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The Relationship Between Local Public Health Agency Administrative Variables and County Health Status Rankings in Kentucky

Harris, April L. MPH; Scutchfield, F. Douglas MD; Heise, Georgia DrPH; Ingram, Richard C. DrPH

Journal of Public Health Management and Practice: July/August 2014 - Volume 20 - Issue 4 - p 378–383
doi: 10.1097/PHH.0b013e3182a5c2f8
Original Articles

Objectives: The purpose of this research study was to determine whether specific local public health agency (LPHA) characteristics were associated with favorable county health status. Specifically, financial and administrative comparisons were made to determine whether variables such as budget size or number of employees, among others, were associated with community health status among the 120 counties in Kentucky. Other financial and administrative variables collected from LPHA data were also investigated in this study.

Methods: Administrative and financial data were collected for each local public health agency in Kentucky. This was matched with data on the health status of Kentucky counties from the 2010 University of Wisconsin MATCH (Mobilizing Action Towards Community Health Assessment) counties in select measures of health. MATCH data used included measures of health outcomes, specifically socioeconomic status (SES), mortality, and morbidity. Logistic regressions were used to determine the relationship, if any, between variations in the health agency data variables, SES, and health status.

Results: Analysis suggests that SES is the strongest link to county health status. Several other variables that appear to have statistically significant association with health status include the education level of the director, whether the LPHA employees received a raise, whether the LPHA had an associated Home Health agency, and the amount of money used from their reserve account to balance the LPHA budget.

Conclusions: For many years, public health in Kentucky has measured the number of clinical visits and other LPHA services but failed to determine specific characteristics and variables that influence community health status. This study suggests that LPHAs in Kentucky can advance public health practice by having well-educated directors, giving annual incremental raises, and utilizing the agency reserve funds to meet budget shortfalls in the short run. Furthermore, LPHAs with an associated home health agency may need to reassess their impact and need in their community, considering the negative effect it may have on county health status.

This study aims at determining whether specific local public health agency characteristics were associated with favorable county health status.

Three Rivers District Health Department, Owenton, Kentucky (Ms Harris and Dr Heise); and Department of Health Services Management, University of Kentucky College of Public Health, Lexington, Kentucky (Drs Scutchfield and Ingram).

Correspondence: April L. Harris, MPH, Three Rivers District Health Department, 510 S Main St, Owenton, KY 40359 (

The authors declare no conflicts of interest.

© 2014 Lippincott Williams & Wilkins, Inc.