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Local Boards of Health Characteristics Influencing Support for Health Department Accreditation

Shah, Gulzar H. PhD, MStat, MS; Sotnikov, Sergey PhD; Leep, Carolyn J. MS, MPH; Ye, Jiali PhD; Corso, Liza MPA

Journal of Public Health Management and Practice: August 21, 2017 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHH.0000000000000623
Research Full Report: PDF Only

Background: Local boards of health (LBoHs) serve as the governance body for 71% of local health departments (LHDs).

Purpose: To assess the impact of LBoH governance functions and other characteristics on the level of LBoH support of LHD accreditation.

Methods: Data from 394 LHDs that participated in the 2015 Local Boards of Health Survey were used for computing summative scores for LBoHs for domains of taxonomy and performing logistic regression analyses in 2016.

Results: Increased odds of an LBoH directing, encouraging, or supporting LHD accreditation activities were significantly associated with (a) a higher overall combined score measuring performance of governance functions and presence of other LBoH characteristics (adjusted odds ratio [AOR] = 1.05; P < .001); (b) a higher combined score for the Governance Functions subscale (AOR = 1.06; P < .01); (c) the “continuous improvement” governance function (AOR = 1.15; P < .001); and (d) characteristics and strengths such as board composition (eg, LBoH size, type of training, elected vs nonelected members), community engagement and input, and the absence of an elected official on the board (AOR = 1.14; P = .02).

Conclusions: LBoHs are evenly split by thirds in their attention to Public Health Accreditation Board accreditation among the following categories: (a) encouraged or supported, (b) discussed but made no recommendations, and (c) did not discuss. This split might indicate that they are depending on the professional leadership of the LHD to make the decision or that there is a lack of awareness. The study findings have policy implications for both LBoHs and initiatives aimed at strengthening efforts to promote LHD accreditation.

Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia (Dr Shah); Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Sotnikov and Corso); and National Association of County & City Health Officials, Washington, District of Columbia (Ms Leep and Dr Ye).

Correspondence: Gulzar H. Shah, PhD, MStat, MS, Jiann-Ping Hsu College of Public Health, Georgia Southern University, PO Box 8015, Statesboro, GA 30460 (

The study was funded by the Centers for Disease Control and Prevention through Cooperative Agreement OT13-1302: Building Capacity of the Public Health System to Improve Population Health Through National, Nonprofit Organizations (NACCHO Cooperative Agreement #5U38OT000172-03).

The conclusions, findings, and opinions expressed in this study by authors do not necessarily reflect the official position of the Centers for Disease Control and Prevention.

No financial disclosures were reported by the authors of this article.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

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