Background
Public health systems are charged with protecting the health and well-being of the
communities they serve. Higher-performing public health systems should be associated
with improved community health status. Currently, little research examines the impact
of variations in public health system performance on community health outcomes.
Purpose
The current study seeks to provide local public health system partners with evidence
regarding the impact of their efforts. It does so through examining the relationship
between variations in local public health system performance in providing the core
functions of public health (assessment, assurance, and policy development) and community
health outcomes.
Methods
Measures of community health status (dependent variables) and community demographic
characteristics, collected from 1994 to 2003, were merged with measures of public
health system performance collected from 2002 to 2007 (independent variables). For
each dependent variable, Pearson correlations were calculated with all of the independent
variables. Multivariate linear regression models were developed for each health outcome.
Analysis was completed in 2010.
Results
Bivariate analysis found nine associations between local public health system performance
and health outcomes. Linear regression models found associations between performance
and three of the six outcomes measured. The outcomes associated with performance are
those that would seem to be most sensitive to variations in practice. Poverty is significantly
associated with all the health outcomes measured.
Conclusions
These associations between performance and health outcomes suggest that improving
performance of the core functions of public health may improve health.
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© 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
