Background: Underserved subgroups face barriers when accessing behavioral healthcare. Local health departments (LHDs) are charged with “linking people to needed personal health services and assure the provision of healthcare when otherwise unavailable”.
Research Objectives: 1) To assess the extent to which LHDs implement and evaluate strategies to target the behavioral healthcare needs for the underserved populations; 2) To identify factors that are associated with these undertakings.
Datasets and Sources: Data were drawn from the 2013 National Profile of Local Health Departments Study conducted by National Association of County and City Health Officials The Module 2 questionnaire of the Profile contained question about strategies used by LHDs to target the behavioral healthcare needs of the underserved populations (N=505).
Study Design: Cross-sectional, quantitative survey.
Analysis: Factors associated with assuring access to behavioral health services were examined by using logistic regression analyses. Descriptive statistics were also computed. To account for complex survey design, we used SVY routine in Stata 11.
Principal Findings: About 30% of LHDs implemented or evaluated strategies to target the behavioral healthcare needs of underserved populations in their jurisdiction. Our multivariate analysis indicates that LHDs with city/multicity jurisdiction (AOR=0.16, 95% CI: 0.04-0.77), centralized governance (AOR=0.12, 95% CI: 0.02-0.85), and those located in the South Region (AOR=.0.25, 95% CI: 0.08-0.14) or the West Region (AOR=.0.36, 95% CI: 0.14-0.94) were less likely to have targeted the behavioral healthcare needs of the underserved. LHDs with higher per capita expenditures (AOR=1.85, 95% CI: 1.00-3.42), or those with greater number of activities to address health disparities (AOR=1.27, 95% CI: 1.08-1.49) had higher odds of having targeted the behavioral healthcare needs of the underserved.
Conclusion: Extent to which the LHDs implemented or evaluated strategies to target the behavioral healthcare needs of the underserved populations varied by centralization of governance, the degree to which LHDs were well-funded, health disparities reduction activities, geographic region, and jurisdiction type.
Implications for Public Health: Policy and practice focus on mental health issues in under-served populations is ever more critical, given the low proportion of LHDs targeting behavioral health needs, and the increased vulnerability of underserved population emanating from recent financial crises.
Keeneland Conference on Public Health Systems and Services Research, Lexington, KY
Shah, Gulzar H. Dr..
"LHDs' Implementation and Evaluation of Strategies to Target Psychological, Mental Health, and Other Behavioral Healthcare Needs of the Underserved Population."
Health Policy and Management Faculty Presentations.