Public Health Departments May Need to be Regionalized, 1999 Survey Suggests

In 1999, the National Association of County and City Health Officials (NACCHO), a national, Washington-based organization of local health officials, conducted a national survey of local public health agencies in order to profile local public health infrastructure.

Key Findings

Project staff disseminated project findings in a report, Local Public Health Infrastructure: A Chartbook and online. Findings include:

  • Sixty percent of local public health agencies are county-based; 69 percent of all agencies serve jurisdictions with a population of less than 50,000.
  • The median annual local public health agency expenditure in constant 1999 dollars was $621,100.
  • The most common programs and services provided by local public health agencies include:
    • Adult and child immunizations.
    • Communicable disease control.
    • Community assessment.
    • Community outreach and education.
    • Environmental health services.
    • Epidemiology and surveillance.
    • Food safety.
    • Health education.
    • Restaurant inspections.
    • Tuberculosis testing.
  • Currently, the greatest workforce needs are consistent across local public health agencies, and include public health nurses, environmental scientists and specialists, administrative support, health educators and epidemiologists.
  • Overall, local public health agencies cited funding as one of the biggest challenges facing them.