Cross-Jurisdictional Sharing at State Health Agencies: A Longitudinal Analysis

State health agencies (SHAs) serve an essential function in promoting and protecting the health of Americans.  To most effectively perform their responsibilities, SHAs must have sufficient resources.  With the current climate of limited resources, cross-jurisdictional sharing may be utilized to efficiently provide services across states and within local health departments.  The current study’s goal is to examine the longitudinal trends of cross-jurisdictional sharing at SHAs.

 

The Association of State and Territorial Health Officials (ASTHO) conducts an online survey of state health agencies every two to three years to document their structure, functions, and resources. In the 2010 and 2012 surveys, respondents were asked about recurring non-emergency sharing of resources with other SHAs, facilitating recurring sharing of resources among local health departments, services and functions shared, and the nature of agreements.  The 2012 ASTHO Profile survey was administered to the 50 states, D.C, and U.S. territories and freely-associated states in October 2012.  Forty-eight states and D.C responded to the 2012 survey.  Data cleaning was completed and unusual values were clarified.  Descriptive statistics were calculated using SPSS.   

Analyses indicate that state-to-state sharing of resources on a recurring, non-emergency basis declined from 2010 to 2012, while the facilitation of sharing among local health departments within states increased.  Trends show increased usage of formal agreements to share resources, and increased sharing of resources in a number of different functional categories.

 

Examining longitudinal trends in cross-jurisdictional sharing in SHAs provides insight into how SHAs have adjusted to the economic climate of reduced resources.  The decreased recurring non-emergency sharing of resources between states coupled with increased non-recurring sharing may be indicative of increasing efficiency in service delivery by SHAs in a normal climate.  Future research should assess the frequency of non-recurring cross-jurisdictional sharing to gain a better understanding about the nature of this type of sharing.