Toward Evidence-based Population Health Practice in Local Health Departments: Evidence from the 2010 NACCHO Profile Survey

LHDs are responsible for addressing population health and are expected to use an evidence-based public health approach but many address health issues without doing either. As a first step toward identifying local, community, and state factors that facilitate the use of EBPH, we examine the extent to which LHDs reported using evidence-based practices and interventions. Data were from a statistical sample (n=516) of all LHDs that participated in NACCHO's 2010 National Profile of LHDs Study.

Twenty-two percent of LHDs report using the Community Guide in a few to all programmatic areas; 45% did not use it. LHDs were most likely to report using epidemiology and surveillance for communicable diseases (91% of LHDs), environmental health (77%), and maternal/child health (62%). Fewer LHDs conducted syndromic (45%) or behavioral risk factor (36%) surveillance. Many LHDs conducted community health assessments (75%, but only 43% in the last 3 years) and developed health improvement plans (58%). Twenty-six percent applied research findings to organizational practices; 16% helped other organizations apply research to practice. The most common population-based primary prevention activities that LHDs reported using were for nutrition (71%), tobacco use (69%), physical activity (55%), and unintended pregnancy (52%). Fewer than half of the LHDs used primary prevention activities associated with injury (39%), substance abuse (27%), or mental illness (13.4%). LHDs are strong in some areas and there is room for improvement in others. The picture might be overly optimistic as some people may have different definitions of or over report the use of these strategies.