Local Legal Infrastructure and Population Health

American Journal of Public Health, August 2012, DOI: 10.2105/AJPH.2012.300656

18 Pages Posted: 3 Sep 2012 Last revised: 26 Sep 2012

See all articles by Julia Field Costich

Julia Field Costich

University of Kentucky

Dana Patton

University of Alabama - Department of Political Science

Date Written: August 31, 2012

Abstract

Objectives: We explored the association between the legal infrastructure of local public health, as expressed in the exercise of local fiscal and legislative authority, and local population health outcomes.

Methods: Our unit of analysis was public health jurisdictions with at least 100 000 residents. The dependent variable was jurisdiction premature mortality rates obtained from the Mobilize Action Toward Community Health (MATCH) database. Our primary independent variables represented local public health’s legal infrastructure: home rule status, board of health power, county government structure, and type of public health delivery system. Several control variables were included. We used a regression model to test the relationship between the varieties of local public health legal infrastructure identified and population health status.

Results: The analyses suggested that public health legal infrastructure, particularly reformed county government, had a significant effect on population health status as a mediator of social determinants of health.

Conclusions: Because states shape the legal infrastructure of local public health through power-sharing arrangements, our findings suggested recommendations for state legislation that positions local public health systems for optimal impact. Much more research is needed to elucidate the complex relationships among law, social capital, and population health status.

Suggested Citation

Costich, Julia Field and Patton, Dana, Local Legal Infrastructure and Population Health (August 31, 2012). American Journal of Public Health, August 2012, DOI: 10.2105/AJPH.2012.300656, Available at SSRN: https://ssrn.com/abstract=2139566

Julia Field Costich (Contact Author)

University of Kentucky ( email )

College of Public Health
111 Washington Ave
Lexington, KY 40536
United States
859-257-6712 (Phone)
859-257-2821 (Fax)

Dana Patton

University of Alabama - Department of Political Science ( email )

Box 870213
Tuscaloosa, AL 35487-0213
United States

Do you have a job opening that you would like to promote on SSRN?

Paper statistics

Downloads
55
Abstract Views
649
rank
526,128
PlumX Metrics