Relationship Between Public Health Enabling Statutes and System Performance

References to the Essential Services of Public Health are ubiquitous in the public health administration literature and form the framework of public health law modernization efforts, but there is scant research examining the relationship between law and public health system performance. This project conducted a qualitative analysis of public health statues to determine the degree to which terms related to the essential services occur in the enabling portion of these statutes. These data were correlated with the performance scores received for each of the essential services on the National Public Health Performance Assessment (NPHPS) Version 1 instruments from local health departments, local governance bodies (i.e., boards of health) and states. These congruence and correlation findings will contribute to an understanding of the structure of health systems and administration, enhance the practice community's understanding of the relationship of public health laws to system performance, and afford a better understanding of how the NPHPS performance instruments relate to the realities of the public health systems, such as statutes and regulations. By improving an understanding of these links, this research will inform both the improvement of performance assessment and the continuing initiatives to modernize public health statutes.