142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Local Health Department Communicable Disease Control expenditures and their impact health: Findings from the Public Health Activities and Services Tracking (PHAST) Study

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 8:50 AM - 9:10 AM

Betty Bekemeier, RN, PhD, FAAN , School of Nursing, Department of Psychosocial & Community Health, University of Washington, Seattle, WA
Athena Pantazis, MA MPH , Department of Sociology, University of Washington, Seattle, WA
Michelle Pui-Yan Yip, MN, MHA , Department of Psychosocial and Community Health, University of Washington School of Nursing, Seattle, WA
Matthew Dunbar, PhD , Center for Studies in Demography and Ecology, University of Washington, Seattle, WA
David Grembowski, PhD, MA , Health Services, University of Washington School of Public Health, Seattle, WA
Tao S. Kwan-Gett, MD, MPH , Northwest Center for Public Health Practice, University of Washington School of Public Health, Seattle, WA
Research Objective

Data limitations and the complex ecological relationships involved in examinations of the health outcomes associated with targeted local health department (LHD) investments in specific service areas have hampered studies that could direct and support policy and practice in the delivery of local public health services. Our study used unique and detailed LHD expenditure data specific to Communicable Disease (CD) Control services to examine ecological relationships between these local-level data depicting a level of service expenditures and related health outcomes.   


Uniquely detailed, unpublished annual local-level CD Control expenditure data were obtained from state health departments in three states representing 2005-2010 expenditures and including 144 LHD jurisdictions. We used county-level rates of communicable diseases that could reasonably be associated with variations in LHD spending related to CD Control activities to statistically estimate ecologic relationships between LHD expenditures on CD Control services and health outcomes.


While controlling for confounders, results indicate that significant inverse relationships exist between per capita LHD expenditures in rural areas and county-level rates of enteric disease.  


Beneficial relationships appear to exist between targeted LHD CD Control expenditures and certain related disease outcomes, particularly in rural areas where small increases in funding may have more of an effect. A more standardized system of detailed administrative data collection among LHDs would support deeper analyses and outcomes research regarding LHD services.

Learning Areas:

Administration, management, leadership
Public health administration or related administration
Public health or related public policy
Public health or related research

Learning Objectives:
Describe the relationship found between enteric disease rates and administrative expenditures for Communicable Disease Control among LHDs. Describe the rural and non-rural differences found in this relationship between and LHD’s CD Control expenditures and health outcomes and what this may indicate.

Keyword(s): Funding/Financing, Public Health Administration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have substantial experience in public health practice, public health practice-based research, and public health systems.
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.