241975 Comparing public health systems in six states in the southeast region of the US to contribute to infrastructure development and systems change

Tuesday, November 1, 2011: 1:30 PM

Lynn D. Woodhouse, M Ed, EdD, MPH , Professor of Community Health, Jiann- Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA
William Livingood, PhD , CHEQR and & JPHsu COPH, Duval County Health Department & Univ of Florida & Georgia Southern Univ, Jacksonville, FL
DeAnna Keene, MPH , Research Associate, JPHCOPH GSU, Statesboro, GA
Krista D. Mincey, MPH, DrPH (c) , Jiann-Ping Hsu College of Public Health, Doctoral Candidate, Georgia Southern University, Statesboro, GA
In this study we compared state and local public health (PH) systems in six states in the southeast region of the US (AL, FL, GA, NC, SC, TN) to contribute to a better understanding of infrastructure development and systems change. Leadership structure of each state, PH responsibilities, population and demographics of each state/region, types of public health data collected, and health status indicators are some examples of the information used in the comparison. Many specific variables were examined such as whether the state has a board of health and/or local boards of health, funding mechanisms, if there are multi-county health departments, districts, or regions, and who is responsible for running them, if the public health leader of the state is a cabinet level position, and what state agency was responsible for environmental regulation and control. Information was gathered using multiple sources such as the statutes of each state, state public health websites, and repeat in-depth interviews with the communications department of each state to verify information collected and get further clarification as needed. We discovered that there are relationships and agreements among PH entities in some states that are not necessarily reflected in formal written policy. These relationships affect how public health is administered and how resources are shared. The different organizational structures of states were not linked to health outcomes. Local public health was primarily organized around county governance in these southeastern states. Many states did not appear to prioritize accreditation of public health departments with some notable exceptions such as NC. The legal structures that permit and encourage multiple county health departments (NC and GA) may be particularly important for small and/or rural counties to be able deliver all essential health services that will be assessed for accreditation.

Learning Areas:
Administration, management, leadership
Public health administration or related administration
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Compare the public health systems of 6 Southeastern states (FL, GA, TN, NC, SC and AL). 2. Describe the relationship between and responsibilities of state and local public health offices in each of the states. 3. Describe the potential contributions of the different types of systems to quality improvement.

Keywords: Accreditation, Public Health Infrastructure

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Authored articles about and completed national presentations on public health systems
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.