Communication Ties Across the National Network of Local Health Departments

Abstract

Using evidence-based strategies within U.S. local health departments (LHDs) to provide community services can increase the likelihood of success and efficient use of resources. Dissemination of such strategies, a necessary precursor to implementation, occurs through networks of relationships and can be facilitated by weak network ties, whereas implementation is associated with strong network ties. To identify LHD characteristics associated with weak and strong ties in the national network of LHDs. Data on the structure and functions of participating LHDs (n=2107) were taken from the 2010 National Association of County and City Health Officials Profile of Local Health Departments (Profile Study). The 2010 Profile Study was the first to include a question on communication links across the national network of LHDs. Descriptive network analysis and exponential random graph modeling were used to identify LHD characteristics associated with weak and strong communication ties. Analysis was conducted in 2012. The LHD network was relatively sparse overall, indicating that dissemination across the entire network would be difficult. Few strong nationwide ties were found, indicating a lack of structural influences encouraging implementation. Several LHD characteristics were associated with a higher likelihood of weak and strong ties. In bivariate analyses, larger health departments were more likely to have strong ties. Weak ties were more likely among LHDs sharing jurisdiction and organizational characteristics. The only network predictor of strong ties was being in the same state. Public health efforts aimed at broad dissemination and implementation of evidence-based programming may benefit from strengthening partnerships in each state. The largest jurisdictions within each state may be identified as partners in order to facilitate implementation, whereas identification of partners with differing levels of staffing, funding, and leadership is key to ensuring widespread dissemination across LHDs.