Online Program

Accreditation Seeking Decisions in Local Health Departments

Tuesday, November 3, 2015

Tyler Carpenter, MPH(c), Department of Health Services Management and Policy, East Tennessee State University College of Public Health, Johnson City, TN
Kate E. Beatty, PHD, MPH, Department of Health Services Management and Policy, East Tennessee State University College of Public Health, Johnson City, TN
Paul Campbell Erwin, MD, DrPH, Professor and Director, Department of Public Health, University of Tennessee, Knoxville, TN
Ross C. Brownson, PhD, The Brown School & Prevention Research Center of St. Louis, Washington University in St. Louis, St. Louis, MO
background: Accreditation of local health departments (LHDs) has been identified as a crucial strategy for strengthening the public health infrastructure. This study seeks to identify the role of organizational and structural factors on accreditation-seeking decisions of LHDs.

data sets and sources: Data were obtained from the NACCHO 2013 National Profile of Local Health Departments Study. . LHDs were coded as “urban”, “micropolitan”, or “rural” based on Rural/Urban Commuting Area codes.  “Micropolitan” includes census tracts with towns of  10,000 - 49,999 population and census tracts tied to these towns through commuting.  “Rural” includes census tracts with small towns of fewer than 10,000 population, tracts tied to small towns, and isolated census tracts. 

analysis: Binary logistic regression analysis was conducted to predict PHAB accreditation decision. Predictors included variables related to rurality, governance, funding, and workforce.

findings:  From a sample of 448, approximately 6% of LHDs surveyed had  submitted their letter of intent or full accreditation application. Over two-thirds were  not seeking accreditation or deferring to the state agency. LHDs located in urban communities were 30.6 times (95% CI: 10.1, 93.2) more likely to seek accreditation compared to rural LHDs. LHDs with a local board of health were 3.5 times (95% CI: 1.6, 7.7) more likely to seek accreditation (controlling for rurality). Additionally, employing an epidemiologist (aOR=2.4, 95% CI: 1.2, 4.9), having a strategic plan (aOR=14.7, 95% CI: 6.7, 32.2) were associated with higher likelihood of seeking PHAB accreditation.

conclusions: : Rural LHDs are less likely to seek accreditation. This lower likelihood of seeking accreditation likely relates to a myriad of challenges. Simultaneously, rural populations experience health disparities related to risky health behaviors, health outcomes, and access to medical care. Through accreditation, rural LHDs can become better equipped to meet the needs of their communities.

Learning Areas:

Administration, management, leadership
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Discuss structural factors on accreditation-seeking decisions of local health departments and the effect of rurality on Public Health Accreditation Board (PHAB) accreditation.

Keyword(s): Accreditation, Local Public Health Agencies

Presenting author's disclosure statement:

Not Answered