Local Public Health Systems and the Incidence of Sexually Transmitted Diseases

被引:20
作者
Rodriguez, Hector P. [1 ]
Chen, Jie [2 ]
Owusu-Edusei, Kwame [3 ]
Suh, Allen [4 ]
Bekemeier, Betty [5 ]
机构
[1] Univ Calif Los Angeles, Fielding Sch Publ Hlth, Dept Hlth Policy & Management, Los Angeles, CA 90095 USA
[2] CUNY Coll Staten Isl, Dept Polit Sci Econ & Philosophy, Staten Isl, NY USA
[3] Ctr Dis Control & Prevent, Natl Ctr HIV AIDS Viral Hepatitis STD & TB Preven, Atlanta, GA USA
[4] Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA
[5] Univ Washington, Sch Nursing, Div Psychosocial & Community Hlth, Seattle, WA 98195 USA
关键词
UNITED-STATES; RACIAL/ETHNIC DISPARITIES; INSURANCE-COVERAGE; CARE ACCESS; RATES; BEHAVIORS; CHLAMYDIA; PARTNERSHIPS; INFECTIONS; GONORRHEA;
D O I
10.2105/AJPH.2011.300497
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objectives. We examined the associations of local public health system organization and local health department resources with county-level sexually transmitted disease (STD) incidence rates in large US health jurisdictions. Methods. We linked annual county STD incidence data (2005-2008) to local health department director responses (n = 211) to the 2006 wave of the National Longitudinal Study of Local Public Health Systems, the 2005 national Local Health Department Profile Survey, and the Area Resource File. We used nested mixed effects regression models to assess the relative contribution of local public health system organization, local health department financial and resource factors, and sociodemographic factors known to be associated with STD incidence to county-level (n = 307) STD incidence. Results. Jurisdictions with local governing boards had significantly lower county-level STD incidence. Local public health systems with comprehensive services where local health departments shoulder much of the effort had higher county-level STD rates than did conventional systems. Conclusions. More integration of system partners in local public health system activities, through governance and interorganizational arrangements, may reduce the incidence and burden of STDs. (Am J Public Health. 2012;102: 1773-1781. doi:10.2105/AJPH.2011.300497)
引用
收藏
页码:1773 / 1781
页数:9
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