Trends in state health agency services: 2001-2010

Background and Significance

The emerging field of Public Health Systems and Services Research has sparse literature on the services provided by state health agencies. The ASTHO Profile Survey provides an opportunity to investigate variation among states and track changes over time in the scope of services provided.

Methods

In 2001, Beitsch and colleagues assessed the structure and functions of state public health agencies. The survey was sent to all active state health officials (SHOs), who had the option of completing the survey on paper or via the web. Responses were collected from 47 of the 50 states , yielding a 94% response rate. This assessment was compared to the 2007 ASTHO Profile survey and the 2010 ASTHO Profile Survey. For both of these surveys, links to web-based instruments were emailed to senior deputies in state, territorial and District of Columbia health agencies. For comparability, the current analysis excludes the territories. The response rate among states and the District of Columbia was 100% in 2007 and 2010.

Results

State health agencies have taken on increasing responsibilities over the course of the decade. Many services that were considered “emerging” in 2001, became widespread by 2007. Despite this trend, state health agencies discontinued some services, most likely in response to budget cuts or moves toward health reform. Services that were less commonly provided by SHAs in 2010 than 2007 include health insurance regulation, SCHIP, and tobacco control and prevention.