Explaining Consolidation Decisions: Motivations for Recent Local Health Department Consolidations in Ohio

Abstract

Funding for this study was provided by the Robert Wood Johnson Foundation through the Practice Based Research Network (PBRN) at the University of Kentucky and the Research Association for Public Health Improvement (RAPHI) at Case Western Reserve University.

Recent studies suggest that consolidating Local Health Departments (LHDs) may improve public health services, increase efficiency, and reduce public health expenditures. To identify factors motivating LHD consolidations that may enhance public health service provision, we investigate potential factors motivating LHD consolidations in Ohio since 2000. Using logistic regression analysis and interviews with local health officials, we find that the financial condition of cities involved in consolidations and the presence of a “Strong Mayor” municipal government system are strong predictors of consolidation decisions in Ohio between 2001 and 2013.

Because of variations in LHD governance arrangements across states, further research is needed to determine whether the drivers of consolidation identified here apply in other states. In addition, testing these results in models with variables representing a more expansive array of potential driving factors for LHD consolidation may help verify and/or build upon the initial findings presented here.

The work underlying portions of this article was supported by funding from the Robert Wood Johnson Foundation (RWJF) Public Health Practice-based Research Networks (PBRN) project, based at the University of Kentucky and Case Western Reserve Universities.  We want to thank both RWJF and these PBRN universities for their support.

We also want to thank all of the senior local health officials who took time to visit with us about their local health department consolidation experiences, as well as Joe Mazzola, formerly of the Ohio Department of Health (ODH), for providing critical assistance at key stages of the project. 

In addition, the following individuals played key roles in enabling this project to be undertaken and completed:  Scott Frank, Krista Wasowski, Jason Orcena, Gene Nixon, Terry Allan, Nancy Osborn, Beth Bickford, Michelle Menegay, Tegan Beechey, Ken Slenkovich, Glen Mays, and Lizeth Fowler.