 2012 - Volume 18 - Issue 2 > Tough Choices in Tough Times: Enhancing Public Health Value...
Journal of Public Health Management & Practice:
doi: 10.1097/PHH.0b013e3182303616
Research Articles

Tough Choices in Tough Times: Enhancing Public Health Value in an Era of Declining Resources

Kuehnert, Paul L. MS, RN; McConnaughay, Karen S.

Collapse Box


The current economic recession is the deepest recession that the United States has experienced in more than 70 years. The convergence of severe economic conditions with the multiple population health and organizational challenges facing public health presents unprecedented demands on public health policymakers and executive leaders. This article reports a case study in which a Midwestern local health department intentionally realigned its structure and human resources to meet national public health accreditation standards while significantly reducing its budget in November 2010. The department transferred personal health care services that it previously provided to 3 federally qualified health centers in the community and reduced its workforce by 50%. The interrelated public policy and organizational management issues raised by the case study are reviewed, and questions and implications of the case for public health executive leaders, managers, policymakers, and researchers are identified.

© 2012 Lippincott Williams & Wilkins, Inc.



Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.