Relationships between local public health agency functions and agency leadership and staffing: a look at nurses.
The United States is facing a severe shortage of well-trained public health workers, and public health nursing is the discipline with the greatest shortage. A local public health agency's (LPHA's) staffing and leadership characteristics are critical in determining its programs, performance, and capacity. A better understanding of the relationship between specific staffing and leadership characteristics and public health programs is needed to address this capacity challenge.


METHODS
Data from the 2005 National Profile of Local Health Departments, were examined to identify associations between an LPHA's nursing workforce and the specific activities performed by LPHAs.


RESULTS
LPHAs with a nurse as senior executive had a greater breadth of immunization, maternal/child health, and prevention activities than their nonnurse-led counterpart LPHAs, particularly in rural areas. Nurse-led LPHAs were less likely, however, to have a broad level of environmental health and regulation activities or to have recently conducted community assessment and planning activities.


CONCLUSIONS
Both LPHA nurse leaders and nursing staff play an important role in the provision of LPHA services, and a shortage of LPHA nursing leaders and staff, particularly in rural areas, will likely have a major impact on certain LPHA programs unless steps are taken to address these challenges.
School of Nursing, University of Washington, Seattle, WA 98195, USA. bettybek@u.washington.edu
Betty
B
Bekemeier
Maggie
M
Jones
D003153:Community Health Services / Q000458:organization & administration; D003430:Cross-Sectional Studies; D017598:Efficiency, Organizational; D006306:Health Surveys; D006801:Humans; D007857:Leadership; D017146:Models, Organizational; D024802:Nurse's Role; D010561:Personnel Staffing and Scheduling; D011635:Public Health Administration; D011637:Public Health Nursing; D014481:United States; D000078329:Workforce