National Longitudinal Survey of Public Health Systems (NLSPHS)

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Since 1998, the National Longitudinal Survey of Public Health Systems (NLSPHS) has followed a nationally representative cohort of U.S. communities to  measure the implementation and impact of multi-sector population health improvement activities. The survey asks local public health officials in each community to report information on a set of 20 activities that are nationally recommended for monitoring, protecting and improving health status at the population level:

The survey captures information on the constellation of organizations in each community—both governmental agencies and private institutions— that participate in implementing these activities, along with measures of the perceived quality of implementation. Data from the NLSPHS are linked with many other national data sources to study how the delivery systems for population health improvement activities vary across communities, how they change over time, and what impact they have on important health and economic outcomes.  A bibliography of studies conducted using the NLSPHS is available here

Data from the NLSPHS are used to monitor the percentage of the U.S. population that is served by a Comprehensive Public Health Delivery System.  A Comprehensive Delivery System supports a broad scope of population health activities through a dense network of multi-organizational and multi-sector relationships.   This measure of access to public health is included in the Robert Wood Johnson Foundation’s set of core metrics for monitoring progress in the Culture of Health Action Framework.

Originally conducted with support from the U.S. Centers for Disease Control and Prevention, the NLSPHS was fielded for the first time in 1998, with follow-up surveys completed in 2006, 2012, 2014 and 2016 (in progress) with support of the Robert Wood Johnson Foundation.  Beginning in 2014, a large sample of communities containing less than 100,000 residents was added to the survey in order to better measure delivery systems in small and rural communities.  Each year, survey respondents receive a customized report of results comparing their community results over time and to national and peer-group norms. 


The choropleth maps shown above display transitions in the percentages of population served by a comprehensive public health system over time in each state.


The maps above display states that are significantly above or below the national average in the percentage of the population served by a Comprehensive Public Health Delivery System.