Relationship between tobacco program spending and network relationships

Recent research has highlighted the importance of non-governmental community partners in New Hampshire, finding that they provide nearly half of all spending on local public health and allocate a greater share of their funding to promoting healthy behaviors.  Despite the importance of their contributions, little is known about how these community partners interact with traditional public health agencies.

Focusing on tobacco control and cessation activities, this study builds a network map of all governmental and community partners in four large health regions, measuring trust, collaboration and value.  In total, over thirty organizations are surveyed.  Data is also collected on tobacco program spending, staffing, service volumes and resource use.  This data is linked to demographics, community health status indicators, and NACCHO profile data.

We analyze the association between resource allocation and network position.  Specifically, are funding sources, spending levels, service volumes or relative resource allocations associated with the levels of trust, collaboration and value in the network of organizations?  Models allow for the influence of other determinants, such as population, poverty, income inequality, age and other health indicators.

Initial findings indicate the network trust is not exclusively related to funds flow, implying that goodwill cannot simply be bought.  Further, levels of collaboration are higher in networks that provide a broader breadth of services, possibly implying that task complexity inspires teamwork.  The association between network characteristics and operating efficiency seems to be tempered primarily by other determinants, such as population and poverty.

This project continues research into the role played by non-governmental community partners in the improvement of community health.  Exploring the association between network characteristics and service delivery improves understanding of the powerful influence of relationships on the effectiveness of extended public health systems.