Presentation Title

Leadership Characteristics of Local Health Department Top Executives and Their Impact on Service Provisions

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Abstract or Description

Research Objective: The future of public health is leading towards local health departments (LHDs) focusing more on core public health functions and less on clinical service offerings. While it has been recognized that organizational characteristics and population demographics have an impact on service provision, the characteristics of the top executive also may influence LHD’s service provisions. This study examines the extent to which top executive characteristics impact the level of service delivery change within each program area.

Study Design: This is an observational study with cross-sectional survey design, using a representative sample of LHDs across the United States.

Population Studied: For this study, we used secondary data from the 2016 National Profile of Local Health Departments Survey, conducted by the National Association of County and City Health Officials (NACCHO). All 2,533 LHDs in the country that meet the NACCHO definition of a local health department, were administered a core set of questions. The response rate for the profile study was 76 percent, 1,930 LHDs responded. The 2016 Profile Study is the latest survey conducted to provide an inclusive representation of LHDs’ infrastructure, governance structure, activities, workforce, and a variety of other topics. To account for the sampling design that oversampled larger LHDs, as well as for disproportional nonresponse rates by size of the population in LHD jurisdiction, we applied statistical weights that accounted for jurisdictional size.

Principal Findings: Being a being a Caucasian top executive was associated with higher odds of service reduction in communicable disease screening or treatment (AOR 4.28, p

Conclusions: The characteristics of a LHD top executive (such as top executive’s race, length of tenure and those with graduate degrees) appear to have a significant relationship with the impact on service provisions and should be considered an important factor for service provision priorities.

Implications for Policy or Practice: This research highlights the importance of having effective public health leaders that understand community health needs, use evidence-based decision making, maintain necessary leadership and management skills, and use of performance management models and standards for departmental evaluations. Thus, more work needs to be done to align public health curriculum and continuing education with leadership roles.


Academy Health Annual Research Meeting


Washington, D.C