Local Health Departments (LHDs) undergoing PHAB accreditation may need to engage with a number of public health systems partners to satisfy certain accreditation standards and pre requisites. In addition, the accreditation process may position LHDs to more effectively deliver core and foundational public health services due to PHAB’s emphasis on core public health activities. This may result in the development of more comprehensive public health systems, which deliver a greater variety of services, and often engage more organizations in the delivery of services. The aims of this project were to identify the differences in public health system structure and the effectiveness of the delivery of public health services between LHDs that have achieved PHAB accreditation and those that have not.
Study Design: Longitudinal Survey Design
Population Studied: The National Longitudinal Survey of Public Health Systems (NLSPHS) tracks a nationally representative sample of 397 LHDs that serve a population of 100,000 or greater. The NLSPHS is sent to local public health officials, and asks a variety of questions relating to three main areas: the kinds of public health activities performed in the community, the variety of organizations contributing to these activities, and the perceived effectiveness of each activity.
Substantial differences in service delivery and system structure were observed between accredited and non-accredited LHDs, even after controlling for confounders. Public health systems with accredited LHDs generally exhibited greater involvement of organizations in the delivery of public health activities, and greater effectiveness of public health activities.
Conclusions: PHAB accreditation may result in the development of more comprehensive public health systems.
Implications for Public Health Policy or Practice:
Evidence suggests that more comprehensive public health systems are associated with improved service delivery, economic benefits, and favorable health outcomes. Thus, PHAB accreditation may be an effective pathway for LHDs to pursue to assure optimal delivery of public health services.