Associations Between Local Health Department Expenditures on Foundational Capabilities and PHAB Accreditation...

Area of Science:

• Public Health Infrastructure
• Health Services Research
• Health Policy and Management

Background:

• Foundational Capabilities (FC) are crucial for local health departments (LHDs) to deliver essential public health services.
• FC are consistently underfunded, with limited research on the link between FC expenditures and LHD performance.
• Public Health Accreditation Board (PHAB) accreditation provides a framework to assess LHD performance against essential public health services.

Purpose of the Study:

• To examine the association between LHD total FC expenditures and FC funding allocation patterns.
• To assess the relationship between FC expenditures and performance scores on selected PHAB accreditation standards.

Main Methods:

• Bayesian regression methods were employed to estimate the association.
• Analysis focused on aggregate performance scores and individual PHAB standard performance scores.

Main Results:

• A $1 increase in total FC expenditures correlated with a 0.2% rise in aggregate PHAB performance scores.
• LHDs with more even FC budget allocations across programs achieved higher performance scores.

Conclusions:

• Increased investment in FC can enhance LHD performance and their capacity to improve community health.
• Strategic allocation of FC resources across programs is vital for optimizing LHD performance, as indicated by accreditation outcomes.
• This study offers insights into public health finance and performance, guiding effective LHD resource allocation.