To have or not to have a Board of Health: Impact on policy making and advocacy, collaborations and partnerships and emergency preparedness

Objective: To study the relationship between the presence of a Board of Health (BOH) and the local public health departments' (LHDs) ability to have a policy making and advocacy role, work in projects in partnerships with public and private organizations and perform emergency preparedness (EP) activities.

Methods: Cross-sectional analysis of the NACCHO 2005 National Profile. Survey items were combined into three summary scales: policy making and advocacy, collaboration and partnership and emergency preparedness. The impact of the presence of a BOH on the LHDs' score reported in each scale was investigated by means of a linear regression model, adjusting for the population size of the area served by the LHD and the number of employees.

Results 75% of LHDs surveyed by NACCHO reported to have a BOH. Our results indicate that, after adjusting for the population size served by the LHD and number of employees, LHDs that have a BOH are more likely to have performed policy making and advocacy activities (i.e. prepared issue briefs for policy makers, communicated with legislators, participated on local or state boards advisory panels), and have undertaken EP activities (i.e. written an emergency response plan, participated in drills and exercises). On the contrary, the presence of a BOH resulted to have a negative impact on the LHDs' ability to work in projects in partnerships with other agencies; however the LHD's number of employees resulted to be an effect modifier of such relationship. Propensity scores were developed to adjust for the results.