CHARACTERISTICS OF LOCAL HEALTH DEPARTMENTS IN ARIZONA AND THEIR ASSOCIATION TO HEALTH OUTCOMES

Persistent Link:
http://hdl.handle.net/10150/202764
Title:
CHARACTERISTICS OF LOCAL HEALTH DEPARTMENTS IN ARIZONA AND THEIR ASSOCIATION TO HEALTH OUTCOMES
Author:
Crescioni, Mabel
Issue Date:
2011
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
Local Health Departments (LHD) that aim to address the public health needs of growing populations require qualified professionals with management competencies. In Arizona, the majority of public health services are delivered by the county health departments, which are charged with assisting community members and monitoring and improving community health. These activities are funded with federal, state and local money, which varies across counties. This study provides a comprehensive understanding of the local public health system in Arizona, the distribution of public health services across counties and examines the association between health outcomes data and funding patterns for each county. National Association of City and County Health Officials (NACCHO) data from their 2008 survey was used to examine the activities performed at the local level. The majority of the activities in which the LHDs focus fall within the assurance function of public health. Interviews with all Arizona county health department directors (N=15) were conducted. Discussion focused on LHD activities, county and state political/policy climate and partnerships that contribute to LHDs activities. Responses varied significantly across the state due to differences in demographic and financial characteristics of the counties. Many political, socioeconomic and environmental barriers to provision of services were identified as well as the need for developing a stronger public health infrastructure.Finally, associations between several health outcomes and funding, workforce and demographic data of the 15 local health departments in Arizona were examined by conducting correlation analysis and linear regressions. This study found strong positive associations between LHD revenues, LHD expenditures, population size and number of LHD employees and HIV/AIDS incidence, low birth weight births and infant mortality rate. Positive associations were also found between revenues and number of women who received prenatal care and HIV/AIDS mortality rate as well as between number of LHD employees and diabetes mortality rate. This study represents a small step in better understanding the local public health system in Arizona, the distribution of public health services across counties and the political, financial and policy constraints faced by county health department directors.
Type:
text; Electronic Dissertation
Keywords:
Infrastructure; Local Health Departments; Policy; Public Health; Agency Capacity; Health Outcomes
Degree Name:
D.P.H.
Degree Level:
doctoral
Degree Program:
Graduate College; Public Health
Degree Grantor:
University of Arizona
Advisor:
Rosales, Cecilia

Full metadata record

DC FieldValue Language
dc.language.isoenen_US
dc.titleCHARACTERISTICS OF LOCAL HEALTH DEPARTMENTS IN ARIZONA AND THEIR ASSOCIATION TO HEALTH OUTCOMESen_US
dc.creatorCrescioni, Mabelen_US
dc.contributor.authorCrescioni, Mabelen_US
dc.date.issued2011-
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractLocal Health Departments (LHD) that aim to address the public health needs of growing populations require qualified professionals with management competencies. In Arizona, the majority of public health services are delivered by the county health departments, which are charged with assisting community members and monitoring and improving community health. These activities are funded with federal, state and local money, which varies across counties. This study provides a comprehensive understanding of the local public health system in Arizona, the distribution of public health services across counties and examines the association between health outcomes data and funding patterns for each county. National Association of City and County Health Officials (NACCHO) data from their 2008 survey was used to examine the activities performed at the local level. The majority of the activities in which the LHDs focus fall within the assurance function of public health. Interviews with all Arizona county health department directors (N=15) were conducted. Discussion focused on LHD activities, county and state political/policy climate and partnerships that contribute to LHDs activities. Responses varied significantly across the state due to differences in demographic and financial characteristics of the counties. Many political, socioeconomic and environmental barriers to provision of services were identified as well as the need for developing a stronger public health infrastructure.Finally, associations between several health outcomes and funding, workforce and demographic data of the 15 local health departments in Arizona were examined by conducting correlation analysis and linear regressions. This study found strong positive associations between LHD revenues, LHD expenditures, population size and number of LHD employees and HIV/AIDS incidence, low birth weight births and infant mortality rate. Positive associations were also found between revenues and number of women who received prenatal care and HIV/AIDS mortality rate as well as between number of LHD employees and diabetes mortality rate. This study represents a small step in better understanding the local public health system in Arizona, the distribution of public health services across counties and the political, financial and policy constraints faced by county health department directors.en_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
dc.subjectInfrastructureen_US
dc.subjectLocal Health Departmentsen_US
dc.subjectPolicyen_US
dc.subjectPublic Healthen_US
dc.subjectAgency Capacityen_US
dc.subjectHealth Outcomesen_US
thesis.degree.nameD.P.H.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.disciplinePublic Healthen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorRosales, Ceciliaen_US
dc.contributor.committeememberVuturo, Anthony T.en_US
dc.contributor.committeememberLaFleur, Bonnie J.en_US
dc.contributor.committeememberBarker, Gailen_US
dc.contributor.committeememberRosales, Ceciliaen_US
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