Developing a Tool to Help Identify Better Ways of Organizing and Delivering Public Health Services at the Local Level

In 2006, a research team based at the University of Arkansas and the University of Kentucky replicated a 1998 survey of large public health systems in order to develop an evidence-based typology of the structure and dynamics of local public health delivery systems. The purpose was to provide researchers and policy-makers with a tool to help identify better ways of organizing and delivering public health services at the local level.

To disseminate its findings, the team published an issue brief and journal articles and organized the first Keeneland Conference on public health services and systems research and its applications.

Key Findings

  • Local public health systems can be classified into seven distinct categories (termed clusters), based on their organizational structure. The classification is based on three factors:
    • The scope of services provided
    • The range of governmental and nongovernmental organizations providing the services
    • The extent to which the governmental public health agency bears the brunt of the delivery effort versus spreading the responsibility across the contributing organizations
  • Local public health systems surveyed for the project frequently migrated across the classifications, trending toward a broader scope of services and engagement with a wider range of organizations.