ArticlePublic health reports (Washington, D.C. : 1974)
Resources that may matter: the impact of local health department expenditures on health status.
Article in Public health reports (Washington, D.C. : 1974). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- No Two Workforces Are the Same: A Systematic Review of Enumerations and Definitions of Public Health Workforces.Frontiers in public health · 2020Pooled it
- Collaborations between healthcare and public health in rural settings.Health affairs scholar · 2026Article
- Unincorporation in counties as a political determinant of health: An exploration of five states.SSM - population health · 2024Article
- Cities as Platforms for Population Health: Past, Present, and Future.The Milbank quarterly · 2023Article
- Not So Fast: Slowing Tuberculosis Decline in California.American journal of public health · 2019Article
- Toward optimal implementation of cancer prevention and control programs in public health: a study protocol on mis-implementation.Implementation science : IS · 2018Article
- Local Health Departments' Activities to Address Health Disparities and Inequities: Are We Moving in the Right Direction?International journal of environmental research and public health · 2015Article
- Laying the groundwork for evidence-based public health: why some local health departments use more evidence-based decision-making practices than others.American journal of public health · 2015Article
- Building the evidence for decision-making: the relationship between local public health capacity and community mortality.American journal of public health · 2015Article
- Does More Public Health Spending Buy Better Health?Health services research and managerial epidemiologyArticle
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study examines the association between changes in local health department (LHD) expenditures, aggregated to the state level, and changes in state-level measures of health, from 1993 to 2005. The literature on the impact of LHD resources on health status has been limited by cross-sectional designs. With repeated surveys of LHDs, it is now possible to use longitudinal designs to explore the association between LHD inputs and outcomes.
methodsThis was a retrospective cohort study. We used a fixed-effects regression model to assess the association between LHD expenditures, aggregated to the state level, and seven separate health measures. We derived LHD expenditure data from the National Association of County and City Health Officials' surveys of LHDs in 1993, 1997, and 2005. We obtained secondary data on seven health measures--smoking and obesity prevalence, infectious disease morbidity, infant mortality, deaths due to cardiovascular disease and cancer, and overall premature death--through the America's Health Rankings® reports, 1990-2008. Usable data were available for 1,470 LHDs, representing 37 states.
resultsAn increase in LHD expenditures, aggregated to the state level, was associated with a statistically significant decline in state-level infectious disease morbidity (t= -3.28, p=0.002) and in years of potential life lost (YPLL) (t= -2.73, p=0.008). For every $10 increase in aggregated LHD expenditures per capita, infectious disease morbidity decreased by 7.4%, and YPLL decreased by 1.5%.
conclusionLHD resources are associated with improvements in preventable causes of morbidity and mortality.
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