Determinants of the core functions of local public health agencies: Examining what matters in local public health practice

Context: This study examines a model of performance measurement in public health on the basis of logic model constructs focusing upon explanatory variables (inputs) within the realm of control of the local public health agency (LPHA), and their subsequent effect on LPHA functions (outputs). Methods: Study protocol was reviewed and approved by an institutional review board, and informed consent was obtained from all participants. The investigation included measuring the human, informational, organizational and fiscal resources of the LPHAs (inputs) to determine the effect upon LPHA performance of the assessment, policy development, and assurance functions of public health (outputs), commonly referred to as the 3 core functions of public health. Results: Study participants included the lead health officials (termed " administrators") representing the LPHAs within the state of Illinois. Forty-three of the 46 LPHAs selected participated in the study for a response rate of 93%. Analysis to identify the presence of any relationship between the explanatory variables (LPHA inputs or resources) and the dependent variables (LPHA outputs or core functions) was undertaken utilizing multiple regression analysis. Conclusions: Results concluded that higher-level performance in areas noted as LPHA inputs or resources were associated with higher-level performance of the core functions of public health.