Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Recorded presentation

Alberto J.F. Cardelle, PhD, MPH, MPH Program, East Stroudsburg University, 200 Prospect Street, East Stroudsburg, PA 18301, 570-422-3401, acardelle@po-box.esu.edu

Currently, none of Pennsylvania's 48 rural counties has a local health department (LHD). This is despite the existence of laws, which provide locales with per capita funding for public health and environmental services. This study looks at the issues that influence the establishment of LHDs in rural counties and the financial issues that may impact the establishment of a robust public health infrastructure. The study looked at 10 rural counties in the state and through financial analysis of different LHD models for rural counties helped demonstrate that the relatively high levels of local funds required to establish LHDs would be a major financial undertaking. Testing three models, single-county, bi-county and tri-county LHDs, the study shows that locales would require an average of $16 per capita annually in local funds. The model analysis showed that population, geographic area, and the availability of primary care services drive expenses. Since rural counties have low population density, cover broad geographic expanses and suffer from chronic lack of primary care services, rural LHDs covering rural counties have to cover a very large geographic area, a critical cost driver especially for environmental services, such as water supply testing, and will be pressured to provide personal health services in areas that have a limited number of primary care providers. The result is very high expenses. The paper concludes with policy considerations that may help to overcome these barriers, including establishing secondary formulas that are an alternative to per capita funding as well as creation start-up costs funds.

Learning Objectives:

• a) Participants will learn about the structure of local health departments.
• b) Attendees will understand the cost-drivers associated with LHD operations.
• c) Participants will increase their knowledge of policy mechanisms that could strengthen the rural public health infrastructure.

Keywords: Public Health Infrastructure, Rural Health

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation