142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

306725
Local Health Department capacities in medically underserved areas

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Huabin Luo , East Carolina University, Greebville, NC
Sergey Sotnikov, PhD , Office for state tribal local and territorial support, CDC, Atlanta, GA
Nancy Winterbauer, PhD, MS, MA , BSOM, Department of Public Health, East Carolina University, Greenville, NC
Objectives:

1) To evaluate public health capacities in medically underserved areas; 2) To assess whether personal health care services provided by LHDs and primary care capacities in the communities are complements or substitutes.

Methods:

Data are from the 2010 National Profile of Local Health Departments Study and Area Resources File. First, we compared public health infrastructure capacities, measured by per capita public health expenditure, public health workers, and number of personal health care services (22 services) provided by an LHD in a community designated by Health Resources and Services Administration as health professional shortage area (HPSA) with a community that is non-HPSA. Second, we conducted a series of regressions to measure complementarity between elements of public health capacities and primary care capacities at community level. The analytical sample size was 1,535 LHDs/counties.

Results:

The results indicate that the per capita public health expenditures were $67.4 and $52.3, public health workers per 10,000 people were 8.8 and 6.6 FTES, the number of personal health care services per 10, 000 people were 6.7 and 4.2 (ps<0.001), in an HPSA and non-HPSA community, respectively. After controlling for state fixed-effects, regression results indicate that the relationships between the number of public health workers and primary care providers (b=-0.12, p<0.001), and between the number of personal health care services provided by an LHD and primary care providers (b=-0.76, p<0.001) were negative. The association between public health expenditure and number of primary care providers was not significant (b=-0.04, p=0.21).

Conclusion:

Public health agencies have more capacities (in terms of funding and workforce) and deliver more personal health care services in medically underserved areas. Public health agencies as a provider of last resort play an important role of compensating for a lack of primary care.

(The abstract is pending CDC clearance)

Learning Areas:

Public health administration or related administration
Public health or related public policy

Learning Objectives:
Evaluate public health capabilities and primary care capabilities in medically underserved areas

Keyword(s): Public Health Research, Primary Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been doing public health system research in the past six years
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.