Characteristics of local health departments associated with community health assessment and community health improvement planning

Background: Even with much emphasis on community health assessment (CHA) and community health improvement planning (CHIP) over the past two decades, only approximately 51% of the local health departments (LHDs) reported completing a CHA and (or) CHIP and 65% planned to complete a CHA or CHIP in the next three years. The purpose of this study is to determine the characteristics of local health departments that are associated with completing a CHA and CHIP. Methods: This study used data from the 2005 National Profile of Local Health Departments. A total of 2,300 LHDs were included in this study. The dependent variables were CHA (Yes/No) and CHIP (Yes/No). The independent variables included the following local health department characteristics: type of jurisdiction, type of governance, workforce, leadership, and funding. Pearson Chi-square test and independent samples t-tests were used to analyze the data. Results: The LHD characteristics that were statistically significantly associated with completing a CHA and a CHIP include total number of LHD Full Time Equivalent (FTEs) employees, epidemiologist FTEs, health educator FTEs, expenditures per 100,000 population, and county jurisdiction type. LHDs that had a board of health with governing and policy functions were significantly associated with completing CHA. LHDs that had a top agency executive with a public health degree were positively associated with CHIP. Conclusions: The results of this study correlate with the recommendations developed by the Institute of Medicine that suggest that the essentials needed by LHDs in order to complete CHA and CHIP are workforce, funding, and leadership.