title: Availability and perceived effectiveness of public health activities in the nation's most populous communities.
abstract: OBJECTIVE
  We examined the availability and perceived effectiveness of 20 basic public health activities in the communities where most Americans reside.
  
  
  METHODS
  A self-administered questionnaire was mailed to the 497 directors of US local health departments serving at least 100 000 residents.
  
  
  RESULTS
  On average, two thirds of the 20 public health activities were performed in the local jurisdictions surveyed, and the perceived effectiveness rating averaged 35% of the maximum possible. In multivariate models, availability of public health activities varied significantly according to population size, socioeconomic measures, local health department spending, and presence of local boards of health.
  
  
  CONCLUSIONS
  Local public health capacity varies widely across the nation's most populous communities, highlighting the need for targeted improvement efforts.
authors.affiliation: Mathematica Policy Research, Washington, DC, USA. MaysGlenP@uams.edu
authors.forename: Glen P
authors.initials: GP
authors.lastname: Mays
authors.forename: Paul K
authors.initials: PK
authors.lastname: Halverson
authors.forename: Edward L
authors.initials: EL
authors.lastname: Baker
authors.forename: Rachel
authors.initials: R
authors.lastname: Stevens
authors.forename: Julie J
authors.initials: JJ
authors.lastname: Vann
mesh_terms: D017598:Efficiency, Organizational / Q000706:statistics & numerical data*; D006801:Humans; D015980:Public Health Practice; D011795:Surveys and Questionnaires; D014481:United States; D014505:Urban Population