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administrative structure, performance standards, personnel, public health finance, public health practice



  1. Bhandari, Michelyn W. DrPH
  2. Scutchfield, F. Douglas MD
  3. Charnigo, Richard PhD
  4. Riddell, Martha C. DrPH
  5. Mays, Glen P. PhD


This study examined the relationship between community and system characteristics of 353 local public health agencies and local public health system performance by revisiting previous research by Mays et al and Scutchfield et al. More recent and coterminous data were used. Local public health agency characteristics were obtained from the National Association of City and County Health Officials' 2005 National Profile of Local Public Health Departments and performance data were obtained from version 1 of the National Public Health Performance Standards Program local performance assessment instrument. Descriptive analyses and multivariate analyses similar to the two previous studies were employed. Population size, presence of a local board of health and whether the board makes policy, educational background of the local public health agency's top executive, and jurisdiction type were found to be important predictors of local public health performance. These findings support some of the earlier findings but do not support all the findings of the earlier studies. Variances are discussed. This study provides researchers and practitioners with an evidence base from which to make suggestions regarding characteristics, many changeable, which may influence system performance.