Open AccessThe Association of Changes in Local Health Department Resources With Changes in State-Level Health Outcomes
Author(s) -
Paul Campbell Erwin,
Sheila Greene,
Glen P. Mays,
Thomas C. Ricketts,
Maryland V. Davis
Publication year - 2011
Publication title -
american journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.284
H-Index - 264
eISSN - 1541-0048
pISSN - 0090-0036
DOI - 10.2105/ajph.2009.177451
Subject(s) - staffing , medicine , health department , environmental health , retrospective cohort study , public health , confounding , demography , multivariate analysis , gerontology , nursing , sociology
We explored the association between changes in local health department (LHD) resource levels with changes in health outcomes via a retrospective cohort study. We measured changes in expenditures and staffing reported by LHDs on the 1997 and 2005 National Association of County and City Health Officials surveys and assessed changes in state-level health outcomes with the America's Health Rankings reports for those years. We used pairwise correlation and multivariate regression to analyze the association of changes in LHD resources with changes in health outcomes. Increases in LHD expenditures were significantly associated with decreases in infectious disease morbidity at the state level (P = .037), and increases in staffing were significantly associated with decreases in cardiovascular disease mortality (P = .014), controlling for other factors.