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Anatomy of a Public Health Agency Turnaround: The Case of the General Health District in Mahoning County

Honoré, Peggy A. DHA; Stefanak, Matthew MPH; Dessens, Scott CPA

Journal of Public Health Management and Practice: July/August 2012 - Volume 18 - Issue 4 - p 364–371
doi: 10.1097/PHH.0b013e3182548e1a
Original Articles

A turnaround describes an organization's ability to recover from successive periods of decline. Current and projected declines in US economic conditions continue to place local public health departments at risk of fiscal exigency. This examination focused on turnaround methodologies used by a local public health department to reverse successive periods of operational and financial declines. Illustrations are provided on the value added by implementing financial ratio and trend analysis in addition to using evidence-based private sector turnaround strategies of retrenchment, repositioning, and reorganization. Evidence has shown how the financial analysis and strategies aided in identifying operational weakness and set in motion corrective measures. The Public Health Uniform Data System is introduced along with a list of standards offered for mainstreaming these and other routine stewardship practices to diagnose, predict, and prevent agency declines.

This study focuses on the analytical tools and strategies used to reverse the decline and bring about the subsequent turnaround in the operational and financial condition of a local public health agency.

College of Health, University of Southern Mississippi, Hattiesburg (Dr Honoré); General Health District in Mahoning County, Youngstown, and Northeast Ohio Medical University, Rootstown, Ohio (Mr Stefanak); and School of Public Health, Louisiana State University Health Sciences Center, New Orleans (Mr Dessens).

Correspondence: Peggy A. Honoré, DHA, College of Health, University of Southern Mississippi, Hattiesburg, MS (

This research was funded with support from the Robert Wood Johnson Foundation.

The authors declare no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.