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The Extent of Interorganizational Resource Sharing Among Local Health Departments: The Association With Organizational Characteristics and Institutional Factors

Vest, Joshua R. PhD, MPH; Shah, Gulzar H. PhD, MStat, MS

Journal of Public Health Management and Practice: November/December 2012 - Volume 18 - Issue 6 - p 551–560
doi: 10.1097/PHH.0b013e31825b89e4
Original Articles

Context/Objective: Resource sharing, arrangements between local health departments (LHDs) for joint programs or to share staff, is a growing occurrence. The post-9/11 influx of federal funding and new public health preparedness responsibilities dramatically increased the occurrence of these inter-LHD relationships, and several states have pursed more intrastate collaboration. This article describes the current state of resource sharing among LHDs and identifies the factors associated with resource sharing.

Design and Setting: Using the National Association of County & City Health Officials' 2010 Profile Survey, we determined the self-reported number of shared programmatic activities and the number of shared organizational functions for a sample of LHDs. Negative binomial regression models described the relationships between factors suggested by interorganizational theory and the counts of sharing activities.

Main Outcome Measures: We examined the extent of resource sharing using 2 different count variables: (1) number of shared programmatic activities and (2) number of shared organizational functions.

Results: About one-half of all LHDs are engaged in resource sharing. The extent of sharing was lower for those serving larger populations, with city jurisdictions, or of larger size. Sharing was more extensive for state-governed LHDs, those covering multiple jurisdictions, states with centralized governance, and in instances of financial constraint.

Conclusions: Many LHDs are engaged in a greater extent of resource sharing than others. Leaders of LHDs can work within the context of these factors to leverage resource sharing to meet their organizational needs.

The article discusses the extent of interorganizational resource sharing among local health departments. A general theory of interorganizational relationship development is also described to identify and describe the key organizational and institutional factors that influence this resource sharing.

Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro.

Correspondence: Joshua R. Vest, PhD, MPH, Center for Health Informatics & Policy, Department of Public Health, Weill Cornell Medical College, 425 E. 61st St, Suite 301, New York, NY 10068 (

The authors declare no conflicts of interest.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.