Public Health Performance Standards: Results and Lessons from Arkansas

The CDC has spearheaded a national partnership initiative to develop public health performance standards (PHPS) in an effort to strengthen PH practice, systems-based performance, and PH infrastructure. This paper reports the results of the assessment in Arkansas. METHODOLOGY: Steering Committees were established at both the state and county levels to guide the assessment process. Staff received training in use of the assessment instruments from the National PH Performance Standards Program, and representatives of the “broadly defined public health system (PHS)” were invited to participate. Participants (1931 statewide) assessed their state or their local PHS against each performance standard and its components. Assessment responses were generated through a consensus process in meetings conducted during Jan-Mar 2006. Arkansas scores, based on an algorithm developed by CDC), were compared with national norms. RESULTS: Arkansas' local PHS exceeded national norms for all 10 PHPS. Further, 81.3% of the state's 75 counties “Met” or “Substantially Met” the PHPS. The highest performance levels occurred in Standard-2: Diagnose/investigate health problems (93); Standard-6: Enforce laws/regulations (79), and Standard-3: Inform/educate (78). Analyses of the 31 components of the EPHS showed that overall scores often “hid” weaknesses that need to be addressed. At the State level, Arkansas exceeded national norms in only 4 of the PHPS. CONCLUSIONS: Arkansas' data demonstrate the usefulness of the PHPS in guiding improvement activities. The incongruity of the state and local results suggest opportunities for improved coordination. Furthermore, results suggest that states that do not participate in the complete assessment process lose valuable information.