Kent State University’s Center for Public Policy and Health and the University of Arkansas for Medical Sciences have recently completed a study on local health department consolidation in Ohio. The study was funded through a “quick strike” grant from the Robert Wood Johnson Foundation’s Practice Based Research Network, managed by the University of Kentucky and the Ohio Research Association for Public Health Improvement based at Case Western Reserve University.

The purpose of the study was to develop evidence regarding the effects of health department consolidation on health department expenditures, revenues and services.

“We hope that our work will help inform the policy decisions made by public officials at the local and state levels,” says John Hoornbeek, Ph.D., director of the Center for Public Policy and Health, and the project’s principal investigator.

The research team focused its analysis on the 20 health department consolidations that have occurred between 2001 and 2012 in Ohio. Both statistical analyses of data submitted by local health departments to the Ohio Department of Health and interviews with key health department personnel involved in the consolidations contributed to the report’s findings.

The study found that community level factors, such as the governance structure and budget situation of the city government, are useful predictors of consolidation. The study also found that total expenditures tend to decrease after a consolidation takes place, and that nonlocal revenues coming into health departments tended to decrease in the first two years after consolidation. Further research is needed to gain a more complete understanding of the long-term impacts of consolidation on nonlocal revenues.

“Many of those we interviewed perceived that benefits from consolidation accrue over time,” says Josh Filla, an outreach coordinator with Kent State's Center for Public Policy and Health and a co-author of the study. “The vast majority of those we interviewed — almost 90 percent — said that their consolidation was a ‘good idea.’”

“We’ve tried to provide answers to some of the questions local health officials hear frequently from township and municipal officials about the costs and benefits of consolidating their health departments,” says study co-author Matthew Stefanak, who served for 25 years as a county health commissioner in Ohio.

Kent State’s Center for Public Policy and Health and the University of Arkansas for Medical Sciences have released two documents that showcase the study’s findings. A policy brief aimed at informing public health practitioners on the study’s findings was released earlier this summer, while the full report, titled “Consolidation of Local Health Departments in Ohio: Motivations and Impacts,” was released more recently. Both the full report and an updated version of the policy brief are available on the center’s website at www.kent.edu/cpph.

Hoornbeek and study co-authors Stefanak and Michael Morris, professor at the University of Arkansas for Medical Sciences, plan to present their findings at the American Public Health Association Conference in Boston this November.

“Hopefully, our work will set the stage for further research relating to how health department consolidations affect public health workforces and services,” notes Morris.