Year: 2012
Funding: NNPHI PHS Natural Experiment Award
Status: Completed
Overview
The economic recession created a natural experiment which can be used to estimate the effect of public health departments on population health. Using a retrospective cohort design, and creating linkages to population-based datasets, this project follows all local health departments (LHDs) in North Carolina (NC) from 2005 - 2010. Data from the National Association of County and City Health Officials (NACCHO) health department 2005 and 2008 profiles are used to measure LHD spending, staffing and services in the time periods prior to, and during, the recession. These LHD metrics are linked with public and private insurance data to explore variations in county-level morbidity and mortality rates for selected outcomes (infant mortality, heart disease, cancer, diabetes and influenza). Data from time periods (2005-2007 and 2008-2010) are examined using generalized estimating equations and geo-spatial approaches to adjust for spatial correlation. This project combines a novel insurance claims data resource with NACCHO data to develop and test new methods and metrics for public health systems research.
Publications
Tools
- Measuring Outcomes for NC Local Health Departments: Preliminary Results Brief (August 2013)
- Assessing Return on Investment for NC Local Health Departments: Relationship Between Staffing, Services and Mortality Brief (August 2014)
- Measuring Community Health Outcomes: New Approaches for Public Health Services Research Brief (April 2015)
- New Methods and Measures to Assess the Impact of the Economic Recession on Public Health Outcomes: Study Implications Brief (April 2015)
- Project Website
Presentations
- Assessing Public Health Return on Investment: Using the NACCHO Profile Data (National Network of Public Health Institutes Annual Conference, May 2013)
- Measuring the Return on Investment in Public Health in North Carolina (North Carolina Public Health Association Fall Educational Conference, September 2013)
- Assessing the Impact of Public Health Investments on Community Health Outcomes (Keeneland Conference, April 2014)
- Assessing the Return on Investment for Public Health: New Measures and Approaches (AcademyHealth Annual Research Meeting, June 2014)
- New Methods and Measures to Assess the Impact of the Economic Recession on Public Health Outcomes (PHSSR Grantee Briefing, Washington DC, August 2014)
- Assessing the Return on Investment in Public Health in North Carolina (North Carolina Public Health Association Fall Educational Conference, September 2014)
- Assessing the Impact of Economic Recession on Public Health Outcomes: Exploring New Methods and Measures (PHSSR Research in Progress Webinar, December 2015 recording)
Contacts
Anna Schenck, Ph.D. and Anne-Marie Meyer, Ph.D.
University of North Carolina at Chapel Hill