Case Studies of Five Regional Public Health Structures - How They Contribute to Public Health Preparedness

Regionalization in local public health systems: Variation in rationale, implementation and impact on public health preparedness

In this 2006 to 2007 project, Michael A. Stoto, PhD, and a team of researchers and public health officials at RAND Corporation and elsewhere conducted case studies of five regional public health structures and then compared them. (Regional public health structures are local public health departments that work together to maximize resources and improve responses to emergencies and the provision of essential public health services.)

The five regions were Massachusetts; one region in the Boston area; Northern Illinois; Nebraska; and the Washington, D.C., metropolitan area. Each case study documents the rationale for creating the regional public health structure and describes how it was organized, implemented and governed.

The project was part of the Robert Wood Johnson Foundation (RWJF) Changes in Health Care Financing and Organization (HCFO) national program. HCFO supports policy analysis, research, evaluation and demonstration projects that provide public and private decision leaders with usable and timely information on health care policy and financing issues.

Key Findings

  • The project director reported the following findings in an article in Public Health Reports (July–August 2008):

    • The five regions developed their regional public health structures using different combinations of coordination, standardization, centralization and networking. Each region used multiple approaches for different public health functions.
    • Regionalization improves public health preparedness by allowing for more efficient use and better coordination of resources.
    • Regionalization may improve public health in general.

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