A strategy for measuring local public health practice

Area of Science:

• Public Health
• Health Services Research
• Health Policy

Background:

• National health objectives for the year 2000 aimed for 90% population coverage by effective local health departments (LHDs).
• Measuring LHD effectiveness was challenging due to a lack of baseline data and accepted assessment methods in 1990.
• The Institute of Medicine and CDC defined core public health functions and practices, providing a framework for evaluation.

Purpose of the Study:

• To develop a surveillance system for measuring the effectiveness of local health departments (LHDs).
• To translate core public health functions and practices into measurable performance standards.
• To establish a nationwide consensus on effective local public health practice measurement.

Main Methods:

• Translated the Institute of Medicine's core functions and CDC's 10 public health practices into practice performance measures.
• Developed performance measures judged as met or not met at the LHD jurisdiction level.
• Field-tested the proposed measures with state-local health liaison officials and LHDs over two years to ensure validity and build consensus.

Main Results:

• A proposed surveillance instrument was established, consisting of 10 performance standards and 29 associated indicators.
• The development process incorporated essential input from key stakeholders, ensuring relevance and validity.
• Two approaches for utilizing the surveillance instrument were described.

Conclusions:

• The developed surveillance instrument provides a standardized method for assessing LHD effectiveness.
• This system supports the national objective of ensuring effective public health services across all populations.
• Continued use and refinement of these performance measures are vital for advancing public health practice.