Community Health Assessment and Improved Public Health Decision-Making: A Propensity Score Matching Approach

• Published in: American journal of public health (1971) 2015-12, Vol.105 (12), p.2526-2533
• Main Authors: Rabarison, Kristina M, Timsina, Lava, Mays, Glen P
• Format: Article
• Language: English
• Subjects: Chronic Disease - epidemiology; Chronic Disease - prevention & control; Chronic illnesses; Community Health; Community health care; Community Health Services - methods; Community Health Services - organization & administration; Decision making; Decision Making, Organizational; Disease prevention; Health Administration; Health Policy; Health risk assessment; Health Status; Health Surveys - methods; Humans; Indigent care; Nonprofit hospitals; Other Chronic Disease; Other Health Service Delivery; Prevention; Propensity Score; Public health; Public Health Administration - methods; Public Health Practice; RESEARCH AND PRACTICE; Rural health care; Studies; Surveys and Questionnaires; United States
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2015.302795

We analyzed the likelihood of chronic disease prevention activities delivery, as a proxy measure of public health decision-making and actions, given that local health agencies (LHAs) implemented a community health assessment and improvement plan in their communities. Using a propensity score matching approach, we linked data from the 2010 National Association of County and City Health Officials profile of LHAs and the 2010 County Health Rankings to create a statistically matched sample of implementation and comparison LHAs. Implementation LHAs were those that implemented a community health assessment and improvement plan. We estimated the odds of chronic disease prevention activities delivery and the average treatment effect on the treated. Implementation group LHAs were 2 times as likely (95% confidence interval = 1.60, 2.64) to deliver population-based chronic disease prevention programs than comparison group LHAs. Furthermore, chronic disease prevention activities were more likely to be delivered among implementation group LHAs (6.50-19.02 percentage points higher) than in comparison group LHAs. Our results signal that routine implementation of a community health assessment and improvement plan in LHAs leads to improved public health decision-making and actions.