Electronic Theses and Dissertations

Date

2018

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Health Systems & Policy

Committee Chair

Erik Carlton

Committee Member

Aram Dobalian

Committee Member

SangNam Ahn

Committee Member

George Relyea

Abstract

Collaboration between local health departments (LHDs) and nonprofit hospitals around community health needs assessment (CHNA) is recognized as a key strategy to improve U.S. population health. This dissertation presents three studies on collaboration between LHDs and nonprofit hospitals around CHNA. The specific aims were to 1) examine whether collaboration between LHDs and nonprofit hospitals around CHNA is associated with community health outcomes, 2) examine the dimensions of collaboration between LHDs and nonprofit hospitals around CHNA that are associated with community health outcomes, and 3) explore the perceptions of facilitators and barriers to effective collaboration, between LHDs and hospitals. Data came from multiple datasets including the 2016 National Profile of Local Health Departments and 2018 County Health Rankings data merged together using the five-digit Federal Information Processing Standards county code. The third study utilized a qualitative method and semi-structured interviews were collected from LHD and hospital leaders across the U.S. In the first study, linear mixed regression models were used to examine the associations between LHD-Hospital collaboration around CHNA, levels of LHD-Hospital collaboration and five community health outcomes. Results showed that communities with high levels of LHD-Hospital collaboration around CHNA had significantly better health outcomes compared to communities with low levels of LHD-Hospital collaboration around CHNA. In the second study, principal axis factor extraction with varimax rotation was conducted to identify the dimensions of collaboration between LHDs and nonprofit hospitals around CHNA. Linear mixed regression models examined the relationship between dimensions of collaboration around CHNA and self-reported fair or poor health and premature death. Findings suggest that dimensions of collaboration around CHNA could improve community health outcomes In the third study, 10 major themes were identified including 5 facilitators and 5 barriers to effective collaboration. Additionally, participants from higher performing communities described engaging in several collaborative projects and having a strong referral system. In conclusion, this dissertation sought to examine how and whether collaboration between LHDs and nonprofit hospitals around CHNA is associated with community health outcomes. The findings from this dissertation will be of interest to practitioners, researchers, and policymakers seeking to address how to improve the U.S. population health.

Comments

Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to ProQuest

Notes

embargoed

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