LOCAL HEALTH DEPARTMENT EFFECTIVENESS IN ADDRESSING THE CORE FUNCTIONS OF PUBLIC-HEALTH - ESSENTIAL INGREDIENTS

Objectives: Objective 8.14 of the U.S. Healthy People 2000 objectives calls for 90%; of the population to be served by a local health depart ment (LHD) which is effectively carrying out the core functions of pub lic health (assessment, policy development, assurance). This study see ks to describe the structural and service characteristics of an effect ive LHD. Methods: Data from a 1993 national random sample survey of LH D practice were merged with data from the 1992-1993 National Associati on of County and City Health Officials (NACCHO) profile of local healt h agencies. Using a definition of effectiveness related to the core fu nctions of public health, the correlates of effectiveness were examine d for 264 health departments in the matched sample. Results: Effective ness of local health agencies was not related to jurisdiction size or type. Inputs (structural factors) associated with effectiveness includ ed having a full-time agency head, a larger budget derived from a grea ter number of funding sources, and a larger number of staff. With resp ect to outputs (services), effective health departments were also more likely to provide a greater number of services directly particularly personal preventive and treatment services. Conclusions: Only a few in puts are correlated with core-function related effectiveness. However, a profile of an effective health department emerges. Effective LHDs a ppear more likely to have full-time leadership which is able to tap di verse funding sources to provide the mix and match of community and pe rsonal prevention and treatment services needed to address community n eeds and improve the public's health.