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Findings from the 2008 National Profile of Local Health Departments Study

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Title: Findings from the 2008 National Profile of Local Health Departments Study


1
Big City LocalHealth Departments
  • Findings from the 2008 National Profile ofLocal
    Health Departments Study

2
National Profile of Local Health Departments Study
  • The National Profile of Local Health Departments
    is a survey of local health department (LHD)
    infrastructure and activities
  • NACCHO sends the Profile questionnaire to every
    LHD in the U.S.
  • Completed by 83 of all LHDs in 2008
  • Data are self-reported by LHDs and not
    independently verified by NACCHO
  • Source of all data in this presentation is from
    2008 findings

3
Big City Local Health Departments
  • Defined for the purpose of this report as LHDs
    that serve a city of 350,000 or more
  • Based on 2008 Census estimates
  • 49 LHDs meet the Big City definition
  • 47 Big City LHDs included in this analysis
  • 1 Big City LHD did not respond to the 2008
    Profile questionnaire
  • District of Columbia omitted because of unique
    status
  • Big City LHDs serve a variety of jurisdictions
  • 36 serve combined city-county jurisdictions
  • 34 serve county jurisdictions
  • 28 serve city jurisdictions
  • 2 serve multi-county, district or regional
    jurisdictions
  • Many Big City LHDs (62) have a Local Board of
    Health

4
Big City LHDs Included in Analysis
Alameda County Public Health Department (Oakland) El Paso County Department of Health and Environment (Colorado Springs) New York City Department of Health and Mental Hygiene
Austin/Travis County Health and Human Services Fresno County Department of Public Health Oklahoma City-County Health Department
Baltimore City Health Department Fulton County Department of Health and Wellness (Atlanta) Philadelphia Department of Public Health
Boston Public Health Commission Houston Department of Health and Human Services Pima County Health Department (Tucson)
Chicago Department of Public Health Kansas City Health Department Public Health - Seattle and King County
City of Cleveland Department of Public Health Long Beach Department of Health and Human Services Sacramento County Department of Health and Human Services
City of El Paso Department of Public Health Louisville Metro Department of Public Health and Wellness San Antonio Metropolitan Health District
City of Milwaukee Health Department Maricopa County Department of Public Health (Phoenix Mesa) San Francisco Department of Public Health
City of Saint Louis Department of Health Marion County Health Department (Indianapolis) Santa Clara County Public Health Department (San Jose)
Columbus Public Health Mecklenburg County Health Department (Charlotte) Sedgwick County Health Department (Wichita)
County of Los Angeles Department of Public Health Memphis and Shelby County Health Department Southern Nevada Health District (Las Vegas)
County of San Diego Health and Human Services Agency, Public Health Services Metro Public Health Department (Nashville) Tarrant County Public Health Department (Fort Worth Arlington)
Denver Department of Environmental Health and Denver Public Health Miami-Dade County Health Department Tulsa City-County Health Department
Detroit Department of Health and Wellness Promotion Minneapolis Department Health and Family Support Virginia Beach Department of Public Health
Douglas County Health Department (Omaha) Multnomah County Health Department (Portland) Wake County Human Services (Raleigh)
Duval County Health Department (Jacksonville) New Mexico Department of Health, Albuquerque and Las Cruces Districts (Albuquerque)
5
Distribution of Big City LHDs by Size of
Population Served
6
Distribution of Big City LHDs by Total Annual
Expenditures
7
Big City LHDs Mean and Median LHD Expenditures
by Size of Population Served
Size of Population Served Mean Median
350,000 499,999 27,900,000 21,700,000
500,000 749,999 54,100,000 27,700,000
750,000 999,999 167,000,000 54,500,000
1,000,000 1,999,999 158,000,000 87,800,000
2,000,000 384,000,000 105,000,000
8
Mean Percentage of Total LHD RevenuesBig City
and Nationallyfrom Various Sources
List does not represent all sources of revenue
9
Mean and Median Per Capita Revenues Big City
and Nationally from Selected Sources
Mean Mean Median Median
Source of Revenue Big City National Big City National
All revenues 105 66 51 37
Local revenues 31 15 13 7
State direct revenues 14 11 4 6
Federal pass-through revenues 10 8 8 5
Federal direct revenues 12 2 4 0
10
Characteristics of LHDs Top Executives Big
City and Nationally
 Characteristic Big City National
Full-time position 100 86
Less than two years in position 28 21
Ten or more years in position 21 35
Race White 70 94
Hispanic 11 2
Female 40 56
Holds graduate degree 98 62
Holds public health degree 53 21
Holds medical degree (MD) 47 14
Holds registered nurse (RN) licensure 20 39
11
Percentage of Big City LHDsEmploying Selected
Occupations
12
FTEs Employed by Big City LHDs Median and
Median per 100,000 Population for All Staff and
Selected Occupations
Occupation Median (FTEs) Median FTE per 100,000 population
Total FTEs 436.5 53.7
Clerical staff 84.6 9
Nurse 62 5.4
Environmental health professional 33 4.7
Manager/Director 20 2.6
FTEFull-time Equivalent Environmental health
professional includes EH specialists (Sanitarian)
and Other EH scientists
13
FTEs Employed by Big City LHDs Median and
Median per 100,000 Population for Selected
Occupations
Occupation Median Median per 100,000 population
Nutritionist 11 1.3
Behavioral health professional 9.5 1.3
Health educator 9 1
Information systems specialist 4 0.6
Epidemiologist 3 0.5
Physician 5 0.4
Public information specialist 1 0.2
Emergency preparedness coordinator 1 0.2
14
Top Activities ServicesProvided by Big City
LHDs
Activity or Service Percent of LHDs
Communicable/Infectious disease surveillance 98
Adult Immunization 96
Child Immunization 96
Tuberculosis screening 96
Population-based nutrition services 96
Tuberculosis treatment 94
HIV/AIDS screening 94
Maternal and child health surveillance 91
STD treatment 91
15
Activities ServicesProvided More Frequently by
Big City LHDsCompared Nationally
Activity or Service Big City LHDs National Difference (Big City -National)
Laboratory services 83 25 58
Syndromic surveillance 89 40 50
Asthma prevention and/or management 64 26 38
STD treatment 91 57 35
Vital records 84 50 35
HIV/AIDS screening 94 59 34
Oral health services 62 29 33
Maternal and child health surveillance 91 61 30

16
Activities ServicesProvided Less Frequently in
Big City LHDsCompared Nationally
Activity or Service Big City LHDs National Difference (Big City -National)
Children's camps regulation 23 48 -25
Home health care 7 25 -18
Campgrounds/ Recreational vehicles regulation 24 42 -18
Septic systems regulation 50 68 -18
Private drinking water regulation 47 59 -12
High blood pressure screening 58 68 -10
Groundwater protection 33 41 -8
Solid waste haulers regulation 22 29 -7
Mobile homes regulation 24 30 -6

17
Emergency Preparedness Activities in Big City
LHDs
Activity Percent of LHDs
Participated in tabletop drills or exercises 98
Developed or updated pandemic flu preparedness plans 96
Updated a written emergency response plan based on recommendations from an exercise After Action Report (AAR) 96
Participated in functional drills or exercises 96
Provided emergency preparedness training to staff on NIMS compliance 91
Reviewed relevant legal authorities to isolate and/or quarantine individuals, groups, facilities, animals, food products 87
Participated in full-scale drills or exercise 81
Assessed emergency preparedness competencies of staff based on the nine core Emergency Preparedness Competencies and the agencys all-hazard response plan 57
18
Addressing Health Disparities in Big City LHDs
Activity Percent of LHDs
Supported community efforts to change the causes of health disparities 96
Described health disparities in jurisdiction using data 96
Prioritized resources and programs specifically for the reduction in health disparities 85
Educated elected or appointed officials about health disparities and their causes 83
Trained workforce on health disparities and their causes 81
Recruited workforce from communities adversely impacted by health disparities 68
Took public policy positions on health disparities 64
Conducted original research that links health disparities to difference in social or environmental conditions 47
19
Percentage of Big City LHDs Performing Community
Health Assessment and Improvement Planning in
Past Three Years
20
For more information, emailProfileTeam_at_naccho.or
g
Mission The mission of the National Association
of County and City Health Officials is to be a
leader, catalyst, and voice for local health
departments in order to ensure the conditions
that promote health and equity, combat disease,
and improve the quality and length of all lives.
The 2008 Profile was made possible through
funding from the Centers for Disease Control and
Prevention and the Robert Wood Johnson
Foundation. 
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