Local health department staffing, services contribute to reduction in infant mortality rate, study finds

March 5, 2015

A clear relationship exists between full-time equivalent staffing, the provision of services for women and children, and a reduction of between 1 to 2 infant deaths per 1,000 live births in North Carolina, according to a paper published online Feb. 17 in the American Journal of Public Health.

Dr. Anna Schenck

Anna Schenck, PhD, director of the UNC Gillings School of Global Public Health’s Public Health Leadership Program and its N.C. Institute for Public Health, is first author of the study, “Building the Evidence for Decision-Making: The Relationship Between Local Public Health Capacity and Community Mortality.” Support for this research was provided by a grant from the Robert Wood Johnson Foundation.

“The recent economic recession resulted in loss of staff and services at our local health departments. This study provides support for the important work those departments do to improve infant health in their communities,” said Schenck, who is also associate dean for public health practice at the Gillings School.

Schenck and colleagues analyzed data from North Carolina’s 85 local health departments (LHDs) to examine how investments in spending, staffing and services impact community health outcomes in the state. This study was conducted in an effort to expand what is known about investments in public health staff and services that generate improvements in community health.

The research team chose to investigate data from the years 2005 to 2010 to explore effects of spending changes related to the economic recession. While spending increased, on average, during this period, the level of full-time equivalent staffing dropped. The total quantity of service provision remained steady, but there was a slight increase specific to maternal and child health services.

While staffing and services were linked to lower infant mortality rates, they did not have a clear impact on the other mortality rates examined in the study: pneumonia and influenza, heart disease, cancer and diabetes. This may be attributable to the limited time span of the research data and the fact that many chronic illnesses progress over many years.

Co-authors for the paper include Anne Marie Meyer, PhD, research assistant professor of epidemiology, and Dorothy Cilenti, DrPH, MSW, clinical assistant professor of maternal and child health, both from the Gillings School, and Tzy-Mey Kuo, PhD, research associate at the UNC Lineberger Comprehensive Cancer Center. At the Gillings School, Cilenti is also accreditation administrator at the N.C. Institute for Public Health and adjunct professor of health policy and management.