The relationship between county variation in macro contextual factors and the performance of public health practice in regional public health systems in Nebraska

Li-Wu Chen, Liyan Xu, Fang Yu, Janelle Jacobson, Sara Roberts, David W Palm

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: This study examined the relationship between county variation in macro contextual variables and the performance of public health practice in regional local health departments (LHDs) in Nebraska. Design and Main Outcomes Measures: County-level data from the US Census Bureau, the Nebraska Department of Health and Human Services, and the University of Nebraska Medical Center's Health Professions Tracking Services were used to create macro context variables (eg, demographic, geographic, social, economic, population health status). The public health performance data were collected through a mail survey of the directors of regional LHDs in Nebraska in 2008. Public health performance measures were created to indicate LHD's general performance as well as core function specific performance (ie, assessment, assurance, policy development). The coefficients of variation were estimated and used to categorize each regional LHD into either a larger county variation group or a smaller county variation group for each domain of macro context variables. Statistical comparisons of public health performance measures were then made between these 2 groups for each domain. Results: The results suggest that the county variation in macro contextual variables within a regional public health district, in general, is negatively associated with the performance of public health practice in regional LHDs. The regional LHD's performance in specific public health core function (eg, assurance) is negatively associated with the county variation in specific types of macro context factors (eg, geographic factors such as land size and population density). Conclusions: Regional LHDs may design and implement their public health programs on the basis of the type and degree of heterogeneity among the member counties within their jurisdiction. The formation of regional LHDs, if possible, should follow geographic boundaries that minimize the heterogeneity of county composition in terms of macro contextual factors.

Original languageEnglish (US)
Pages (from-to)132-140
Number of pages9
JournalJournal of Public Health Management and Practice
Volume18
Issue number2
DOIs
StatePublished - Mar 1 2012

Fingerprint

Public Health Practice
Public Health
Health
United States Dept. of Health and Human Services
Health Occupations
Geography
Policy Making
Postal Service
Censuses
Population Density
Health Status
Economics
Demography
Outcome Assessment (Health Care)
Population

Keywords

  • county variation in macro context
  • performance of public health practice
  • regional local health departments

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

@article{98e783bfcbff48fc9b95199c26a001ad,
title = "The relationship between county variation in macro contextual factors and the performance of public health practice in regional public health systems in Nebraska",
abstract = "Objective: This study examined the relationship between county variation in macro contextual variables and the performance of public health practice in regional local health departments (LHDs) in Nebraska. Design and Main Outcomes Measures: County-level data from the US Census Bureau, the Nebraska Department of Health and Human Services, and the University of Nebraska Medical Center's Health Professions Tracking Services were used to create macro context variables (eg, demographic, geographic, social, economic, population health status). The public health performance data were collected through a mail survey of the directors of regional LHDs in Nebraska in 2008. Public health performance measures were created to indicate LHD's general performance as well as core function specific performance (ie, assessment, assurance, policy development). The coefficients of variation were estimated and used to categorize each regional LHD into either a larger county variation group or a smaller county variation group for each domain of macro context variables. Statistical comparisons of public health performance measures were then made between these 2 groups for each domain. Results: The results suggest that the county variation in macro contextual variables within a regional public health district, in general, is negatively associated with the performance of public health practice in regional LHDs. The regional LHD's performance in specific public health core function (eg, assurance) is negatively associated with the county variation in specific types of macro context factors (eg, geographic factors such as land size and population density). Conclusions: Regional LHDs may design and implement their public health programs on the basis of the type and degree of heterogeneity among the member counties within their jurisdiction. The formation of regional LHDs, if possible, should follow geographic boundaries that minimize the heterogeneity of county composition in terms of macro contextual factors.",
keywords = "county variation in macro context, performance of public health practice, regional local health departments",
author = "Li-Wu Chen and Liyan Xu and Fang Yu and Janelle Jacobson and Sara Roberts and Palm, {David W}",
year = "2012",
month = "3",
day = "1",
doi = "10.1097/PHH.0b013e3182294e66",
language = "English (US)",
volume = "18",
pages = "132--140",
journal = "Journal of Public Health Management and Practice",
issn = "1078-4659",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - The relationship between county variation in macro contextual factors and the performance of public health practice in regional public health systems in Nebraska

AU - Chen, Li-Wu

AU - Xu, Liyan

AU - Yu, Fang

AU - Jacobson, Janelle

AU - Roberts, Sara

AU - Palm, David W

PY - 2012/3/1

Y1 - 2012/3/1

N2 - Objective: This study examined the relationship between county variation in macro contextual variables and the performance of public health practice in regional local health departments (LHDs) in Nebraska. Design and Main Outcomes Measures: County-level data from the US Census Bureau, the Nebraska Department of Health and Human Services, and the University of Nebraska Medical Center's Health Professions Tracking Services were used to create macro context variables (eg, demographic, geographic, social, economic, population health status). The public health performance data were collected through a mail survey of the directors of regional LHDs in Nebraska in 2008. Public health performance measures were created to indicate LHD's general performance as well as core function specific performance (ie, assessment, assurance, policy development). The coefficients of variation were estimated and used to categorize each regional LHD into either a larger county variation group or a smaller county variation group for each domain of macro context variables. Statistical comparisons of public health performance measures were then made between these 2 groups for each domain. Results: The results suggest that the county variation in macro contextual variables within a regional public health district, in general, is negatively associated with the performance of public health practice in regional LHDs. The regional LHD's performance in specific public health core function (eg, assurance) is negatively associated with the county variation in specific types of macro context factors (eg, geographic factors such as land size and population density). Conclusions: Regional LHDs may design and implement their public health programs on the basis of the type and degree of heterogeneity among the member counties within their jurisdiction. The formation of regional LHDs, if possible, should follow geographic boundaries that minimize the heterogeneity of county composition in terms of macro contextual factors.

AB - Objective: This study examined the relationship between county variation in macro contextual variables and the performance of public health practice in regional local health departments (LHDs) in Nebraska. Design and Main Outcomes Measures: County-level data from the US Census Bureau, the Nebraska Department of Health and Human Services, and the University of Nebraska Medical Center's Health Professions Tracking Services were used to create macro context variables (eg, demographic, geographic, social, economic, population health status). The public health performance data were collected through a mail survey of the directors of regional LHDs in Nebraska in 2008. Public health performance measures were created to indicate LHD's general performance as well as core function specific performance (ie, assessment, assurance, policy development). The coefficients of variation were estimated and used to categorize each regional LHD into either a larger county variation group or a smaller county variation group for each domain of macro context variables. Statistical comparisons of public health performance measures were then made between these 2 groups for each domain. Results: The results suggest that the county variation in macro contextual variables within a regional public health district, in general, is negatively associated with the performance of public health practice in regional LHDs. The regional LHD's performance in specific public health core function (eg, assurance) is negatively associated with the county variation in specific types of macro context factors (eg, geographic factors such as land size and population density). Conclusions: Regional LHDs may design and implement their public health programs on the basis of the type and degree of heterogeneity among the member counties within their jurisdiction. The formation of regional LHDs, if possible, should follow geographic boundaries that minimize the heterogeneity of county composition in terms of macro contextual factors.

KW - county variation in macro context

KW - performance of public health practice

KW - regional local health departments

UR - http://www.scopus.com/inward/record.url?scp=84856764395&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84856764395&partnerID=8YFLogxK

U2 - 10.1097/PHH.0b013e3182294e66

DO - 10.1097/PHH.0b013e3182294e66

M3 - Article

VL - 18

SP - 132

EP - 140

JO - Journal of Public Health Management and Practice

JF - Journal of Public Health Management and Practice

SN - 1078-4659

IS - 2

ER -