Local health departments (LHDs) play a key role in the provision of public health services in the United States. Little is known about the extent to which LHD service availability varies by the socioeconomic characteristics of regional populations. This study merges data from the 1996 National Association of County and City Health Officials LHD profile survey and the Area Resource File system. The empirical analysis suggests that LHDs in low-socioeconomic background counties are more likely to provide services such as family planning. For other services, either LHD involvement is low across the board or the distribution of LHD services does not favor low-socioeconomic background counties. Thus, there is often room for improvements in service availability and targeting.
Cem Mete, PhD, is an Economist, Europe and Central Asia Region, The World Bank in Washington, D.C. and conducted this work while a Prevention Effectiveness Fellow, Centers for Disease Control and Prevention in Atlanta, Georgia.
Joan P. Cioffi, PhD, is a Senior Service Fellow, Office of Workforce Policy and Planning, Public Health Practice Program Office, Centers for Disease Control and Prevention in Atlanta, Georgia.
Maureen Y. Lichtveld, MD, MPH, is Associate Director for Workforce Development, Office of Workforce Policy and Planning, Public Health Practice Program Office, Centers for Disease Control and Prevention in Atlanta, Georgia.
This article is adapted from a presentation at the Academy for Health Services Research and Health Policy Annual Research Meeting, Affiliate on Public Health Systems Research, June 2002, in Washington, D.C.