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Local Public Health Agency Capacity and its Relationship to Public Health System Performance

Scutchfield, F Douglas MD; Knight, Evelyn A. PhD; Kelly, Ann V. MHA; Bhandari, Michelyn W. MPH; Vasilescu, Ilie Puiu PhD

Journal of Public Health Management and Practice: May-June 2004 - Volume 10 - Issue 3 - p 204–215

The study described in this article identifies local public health agency capacity characteristics that are related to their local public health systems' performance scores on the CDC's National Public Health Performance Standards Program assessment instrument. Public health system performance scores from a test version of the National Public Health Performance Standards instrument (5b) from county and city/county jurisdictions in three states were matched to organizational capacity data from the 1997 National Association of County and City Health Officials profile of health departments, resulting in a sample of 152 jurisdictions. Twenty-eight capacity variables from the profile and all 10 scores on the Essential Public Health Services plus the total performance score were analyzed in 11 separate multivariate regression models. Public health agency capacities in the areas of funding, organizational leadership, and certain nonprovider partnerships were found to be significantly related to public health system performance. Further study is needed to determine if these relationships between agency capacities and system performance are found, with data from other states now using the nationally released performance assessment instruments and with capacity measures that are more specific for evaluating public health system performance.

Principal Investigator, University of Kentucky School of Public Health, Lexington. (Scutchfield)

Project Director, University of Kentucky School of Public Health, Lexington. (Knight)

Project Manager, University of Kentucky School of Public Health, Lexington. (Kelly)

Research Assistant, University of Kentucky School of Public Health, Lexington. (Bhandari)

Statistician, University of Virginia's College at Wise, Department of Social and Behavioral Sciences. (Vasilescu)

The University of Kentucky Center for Health Services Management and Research gratefully acknowledges the financial support by the Public Health Practice Program Office (PHPPO), Centers for Disease Control and Prevention (CDC) for the analysis described in this report. This work was funded through ATPM/CDC cooperative agreement TS01-0608.

An earlier version of this article was presented at the AcademyHealth Annual Research Meeting, Public Health Systems Research Affiliate, on June 26, 2003, in Nashville, Tennessee.

Corresponding author: Evelyn A. Knight, PhD, University of Kentucky School of Public Health, 121 Washington Ave, Room 107C, Lexington, KY 40536-0003 (e-mail:

© 2004 Lippincott Williams & Wilkins, Inc.