Examining the impact of the legal structure and governance of local boards of health on population-health outcomes

The Foundation's program, Public Health Law Research: Making the Case for Laws That Improve Health, was designed to build the evidence for public health law and policy, translate research findings into practical tools to increase the support for and use of law by policy makers and public health practitioners, and to translate findings to other fields and venues to improve and protect health.This study analyzes the impact of the governance and policy structure of local public health departments (LHD) on public health outcomes, placing LHDs in the context of their state and community. The study also examines the state and community context, the LHD administrative structure, LHD financial health, leadership, innovation and service delivery, and an index of local health. The research hypothesis posits that, regardless of the context of the community and state, more innovative and professionalized LHDs result in healthier communities. The study will analyze the top 100 healthiest counties and the bottom 100 healthiest counties in the United States. Quantitative statistical analysis tests the overall research hypotheses. To further examine the quantitative findings and assess their relevance to LHDs, the study will survey public health administrators in a three-state region in the Midwest. Finally, 20 counties will be selected from across the United States for more detailed analysis. The logic model advanced by this study posits that LHD structures and policies impact a community's overall health. By examining the overall health of a community as the dependent variable, the broad impact of these structures and policies can be fully assessed. The study will clearly reveal the structures that can have the strongest positive impact on improving a community's health, controlling for other factors. The information provided by this analysis is critical to improving health at the local level, where public health service delivery is most critical. This study will help illuminate the types and kinds of reforms and other structural changes that will have the most significant impact in public health. Deliverables include research manuscripts, peer-reviewed articles and presentations at conferences and to stakeholder groups.

Grant Details

Amount Awarded $443,547.00

Awarded on: 10/19/2010

Time frame: 11/15/2010 - 5/14/2013

Grant Number: 68400


University of Illinois at Chicago

601 South Morgan Street
Chicago, 60607-7100


Scott Page Hays
Project Director