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This study describes the results of an analysis of the relationship between local public health agency performance and health outcomes. Findings support the model that local public health agency performance affects community health status, and depending on the outcome, performance contributions vary. New hypotheses are offered that could help determine how system performance affects health outcomes. [ABSTRACT FROM AUTHOR]

Healthy People 2010 national objectives seek to engage public health systems in health improvement. Focusing on "healthy communities," the article describes the readiness of U.S. counties to meet targets and the technical assistance that may be needed. Using rate comparisons and trends, four readiness-to-improve health categories are calculated for nine mortality rates. Greatest readiness for improvement was found for coronary heart disease mortality, where the fewest jurisdictions (35%) were static, having neither met targets nor improved; least readiness (65%) was observed for colon and rectum cancer and suicide. Nevertheless, some counties (50-1,050) were exemplary, already meeting the target and still improving. [ABSTRACT FROM AUTHOR]

This article describes one effort to develop management tools that will help public health administrators and policy makers implement comprehensive public health strategies. It recounts the ongoing development of a methodology through which the Essential Public Health Services can be related to public health budgets, appropriations, and expenditures. Through three pilot projects involving: (1) nine state health agencies, (2) three local health agencies, and (3) all local jurisdictions and the state health agency in one state, a workable methodology for identifying public expenditures lot comprehensive public health programming has been identified. [ABSTRACT FROM AUTHOR]