This project seeks to explore the relationship between local public health agency performance as assessed by the National Environmental Public Health Performance Standards (NEPHPS) instrument and various measures of local health agency capacity contained in contemporaneous data collected by the 2008 National Association of County and City Health Officials (NACCHO) Profile of Local Health Departments survey instrument, such as distribution of regulation, inspection and licensing activities in a community, as well the ratio of observed/expected cases of E.Coli, Shigella and Salmonella contained in the Community Health Status Indicators (CHSI). Our specific research questions are:
1. What is the effect of direct (local health department) versus indirect (other government agency or contracted to third party) provision of services on public health performance and on community health as reflected by the CHSI data mentioned above?
2. What is the relationship between variations in performance as measured by the NEPHPS instrument and community health as reflected by the CHSI data mentioned above?
3. What is the relationship between variations in environmental workforce capacity (number of FTEs classified as environmental health specialists, as epidemiologists, and as "other environmental scientists or technicians) and public health performance and on community health as reflected by the CHSI data mentioned above?
4. How do LHD that participated in EPHLI compare with peer counties on community health as reflected by the CHSI data? Data from the NEPHPS instruments comes from public health system personnel, mostly health department personnel, responsible for providing environmental health services in a community; this data will be matched with the 2008 Profile and version 2.0 of the CHSI.
Preliminary findings reveal that that those LHDs with increase EH budget have improved performance. There also appears to be a relationship between EPHLI participating and improved environmental health outcomes compared to their peer counties.
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