LV and Beyond: Regionalizing Public Health in Other States

Just last month, the Robert Wood Johnson Foundation released this short report summarizing the overall challenges to improving public health capacity through cross-jurisdictional relationships, conditions for successful relationships, and moving forward with regionalization.

Information was gathered through in-person interviews and site visits with executive leadership and important staff at organizations such as CDC, NACCHO, PHAB, and HRSA.  Researchers interviewed various local public health leaders and policymakers either interested or currently involved in regionalization in Colorado, Wyoming, South Carolina, Connecticut, New Hampshire, Nebraska, and Illinois.

Although these efforts are specific to location, the report provides insightful generalizations about regionalizing public health. Here’s a short outline of its key points:

Key barriers to improving cross-jurisdictional relationships:

  • A gap exists between elected officials and public health leaders in understanding population health.
  • There are differences in understanding, appreciating, and operationalizing cross-jurisdictional relationships within the public health practice community.
  • No common language or frame of reference exists for discussing cross-jurisdictional sharing.
  • Cross-jurisdictional sharing and regionalization are occurring in a range of ways.
  • Regionalization does not necessarily result in improved public health capacity or performance, but cross-jurisdictional sharing often does.

Conditions for successful cross-jurisdictional relationships:

  • Clarity of purpose (Policy makers and public health leaders must be clear about their purpose)
  • Incentives, especially financial, are helpful
  • Willingness on both sides—public health leaders and elected policymakers
  • Attention to environment, culture, and history (interplay of history, culture, and relationships must be addressed)
  • Role in governance (all parties should feel that they have sufficient voice and control)

So, how should we move forward with collaboration?

  • Elected state and local policymakers need to be involved in national public health systems development work.
  • Understanding of the local environment is essential to successful public health endeavors.
  • Cross-jurisdictional relationships vary greatly in their details and address a wide variety of needs, but they do not have to develop further beyond their original purpose.

The conclusion?:

Public health leaders and policymakers found that cross-jurisdictional relationships improve local public health. Although accreditation was not a central focus of the report, the public health leaders acknowledged that cross-jurisdictional sharing will likely be necessary for health departments applying for national accreditation.

Visit RenewLV’s Regional Health Department page for information about local efforts in the Lehigh Valley.

Posted on February 25, 2011, in Health, Regions and tagged , . Bookmark the permalink. 1 Comment.

  1. Good information, and some good reasons why regionalization makes sense.

    But there are two big shortcomings in most public health programs, and regionalizing won’t solve them.

    First of all, most public health programs tend to ignore even proven alternative therapies that help prevent disease and promote health; instead they tend to focus primarily on improving access to traditional medicine.

    Perhaps even more important, they place very little emphasis on environmental health and the many harmful, disease-causing chemicals to which we are exposed every day in the air we breathe, the water we drink, and the food we eat.

    Ignoring these factors just guarantees more disease and more need for treatment.


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