Investigating the effects of partnerships of local health departments with schools on public health preparedness

RESEARCH OBJECTIVES: This study provides quantitative evaluation of the effects of partnerships of local health departments (LHDs) with schools on the preparedness of LHDs.

STUDY DESIGN: Propensity-scores-matching is used to conduct quasi-experimental assignment of LHDs into comparable pairs of cases and controls. We estimate a Probit model of educational partners' choice as a function of observable characteristics (LHD expenditures, number of customers in jurisdiction, number of employees). Predicted probabilities of having an educational partner are used to match LHDs with and without educational partners by nearest-neighbor-matching method. The effects of LHD private partnerships are estimated by calculating the difference in outcome variables for each pair.

POPULATION STUDIED: The main sources of data on LHD characteristics, partnerships, and types emergency preparedness activities is the 2005 NACCHO survey of 440 LHD. The six preparedness activities included: 1) develop or update a written emergency plan, 2) review relevant legal authorities 3) participate in drills or exercises, 4) participate in an actual public health emergency, 5) assess emergency preparedness competencies of staff, 6) provide emergency preparedness training to staff.

FINDINGS: LHDs that partner with schools are more likely to be engaged in the following activities: participate in an actual public health emergency (20.4% point difference, t=1.99); develop or update a written emergency plan (16.4% point difference, t=1.79). No statistically significant effects (at 0.05 level) of partnerships were observed for four other activities.

CONCLUSIONS: Promoting LHD partnerships with educational institutions may have heterogeneous effects on preparedness. Some aspects of preparedness may improve more than others.