| Leadership matters: local health department clinician leaders and their relationship to decreasing health disparities. | |
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MedLine Citation:
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PMID: 22286291 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: : The activities that local health departments (LHDs) conduct and their workforce characteristics change over time. We know little, however, about how changes among the services LHDs conduct are associated with the nature of LHD leadership and how these factors impact health. This study investigated changes in LHD services and leadership and how these changes are associated with mortality disparities. DESIGN: : We conducted regression analyses of secondary data using an exploratory panel time series design. MEASURES: : We used secondary data to investigate changes in LHD services and leadership and how these changes were associated with each other and with 1993 to 2005 changes in black-white mortality disparities. Local health department services were examined relative to change in breadth of services within each of 10 program domains between 1993 and 2005. LHD leadership was examined for discipline of the lead executive in 1993 and 2005. STUDY POPULATION: : Our sample included 558 county or multicounty "common local areas," representing county-level data for LHDs and their jurisdictions. RESULTS: : Significant beneficial relationships exist between having a clinician as lead executive in an LHD and reductions in black-white mortality disparities. Local health departments with a clinician (usually a nurse or physician) as their lead executive in 1993 and/or 2005 experienced a significant decrease in black-white mortality disparities for young adults (age 15-44 years) in their jurisdictions from 1993 to 2005 when compared with LHDs with nonclinician leaders. CONCLUSIONS: : The discipline of an LHD's lead executive as a clinician appears to have a significant relationship with the impact of LHD practice on reducing black-white mortality disparities. This study suggests that the discipline of an LHD's leadership may be an important factor to consider in relation to local public health capacity to impact health disparities. Further research related to the mechanisms at play in these relationships is warranted. |
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Authors:
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Betty Bekemeier; David Grembowski; Youngran Yang; Jerald R Herting |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of public health management and practice : JPHMP Volume: 18 ISSN: 1550-5022 ISO Abbreviation: J Public Health Manag Pract Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-01-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9505213 Medline TA: J Public Health Manag Pract Country: United States |
Other Details:
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Languages: eng Pagination: E1-E10 Citation Subset: T |
Affiliation:
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Department of Psychosocial and Community Health, School of Nursing (Drs Bekemeier, Grembowski, and Herting and Ms Yang), Department of Health Services, School of Public Health (Drs Bekemeier and Grembowski), and Department of Sociology, School of Arts and Sciences (Dr Herting), University of Washington, Seattle. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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