Strengthening the Performance and Impact of Public Health Departments

Field of Work: Public health services and systems research

Problem Synopsis: Events such as the September 11, 2001 attacks, Hurricane Katrina, the Gulf of Mexico oil spill and increases in obesity and other chronic health problems have prompted a new focus on the nation’s public health delivery system. Policy-makers, practitioners and researchers are paying more attention to the way these diverse and decentralized public health departments are organized, staffed and financed.

Synopsis of the Work: An RWJF national program with major grants to the University of Kentucky and three public health practice associations—the National Association of County and City Health Officials (NACCHO), the Association of State and Territorial Health Officials (ASTHO) and the National Association of Local Boards of Health (NALBOH)—has supported projects to create, expand and promote use of a database of research about public health services and systems; increase the number of researchers interested in public health services and systems research; and develop and sustain the capacity of the three organizations to collect and analyze timely, comparable data on the structure and characteristics of their member agencies and, thereby, of the nation’s public health services and systems.

Key Results to Date

  • F. Douglas Scutchfield, MD, his colleagues at the University of Kentucky, the three public health associations and RWJF staff report significant accomplishments in several areas.

    • Comprehensive, accessible information. As of August 2010, researchers had identified 165 software datasets and located 782 relevant articles, reports and other documents through the literature review. The database of this material is housed in a subset of the Health Services and Sciences Research Resources Web site at the National Library of Medicine.
    • New researchers are entering the field. As of August 2010, 33 researchers had received minigrants. “Some of these grantees have gone on to become professors in this field and have mentored new doctoral students, who might also receive minigrants,” says Scutchfield.
    • Timely, reliable and harmonized surveys. The public health association partners consider the now harmonized surveys to be a significant milestone and accomplishment. Because they are conducted over several years, the associations can see trends in the data. In addition, other researchers have conducted analyses on narrowly defined subtopics.
    • Collaborative relationships and new capacities at the public health associations. Everyone involved credits the process of harmonizing surveys with creating new relationships that have yielded benefits beyond the surveys.
    • Networking and information-sharing. The Keeneland Conference has become an important facilitator of the effort to build public health services and systems research as a creditable field. The conference also has grown significantly. Some 150 people participated in 2008; 350 people participated in 2010.
    • A place in Federal health care reform. The strengthening of public health services and systems research earned a place in the 2010 Patient Protection and Affordable Care Act. Section 4301, Research on Optimizing the Delivery of Public Health Services, authorizes the CDC to provide funding for public health services and systems research.