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Application for Public Health Accreditation Among US Local Health Departments in 2013 to 2019: Impact of Service and
Jonathon P Leider1, Jessica Kronstadt1, Valerie A Yeager1
1Jonathon P. Leider is with the Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN. Jessica Kronstadt, Chelsey K. Saari, and Paul Kuehnert are with the Public Health Accreditation Board (PHAB), Alexandria, VA. Valerie A. Yeager is with the Department of Health Policy and Management at the Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN. Kellie Hall, Aaron Alford, and Lori Tremmel Freeman are with the National Association of County and City Health Officials (NACCHO), Washington, DC.
Abstract:
Objectives. To examine correlates of applying for accreditation among small local health departments (LHDs) in the United States through 2019.Methods. We used administrative data from the Public Health Accreditation Board (PHAB) and 2013, 2016, and 2019 Profile data from the National Association of County and City Health Officials to examine correlates of applying for PHAB accreditation. We fit a latent class analysis (LCA) to characterize LHDs by service mix and size. We made bivariate comparisons using the t test and Pearson χ2.Results. By the end of 2019, 126 small LHDs had applied for accreditation (8%). When we compared reasons for not pursuing accreditation, we observed a difference by size for perceptions that standards exceeded LHD capacity (47% for small vs 22% for midsized [P < .001] and 0% for large [P < .001]).Conclusions. Greater funding support, considering differing standards by LHD size, and recognition that service mix might affect practicality of accreditation are all relevant considerations in attempting to increase uptake of accreditation for small LHDs.Public Health Implications. Overall, small LHDs represented about 60% of all LHDs that had not yet applied to PHAB.
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