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National Profile of National Profile of Local Health Local Health Departments Departments Public Health Systems Research Group Public Health Systems Research Group Meeting Meeting Patrick M. Libbey Patrick M. Libbey Carolyn J. Leep Carolyn J. Leep February 8, 2006 February 8, 2006

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National Profile of Local Health Departments Public Health Systems Research Group Meeting. Patrick M. Libbey Carolyn J. Leep February 8, 2006. 2005 National Profile of Local Health Departments Study. Census – includes all LHDs in U.S. Three prior studies - PowerPoint PPT Presentation

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Page 1: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

National Profile of Local National Profile of Local Health Departments Health Departments

Public Health Systems Research Group MeetingPublic Health Systems Research Group Meeting

Patrick M. LibbeyPatrick M. Libbey

Carolyn J. LeepCarolyn J. Leep

February 8, 2006February 8, 2006

Page 2: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

2005 National Profile of Local 2005 National Profile of Local Health Departments StudyHealth Departments Study

Census – includes all LHDs in U.S.Census – includes all LHDs in U.S. Three prior studiesThree prior studies

Conducted in 1989, 1992-93, and 1995-96Conducted in 1989, 1992-93, and 1995-96 First National Profile to be conducted First National Profile to be conducted

as web-based surveyas web-based survey CDC is primary funderCDC is primary funder

NLM and HRSA support for specific analysesNLM and HRSA support for specific analyses

Page 3: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

2005 Profile Questionnaire2005 Profile Questionnaire

Structured as Core and ModulesStructured as Core and Modules

Core questionnaire sent to every LHDCore questionnaire sent to every LHD N = 2864N = 2864

Three different modules Three different modules Each sent to sample of ~550 LHDsEach sent to sample of ~550 LHDs Stratified by population servedStratified by population served

Page 4: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

Topics in Profile CoreTopics in Profile Core

GovernanceGovernance Population servedPopulation served FinancesFinances Characteristics of top Characteristics of top

executiveexecutive LPHA workforceLPHA workforce

Activities and services Activities and services providedprovided

Community health Community health assessment & assessment & improvementimprovement

Information Information technologytechnology

Page 5: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

Topics in Profile ModulesTopics in Profile Modules

Detailed information on:Detailed information on: FinancesFinances LPHA workforceLPHA workforce Community health Community health

assessment & assessment & improvementimprovement

Information technologyInformation technology

Additional Topics:Additional Topics: Performance Performance

improvementimprovement Emergency Emergency

preparednesspreparedness PartnershipsPartnerships Policy-making and Policy-making and

advocacyadvocacy Addressing health Addressing health

inequitiesinequities

Page 6: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

Overall Response Rate = 80%

LA

ID

AZ

UT

MT

WY

NM

CO

AL

FL

SC

TN

KY

INOH

NC

SD

KS

NE

MN

WI

IA

IL

MO

AR

MS

OK

ND

OR

CA NV

WA

TX

MI

GA

AK

HI

PA

ME

VA

NY

CT

WV

MD NJ

VTN H

M A

D E

RI

Final Response Rates to 2005 National Profileof Local H ealth Departments S tudy

Dark Green = 100%Med Green = 90 - 99%Lt Green = 80 - 89%Lt Orange = 70 - 79%Med Orange = 60 - 69%Dark Orange < 60%

Page 7: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

How are Profile Data Used?How are Profile Data Used?

By LHDs to benchmark and advocateBy LHDs to benchmark and advocate By state and federal agencies to better By state and federal agencies to better

understand LPH practiceunderstand LPH practice By policymakers addressing LPH issuesBy policymakers addressing LPH issues By NACCHO staff to support programs for By NACCHO staff to support programs for

LHDsLHDs By researchers exploring specific By researchers exploring specific

hypotheseshypotheses

Page 8: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

Preview of 2005 Profile DataPreview of 2005 Profile Data

Data collection completed in November Data collection completed in November 20052005

Data cleaning is ongoingData cleaning is ongoing

IMPORTANT NOTE: IMPORTANT NOTE: Data presented are preliminary Data presented are preliminary

..

Page 9: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

Who funds local health Who funds local health departments?departments?

Examined self-reported data on funding from Examined self-reported data on funding from 1992-93 and 2005 National Profile of Local 1992-93 and 2005 National Profile of Local Health Departments studiesHealth Departments studies

Looked for differences in funding sources by:Looked for differences in funding sources by: population served population served jurisdiction (city/town, county, district/region, etc.) jurisdiction (city/town, county, district/region, etc.) statestate

Compared funding sources in 1993 and 2005Compared funding sources in 1993 and 2005

Page 10: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

National Profile of Local Health National Profile of Local Health DepartmentsDepartments

1993 National Profile1993 National Profile Mailed survey Mailed survey N= 2,875N= 2,875 Fielded for 14 months Fielded for 14 months

in 1992-93in 1992-93 Response rate = 72%Response rate = 72%

2005 National Profile2005 National Profile Web-based surveyWeb-based survey N=2,864N=2,864 Fielded for 4 months Fielded for 4 months

in 2005in 2005 Response rate = 80%Response rate = 80%

Page 11: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

1993 Profile of LHDsMean Percentage of Total Revenue from Various Sources

43

29

5

7

6

6 1

Local

State

Federal

Medicaid

Medicare

Fees

Other

Page 12: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

2005 Profile of LHDs Mean Percentage of Total Revenue from Various

Sources

34

37

2

8

4

9

5

Local

State

Federal

Medicaid

Medicare

Fees

Other

Page 13: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

Mean Percentage of Total Revenue from Various Sources1993 and 2005 Profiles of LHDs

Local, 43

State , 29

Federal, 5

Medicaid, 7

Medicare, 6

Fees, 6 Other, 1

Local, 34

State, 37

Federal, 2

Medicaid, 8

Medicare, 4

Fees, 9

Other, 5

Page 14: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

1993 Profile: Mean Revenue Sources by Population Served

0

5

10

15

20

25

30

35

40

45

50

Local State Federal Medicaid Medicare Fees Other

Revenue Source

Mea

n P

erce

nta

ge

of

To

tal

Rev

enu

e

All data < 25,000 25,000 - 49,999 50,000 - 99,999

100,000 - 249,999 250,000 - 499,999 500,000 - 999,999 1 million +

Page 15: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

2005 Profile: Mean Revenue Source by Population Served

0

5

10

15

20

25

30

35

40

45

50

Local State Federal Medicaid Medicare Fees Other

Revenue Source

Mea

n P

erce

nta

ge

of

To

tal

Rev

enu

es

<25,000 25,000 - 49,999 50,000 - 99,999 100,000 - 249,999

250,000 - 499,999 500,000 - 999,999 1 million +

Page 16: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

1993 Profile: Mean Revenue Sources by LHD Type

0

10

20

30

40

50

60

70

80

90

100

Local State Federal Medicaid Medicare Fees Other

Type of LHD

Per

cen

tag

e o

f T

ota

l Rev

enu

e

County City-County City Town/township Region/District

Page 17: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

2005 Profile: Mean Revenue Sources by LHD Type

0

10

20

30

40

50

60

70

80

90

100

Local State Federal Medicaid Medicare Fees Other

Revenue Source

Per

cen

tag

e o

f T

ota

l R

even

ue

County City-County City Town/township Region/District

Page 18: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

Revenue Sources by State

• Large differences in funding patterns by state

• Both 1993 & 2005 data demonstrate differences

2005 Profile of LH DsMean Percentage of Revenue from Local S ources

Dark Green: > 50%Light G reen: 26- 49%

Light Orange: 15- 25%Dark Orange: <15%

Page 19: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

1993 Profile of LH DsS tates w ith Mean Local Revenue S ources < 25%

Page 20: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

2005 Profile of LH DsS tates w ith Mean Local Revenue S ources < 25%

Page 21: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

2005 Profile of LH DsS tates w ith Mean Local Revenue S ources < 25%

Note: Black pushpins show statesw here mean local revenue sourcesw ere < 25% in 1993 Profi le

Page 22: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

1993 Profile of LH DsS tates w ith Mean S tate Revenue S ources < 25%

Page 23: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

2005 Profile of LH DsS tates w ith Mean S tate Revenue S ources < 25%

Page 24: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

2005 Profile of LH DsS tates w ith Mean S tate Revenue S ources < 25%

Note: Black pushpins show statesw here mean state revenues sourcesw ere < 25% in 1993 Profi le

Page 25: National Profile of Local Health Departments  Public Health Systems Research Group Meeting

Availability of 2005 Profile DataAvailability of 2005 Profile Data

Researchers can request to purchase Researchers can request to purchase Profile data from NACCHOProfile data from NACCHO Expected to be available in June 2006Expected to be available in June 2006 Data use policy available at:Data use policy available at:http://www.naccho.org/topics/infrastructure/2005Profile.cfmhttp://www.naccho.org/topics/infrastructure/2005Profile.cfm

Carolyn Leep, Profile Program ManagerCarolyn Leep, Profile Program Manager

[email protected]@naccho.org