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Objective: Collaborative arrangements between local health departments (LHDs) by which they share services, responsibilities, or staff, is a growing occurrence in the US. This phenomenon is referred to as regionalization, resource sharing, or intra-state resource sharing. Participants of this session will learn about the current state of resource sharing among LHDs in terms of the public health activities, nature of the relationships, and geography. We will also discuss which characteristics of LHDs are associated with resource-sharing.

Data Source: Data for this analysis come from the National Association of City & County Health Official's 2010 Profile of Local Health Departments. The sample included 531 organizations and was weighted to reflect all LHDs in the US. Analysis: We examined the extent of resource sharing using two different count variables: 1) the number of shared programmatic activities, and 2) the number of organizational functions shared with other LHDs. Both counts were limited to only those instances occurring on a non-emergency basis. We also examined the bivariate association of resource sharing activities with key structural and organizational variables as well as geography, using appropriate statistical measures.

Principal Findings: About half (51%) of all LHDs engaged in some type of resource sharing. Among those that shared resources, 50% obtained resources form another LHD, 57% provided resources to another LHD, and 56% shared staff/physical resources. The average number of shared programs was higher (1.5) than the average number of shared organizational functions (0.6). LHDs governed by state agencies tended to share more than LHDs with a county or district jurisdiction. Sharing also varied at the state level; in some states the majority of LHDs engaged in resource sharing and in others it was uncommon. Conclusions: The sharing of programs and organizational functions is a common occurrence among LHDs. Existing organizational structures may make sharing arrangements easier.


Reproduced with permission of the National Coordinating Center for PHSSR and the Robert Wood Johnson Foundation, Princeton, N.J. Presentation obtained from the Keeneland Conference site.


2012 Keeneland Conference on Public Health Systems and Services Research