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

描述（申请人提供）：拟议研究的具体目标是开发GIS边界形状文件，并为美国地方卫生部门（LHD）服务的司法管辖区分配标准FIPS代码。形状文件和FIPS代码将附加到通过NACCHO的国家地方卫生部门（LHD）研究概况收集的LHD基础设施和活动数据中，使这些数据能够与社区特征、风险因素和健康结果的其他数据来源联系起来。为了完成这些任务，NACCHO将为复杂的LHD编制有关LHD管辖权的主要信息-这些LHD的服务区域覆盖没有“地点”FIPS代码的城市或城镇，单个县的一部分或多个县的一部分。对于服务区域覆盖单个县、多个县或具有FIPS代码的城市的不太复杂的LHD，将从现有资源中提取此类信息。最终产品将是一个FIPS代码数据库和每个铲运机的边界形状文件，代表其服务区域，以便利地理空间分析。拟议活动的长期目标是促进和便利研究，审查公共卫生系统三个重要组成部分之间的关系-地方卫生部门的基础设施和活动;社区特点;以及健康风险因素和结果。NACCHO在1990年、1993年、1997年和2005年（2008年目前正在实地调查）进行的全国LHD概况调查提供了关于LHD基础设施和做法的综合数据集，包括关于LHD结构、治理、融资、劳动力和活动的信息。研究人员、政策制定者和从业人员使用Profile研究数据支持公共卫生系统对广泛主题的研究。公共卫生研究通常需要汇集来自多个来源的信息，以检查公共卫生系统，资源分配，服务和健康状况结果之间的关系。然而，由于无法将社区的各种数据来源与公共卫生系统的特点联系起来，这类研究的范围有时受到限制。拟议的方法将使这种联系成为可能，并促进公共卫生系统的研究和政策决定。NACCHO将通过各种手段向不同的受众传播该项目产生的产品。公共卫生相关性：面对公共卫生资源的稀缺和对公众健康日益增长的威胁（例如，生物恐怖主义、新出现的传染病、肥胖流行病），拟议的工作将使研究如何改善国家的公共卫生系统成为可能。例如，NACCHO的概况研究收集的地方卫生部门癌症预防活动的数据可以与社区一级的癌症发病率、风险因素（例如，吸烟率），或寻求健康的行为（例如，癌症筛查率），以调查LHD活动是否影响这些结果。

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.