1. The National Profile of Local Health Departments study Barbara Laymon, MPH June 7, 2008

2. The problem – and the NACCHO response 1988 The Future of Public Health (Institute of Medicine report): “…data on the activities of local health departments are hard to come by.” 2007 Public Health Performance (Academy of Health White Paper by Scutchfield and Bandari) “…The litany of issues is long, and includes such concerns as assuring that data is collected on public health infrastructure, practice, and performance… Those of us in the public health practice are research arena are frustrated at the lack of research that will guide our efforts to improve public health practice, and, by that declination, the health status of communities.” 2008 Letter to LHDs (NACCHO) “…The National Profile study is the only study that includes every LHD in the U.S. and is the only national source of critical information on infrastructure and public health practice at the local level.”

3. Background 1990 NACCHO conducted the first National Profile of Local Health Departments study. Funded by the CDC, the six page questionnaire had a 77% response rate. 1993 NACCHO conducted the second Profile study. Funded by the CDC and the NIOSH, the instrument, with a 13-page core section and an 8 page section on occupational safety and health, had a 72% response rate. 1996 NACCHO conducted a limited Profile study. Funded by the CDC, the five page questionnaire had an 88% response rate. 1999 Mathematica conducted the 1999 Local Health Department Infrastructure Survey, with guidance from NACCHO. The study was a sample survey (n = 1100), yielding a response rate of 63%. 2005 NACCHO conducted the 2005 National Profile of Local Health Departments study, funded by the CDC, with supplemental funding from HRSA and the NLM. The study was launched in a web-based format, with a response rate of 80%.

4. 2008 study Similar in format to the 2005 study, a web-based design with a core section for all participants and three modules, to be distributed in a stratified random design. Nine new topic areas included in modules. Timeline Highlights: June 2008 – Completion of Pilot study July – October 2008 - Fielding of survey Fall 2009 – NACCHO publishes initial findings, data available for further research.

5. Data Use Policy Goals of the data use policy: 1.Make Profile data available to the public health community and to other interested parties. 2.Assure that data are shared appropriately and that confidentiality of respondents is respected. 3.Track use of the Profile data.

6. Denominator questions Every National Profile study has used the same definition of a local health department: An administrative or service unit of local or state government concerned with health, and carrying some responsibility for the health of a jurisdiction smaller than the state. In the 2005 National Profile study, a total of 2,864 LHDs were included in the study population.

7. Future directions (dependent on funding!) Data harmonization Longitudinal analysis and linking of files GIS capacity Increased online access to public information

8. Acknowledgements Carolyn Leep Marisela Rodela Gulzar Shah Profile Workgroup members: Joan Ellison, chair; Steve Gold, Lea Morgan, Lee Thielen, Richard Brown, Kristine Gebbie, Glen Mays, Bernard Turnock, Dennis Lenaway, Charles Moon, and Jim Pearsol

9. Contact information Barbara Laymon, Program Manager, Profile Study blaymon@naccho.org 202-507-4240 (direct line) 202-783-5550 (NACCHO) http://www.naccho.org/profile