Since 1998, researchers have followed a nationally representative cohort of U.S. communities to examine the types of public health activities performed within the community, the range of organizations contributing to each activity, and the perceived effectiveness of each activity in addressing community needs. This information, obtained through a validated survey of local public health officials, provides an in-depth view of the structure and function of local public health delivery systems and how these systems evolve over time. Originally conducted with support from the U.S. Centers for Disease Control and Prevention, the National Longitudinal Survey of Public Health Systems (NLSPHS) was fielded for the first time in 1998, with a follow-up survey conducted in 2006 as part of a Robert Wood Johnson Foundation-funded project to develop an evidence-based typology of local public health delivery systems. Each wave of the survey has been linked with data on local health departments collected from the prior year’s National Profile of Local Health Departments survey conducted by the National Association of County and City Health Officials (NACCHO), allowing for an in-depth view of how local health departments relate to the multi-organizational delivery systems in which they operate. These data, linked with still other data sources on community demographic, health, and economic characteristics, have supported a wide array of studies regarding the organization, financing, and delivery of public health services and provided considerable insight into policy and administrative mechanisms for improving the practice of public health.

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