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local public health agency, local public health system, performance, performance monitoring, public health functions



  1. Kanarek, Norma PhD, MPH
  2. Stanley, Jennifer MA
  3. Bialek, Ron MPP


This study describes the results of an analysis of the relationship between local public health agency performance and health outcomes. Findings support the model that local public health agency performance affects community health status, and depending on the outcome, performance contributions vary. New hypotheses are offered that could help determine how system performance affects health outcomes.