5,846 Works

What “Community Building” Activities are Nonprofit Hospitals Reporting as Community Benefit?

Erik Bakken, David Kindig & Jo Ivey Boufford
In 2008, the Internal Revenue Service (IRS) revised and standardized the reporting policy for community benefit expenses for non-profit hospitals. These expenses are required for tax-exemption. At that time, the IRS designated some categories of activities as non-eligible as a community benefit, but still mandated their reporting on hospitals’ Form 990- the annual tax filing for non-profit organizations. One such category was community building, which encompasses a broad range of non-medial determinants of health and...

Diffusion of Innovation Across a National Local Health Department Network

Mark Orr & Jacqueline Merrill
The network that local health officials use to communicate about professional issues is sparsely connected, which may limit the spread of innovative practices. We used agent-based simulation modeling to find out if a policy to promote more connections improved the network’s capability to diffuse innovation. We found that unanticipated effects could result, depending on the requirements of the policy and the proportion of health officials involved. With carefully crafted assumptions and reliable data it is...

Addressing health inequalities in the United States

Sara N. Bleich, Marian P. Jarlenski, Caryn N. Bell & Thomas A. LaVeist
Health inequalities, which have been well documented for decades, have recently become policy targets in the United States. This report summarizes current patterns and trends in health inequalities, commitments to reduce health inequalities, and progress made to eliminate health inequalities. Time trend data indicate improvements in health status and major risk factors but increases in morbidity, with black and lower-education individuals experiencing a disproportionate burden of disease. A common policy response has been priority setting...

The Effects of the State of Tennessee Immunization Policy Change of 2011 - 2012 on Vaccination Uptake in East Tennessee

Margaret A. Knight, Anne D. Kershenbaum, Martha Buchanan, Janet Ridley & Paul C. Erwin
In the United States, funding for the purchase of vaccines depend on annual Congressional allocations. These allocations fluctuate from year to year as Congress responds to changes in national needs for immunizations. The Affordable Care Act requires first dollar coverage of immunizations and other preventive care, allowing a reduction in federal funding for vaccine purchase and a reallocation of funds to other uses such as infrastructure development. In fiscal year 2012, the loss of funds...

Carrots, Sticks and False Carrots

Harald Schmidt
Employers are increasingly using wellness incentives, including penalties for unhealthy behavior. Survey data suggests that people are willing to accept the principle of penalizing those perceived to take health risks, but the equally relevant question of the magnitude of acceptable penalties is unclear. While the principle of penalizing overweight and obese people has some support, findings from a population-level experiment (n=1,000) suggest that the acceptable size of penalties is comparatively small, around $50: more than...

A Patient-Centered Approach for Evaluating Public Health Roles within Systems of Care for Children with Special Healthcare Needs

Danielle M. Varda & Ayelet Talmi
Despite the apparent success that local and state health departments have had integrating a public health approach to provide programs and services for families with children who have complex health needs, there continues to be mixed results in terms of satisfaction and degree of support from this system. Current evaluations collect performance data from system stakeholders, rarely including the patient perspective. Examining the system holistically using Social Network Analysis, to include both the stakeholder and...

Public Health Services Most Commonly Provided by Local Health Departments in the United States

Gulzar H. Shah, Huabin Luo & Sergey Sotnikov
The primary purpose of this research is to identify the most commonly performed public health services by local health departments (LHDs) and highlight variation by LHD characteristics. Data were drawn from the 2008 and 2010 National Profile of LHDs, conducted by the National Association of County and City Health Officials (NACCHO). The descriptive analysis aims to further the essential dialogue triggered by a recent Institute of Medicine (IOM) report about the standard minimum set of...

Health Department–Hospital Collaboration on Community Health Assessments

F. Douglas Scutchfield & Kaylee R. Hicks
The paper by Carlton and Singh in the March 2015 issue of Frontiers in Public Health Services and Systems Research represents an effort to show that, at least indirectly, hospitals and health departments in some communities apparently are in partnership, at least in the health department’s judgment: That is, the health department listed hospitals as a partner in the National Association of County and City Health Officials (NACCHO) survey of local health departments. They also...

Keeneland Conference Plenary Sessions

Richard J. Umbdenstock
Historically individual and community health problems fed off one another, nonetheless the connection eventually became clear and individual health and population health solutions started to emerge and built off one another. Somewhere along the line, population health and patient health seemed to become divided by a brighter line into 2 separate realms, few of us crossing from one to the otherToday we are looking out for the good of our respective communities. As hospitals move...

Effectiveness and Challenges for Implementing Quality Improvement Activities in Nebraska’s Local Health Departments

Li-Wu Chen, Anh Nguyen, Janelle J. Jacobson, Diptee Ojha & David Palm
What is already known on this topic? Although the implementation strategies and effectiveness of quality improvement (QI) activities have been examined extensively for many industries, including the health care sector, very few studies have focused on QI activities in the public health context. What is added by this report? The study results indicated that Nebraska’s LHDs still face significant barriers for QI implementation, including low capacity, knowledge gaps, inadequate resources, and low institutional QI maturity....

Use of the County Health Rankings by Local Health Departments in Florida, 2010 - 2011

Nancy L. Winterbauer, Bonita Winterbauer & James B. Tidwell
This paper describes how local health departments (LHDs) in Florida used the County Health Rankings over the first two years of their release (2010 – 2011). We surveyed LHD leadership to describe if, how and to what extent the Rankings were used by Florida’s 67 LHDs to improve the health of their communities and describe changes in use from the 2010 to the 2011 release. Our results indicate substantial use of the Rankings by Florida’s...

Racial Disparities in Access to Community Water Supply Service in Wake County, North Carolina

Jacqueline MacDonald Gibson, Nicholas DeFelice, Daniel Sebastian & Hannah Leker
Anecdotal evidence suggests that historically African American communities on the fringes of cities and towns in North Carolina have been systematically denied access to municipal drinking water service. This paper presents the first statistical analysis of the role of race in determining water access in these fringe areas, known as extraterritorial jurisdictions. Using publicly available property tax data, we quantified the percentage of residences with municipal water service in each census block in Wake County...

Editorial Comment: Local Health Department Provision of WIC Services Relative to Local Need

Paul C. Erwin

Editorial Comment: Public Health Governance and Population Health Outcomes

F. Douglas Scutchfield & Elizabeth Harper

Policymakers Identify Priorities for PHSSR

Katherine Froeb Papa
A major goal for the health services research community is to provide evidence policymakers can use to improve the public’s health. However, it can be difficult to know what evidence policymakers want and how they decide what research to fund. In order to understand where policymakers turn for evidence and how they make funding decisions amid fiscal and political constraints, AcademyHealth conducted a 3-part Fireside Chat series in the spring of 2014. This editorial summarizes...

Public health system partnerships and the scope of maternal and child services

Sharla Smith, Glen Mays, Tommy Mac Bird & Michael A. Preston
Local health departments (LHDs) struggle to serve their communities in the face of ongoing fiscal constraints. Fiscal constraints have led to the elimination and reduction of maternal and child health services (MCH). LHDs have used various strategies to minimize the negative impact fiscal constraints of elimination or reduction of services provided to their communities. Many LHDs have used strategies such as developing partnerships. While these strategies are assumed to increase the delivery of services and...

Answering the Call to Integrate

Gulzar Shah
These editorial comments attempt to provide some contextual background to the primary focus of the study by Carlton and Erwin in the March 2015 issue of Frontiers in Public Health Services and Systems Research, integration of health care and public health (executives). The purpose is also to provide a critical assessment of the value of evidence about strategies for integration, identified by the stakeholders in these two industries. Findings from the Carlton and Edwin study...

Measures of Highly Functioning Health Coalitions

Priscilla A. Barnes, Paul C. Erwin & Ramal Moonesinghe
In Tennessee, health coalitions provide guidance in conducting community assessments, health improvement plans and policies and delivering of health and human services, which are considered core functions of public health. In fact, it has been postulated that these coalitions may serve as the organizational embodiment of the local public health system (LPHS). This study identifies functional characteristics of 63 Tennessee County Health Councils (CHCs), advisory councils to local and regional governmental public health agencies on...

Developing a Tool to Assess Administrative Evidence-Based Practices in Local Health Departments

Rodrigo S. Reis, Kathleen Duggan, Peg Allen, Katherine A. Stamatakis, Paul C. Erwin & Ross C. Brownson
There is need for assessing the practices undertaken by local health departments in order to improve the implementation of evidence-based actions. This paper describes the development and testing of a survey instrument for assessing Administrative Evidence-Based Practices (A-EBPs) in Local Health Departments. A-EBPs identified through a review of the literature were used to develop a survey composed of nine sections and tested in a sample of local health department practitioners. The resulting tool showed adequate...

Do PHAB accreditation prerequisites predict local health departments’ intentions to seek voluntary national accreditation?

Gulzar H. Shah, Kate Beatty & Carolyn Leep
Accreditation has been identified as a crucial strategy for strengthening the public health infrastructure. As agencies prepare for accreditation, it is important to understand how intentions to seek accreditation are related to the current level of readiness based on the three Public Health Accreditation Board (PHAB) prerequisites. Using the National Association of County and City Health Officials’ (NACCHO) 2010 Profile Study, we examined the relationship between the PHAB accreditation prerequisites and local health department (LHD)...

Efficiency in Public Health Service Delivery

Simone R. Singh
The ability of local health departments (LHDs) to provide public health services to improve the health of their communities depends to a large extent on their financial resources. More money by itself, however, does not necessarily translate into better population health. LHDs also have to use their resources in an efficient manner to achieve the best possible outcomes. This article first describes two techniques that LHDs can use to assess their efficiency at providing public...

Evaluating Quality Improvement to Improve HIV Reporting

Nandi A. Marshall, William C. Livingood, Angela Peden, Gulzar H. Shah, Russ Toal, Dayna Alexander, Alesha Wright, Sandra Jump, Shelby Freeman, Kay Davis, Lynn Woodhouse & Kellie Penix
The incorporation and evaluation of Quality Improvement into Georgia’s public health systems continues to be a focus of the Georgia Public Health Practice Based Research Network. This report describes the process, preliminary results and lessons learned from incorporating Quality Improvement into one of Georgia’s public health districts.

From the Frontier

Paul C. Erwin
This article is number two in the series From the Frontier: Translating Research to Practice. The narrative describes the interactions between a local health department director and two academicians in addressing the impact of the 2008 financial crisis. In a first set of activities, practice-academic partners used Financial and Operational Ratio and Trend Analysis to identify periods of a negative total margin and the impact of that on the agency’s declining fund balance. The use...

Evidence-based Decision Making to Improve Public Health Practice

Ross C. Brownson, Jonathan E. Fielding & Christopher M. Maylahn
Despite the many accomplishments of public health, greater attention on evidence-based approaches is warranted. This article reviews the concepts of evidence-based public health (EBPH), on which formal discourse originated about 15 years ago. Key components of EBPH include: making decisions based on the best available scientific evidence, using data and information systems systematically, applying program planning frameworks, engaging the community in decision making, conducting sound evaluation, and disseminating what is learned. Core competencies for EBPH...

Using Learning Collaboratives to Improve Public Health Emergency Preparedness Systems

Michael A. Stoto, Harold Cox, Melissa Higdon, Kerry Dunnell & Donald Goldmann
The U.S. National Health Security Strategy calls for the development and wide-spread implementation of quality improvement (QI) tools in public health emergency preparedness (PHEP), including the development of “learning collaboratives,” a structured way for organizations with common interests to close the gap between potential and practice by learning from each other. To test this approach, we developed and assessed separate learning collaboratives focused on PHEP emergency communications and on the use of Medical Reserve Corps...

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