Content area
Abstract
Local Health Departments (LHDs), organized as units of county government, operate in highly political and competitive environments. To improve the flexibility and accountability of its public health agency at the local level, Cabarrus County North Carolina established a public health authority to provide population based and primary care health services. This research designed an evaluation to assess the degree to which the transition from a LHD to a public health authority in Cabarrus County produced intended results. A review of the existing literature provided tools and methods for assessing health status in the community, and offered examples of how other researchers had studied local public health functions. This evaluation model was designed to provide a local public health organization with empirical data for measuring and monitoring organizational performance. The model was applied to assess differences between capacity, commitment and performance of the Cabarrus County LHD in 1996–1997 and the public health authority in 1997–1998. Using participatory action research, qualitative and quantitative methods were used in the design and application of the evaluation model. Findings from the evaluation of the LHDs and public health authority's capacity, commitment and performance presented and described. The work concludes with a critique of the evaluation and the implementation process, and offers suggestions to other researchers and practitioners about how this model might be adapted for other local public health organizations.
