Enabling Integration of Local Health Department (LHD) Infrastructure, Community C

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DESCRIPTION (provided by applicant): The specific aim of the proposed study is to develop GIS boundary shape files and assign standard FIPS codes for jurisdictions served by local health departments (LHDs) in the U.S. The shape files and FIPS codes will be attached to data on LHDs' infrastructure and activities collected through NACCHO's National Profile of Local Health Departments (LHD) study, allowing these data to be linked with other sources of data on community characteristics, risk factors, and health outcomes. To accomplish these tasks, NACCHO will compile primary information about LHD's jurisdiction for complex LHDs - those with service regions covering a city or town without 'Place' FIPS code, portion of a single county, or portions of multiple counties. For less complex LHDs with service regions covering single-county, multiple-county, or city with FIPS codes, such information will be extracted from existing resources. The final product will be a database of FIPS codes and boundary shape files for each LHD to represent their service regions, in order to facilitate geo-spatial analyses. The long term objective for the proposed activities is to promote and facilitate studies that examine the relationships among three important components of the public health systems -- local health department infrastructure and activities; community characteristics; and health risk factors and outcomes. NACCHO's National Profile of LHDs (Profile) surveys -- 1990, 1993, 1997, and 2005 (2008 is currently in field)--provide a comprehensive data set on LHDs' infrastructure and practice, including information on LHD structure, governance, financing, workforce, and activities. Researchers, policy makers and practitioners use Profile study data to support public health systems research on a wide range of topics. Public health research studies often require bringing together information from multiple sources to examine the relationship between public health systems, resource allocation, services, and health status outcomes. The scope of such studies, however, is sometimes limited by an inability to link various sources of data for communities with public health system characteristics. The proposed methodology will enable such linkage, and facilitate public health systems research and policy decisions. NACCHO will disseminate products resulting from this project to diverse audiences through a variety of means. PUBLIC HEALTH RELEVANCE: In face of scarcity of resources available for public health and growing threats to the public's health (e.g., bioterrorism, emerging infectious diseases, the obesity epidemic), the proposed work will enable research on ways to improve the nation's public health system. For example, data on cancer prevention activities of local health departments collected by NACCHO's Profile study could be linked with community-level data on cancer incidence, risk factors (e.g., smoking rates), or health-seeking behaviors (e.g., rates of cancer screening), to investigate whether LHD activities influence these outcomes.