Exploring New Methods and Measures to Assess the Impact of the Economic Recession on Public Health Outcomes

Year: 2012
Funding: NNPHI PHS Natural Experiment Award
Status: Completed

Back to Grantee Profiles


The economic recession created a natural experiment which can be used to estimate the effect of public health departments on population health.  Using a retrospective cohort design, and creating linkages to population-based datasets, this project follows all local health departments (LHDs) in North Carolina (NC) from 2005 - 2010.  Data from the National Association of County and City Health Officials (NACCHO) health department 2005 and 2008 profiles are used to measure LHD spending, staffing and services in the time periods prior to, and during, the recession.  These LHD metrics are linked with public and private insurance data to explore variations in county-level morbidity and mortality rates for selected outcomes (infant mortality, heart disease, cancer, diabetes and influenza).  Data from time periods (2005-2007 and 2008-2010) are examined using generalized estimating equations and geo-spatial approaches to adjust for spatial correlation.  This project combines a novel insurance claims data resource with NACCHO data to develop and test new methods and metrics for public health systems research. 





Anna Schenck, Ph.D. and Anne-Marie Meyer, Ph.D.
University of North Carolina at Chapel Hill

Research Areas