PMID- 35692346
OWN - NLM
STAT- MEDLINE
DCOM- 20220614
LR  - 20230202
IS  - 2296-2565 (Electronic)
IS  - 2296-2565 (Linking)
VI  - 10
DP  - 2022
TI  - Associations Between Local Health Department Expenditures on Foundational 
      Capabilities and PHAB Accreditation Standards Scores.
PG  - 861587
LID - 10.3389/fpubh.2022.861587 [doi]
LID - 861587
AB  - CONTEXT: Foundational Capabilities (FC) are the public health (PH) infrastructure 
      areas that are essential for local health departments (LHDs) to support a 
      "minimum package" of programs and services that promote population health. 
      Despite being a critical component of LHD programs, FC are chronically 
      underfunded, and studies specific to the relationship between LHD FC expenditures 
      and their performance-the LHDs' ability to provide essential PH programs and 
      services to their community-have not been previously reported. Public Health 
      Accreditation Board (PHAB) accreditation is a nationally recognized accreditation 
      program for PH agencies. PHAB accreditation assesses LHDs' performance against 
      sets of standards that are based on the 10 essential PH services. Alignment 
      between FC and the PHAB standards presents a means for assessing LHD FC 
      expenditures relative to their performance in PHAB accreditation standards. 
      OBJECTIVES: We examined the association between LHD total FC expenditures, as 
      well as FC funding allocation patterns, and performance score on selected PHAB 
      accreditation standards. METHODS: We used Bayesian regression methods to estimate 
      the coefficients for the aggregate performance score, and performance scores on 
      individual PHAB standards. RESULTS: Analyses showed that a dollar increase in 
      total FC expenditures is associated with a 0.2% increase in the aggregate 
      performance score in selected PHAB standards as well as the performance score on 
      most of the standards examined. LHDs that allocated FC budgets more evenly across 
      FC programs were found to be more likely to have higher scores. CONCLUSIONS: 
      Investment in FC could improve LHD performance scores in PHAB accreditation 
      standards and support LHDs' capability for improving community health outcomes. 
      Allocating available FC resources across the various FC programs could support 
      better LHD performance, as indicated by accreditation scores. This study 
      contributes to advancing the understanding of public health finances in relation 
      to performance and could help guide effective LHD resource allocation.
CI  - Copyright (c) 2022 Dada, Bekemeier, Flaxman and de Castro.
FAU - Dada, Oluwatosin O
AU  - Dada OO
AD  - Department of Child, Family, and Population Health Nursing, School of Nursing, 
      University of Washington, Seattle, WA, United States.
FAU - Bekemeier, Betty
AU  - Bekemeier B
AD  - Department of Child, Family, and Population Health Nursing, School of Nursing, 
      University of Washington, Seattle, WA, United States.
FAU - Flaxman, Abraham
AU  - Flaxman A
AD  - Department of Health Metrics Sciences, School of Medicine, University of 
      Washington, Seattle, WA, United States.
AD  - Department of Global Health, School of Public Health, University of Washington, 
      Seattle, WA, United States.
FAU - de Castro, A B
AU  - de Castro AB
AD  - Department of Child, Family, and Population Health Nursing, School of Nursing, 
      University of Washington, Seattle, WA, United States.
LA  - eng
GR  - T42 OH008433/OH/NIOSH CDC HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220525
PL  - Switzerland
TA  - Front Public Health
JT  - Frontiers in public health
JID - 101616579
SB  - IM
MH  - Accreditation/methods
MH  - Bayes Theorem
MH  - Health Expenditures
MH  - *Local Government
MH  - *Public Health
MH  - Quality Improvement
PMC - PMC9174657
OTO - NOTNLM
OT  - Accountability and Performance Management
OT  - Foundational Capabilities
OT  - Local Health Departments
OT  - Population Health
OT  - Public Health Accreditation
OT  - Resource Allocation
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/06/14 06:00
MHDA- 2022/06/15 06:00
PMCR- 2022/05/25
CRDT- 2022/06/13 02:56
PHST- 2022/02/09 00:00 [received]
PHST- 2022/04/27 00:00 [accepted]
PHST- 2022/06/13 02:56 [entrez]
PHST- 2022/06/14 06:00 [pubmed]
PHST- 2022/06/15 06:00 [medline]
PHST- 2022/05/25 00:00 [pmc-release]
AID - 10.3389/fpubh.2022.861587 [doi]
PST - epublish
SO  - Front Public Health. 2022 May 25;10:861587. doi: 10.3389/fpubh.2022.861587. 
      eCollection 2022.