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首页> 外文期刊>Journal of public health management and practice: JPHMP >Leadership matters: Local health department clinician leaders and their relationship to decreasing health disparities
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Leadership matters: Local health department clinician leaders and their relationship to decreasing health disparities

机译：领导能力很重要：当地卫生部门临床医生领导及其与减少健康差异的关系

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Objective: The activities that local health departments (LHDs) conduct and their workforce characteristics change over time. We know little, however, about how changes among the services LHDs conduct are associated with the nature of LHD leadership and how these factors impact health. This study investigated changes in LHD services and leadership and how these changes are associated with mortality disparities. Design: We conducted regression analyses of secondary data using an exploratory panel time series design. Measures: We used secondary data to investigate changes in LHD services and leadership and how these changes were associated with each other and with 1993 to 2005 changes in black-white mortality disparities. Local health department services were examined relative to change in breadth of services within each of 10 program domains between 1993 and 2005. LHD leadership was examined for discipline of the lead executive in 1993 and 2005. Study Population: Our sample included 558 county or multicounty "common local areas," representing county-level data for LHDs and their jurisdictions. Results: Significant beneficial relationships exist between having a clinician as lead executive in an LHD and reductions in black-white mortality disparities. Local health departments with a clinician (usually a nurse or physician) as their lead executive in 1993 and/or 2005 experienced a significant decrease in black-white mortality disparities for young adults (age 15-44 years) in their jurisdictions from 1993 to 2005 when compared with LHDs with nonclinician leaders. Conclusions: The discipline of an LHD's lead executive as a clinician appears to have a significant relationship with the impact of LHD practice on reducing black-white mortality disparities. This study suggests that the discipline of an LHD's leadership may be an important factor to consider in relation to local public health capacity to impact health disparities. Further research related to the mechanisms at play in these relationships is warranted.
机译：目标：地方卫生部门（LHD）开展的活动及其员工特征随时间而变化。但是，我们对LHD行为之间的变化与LHD领导力的性质以及这些因素如何影响健康的了解甚少。这项研究调查了LHD服务和领导力的变化以及这些变化与死亡率差异的关系。设计：我们使用探索性面板时间序列设计对辅助数据进行了回归分析。措施：我们使用辅助数据调查了左室卒中服务和领导能力的变化，以及这些变化如何相互关联以及1993年至2005年黑白死亡率差异的变化。在1993年至2005年期间，对地方卫生部门服务相对于10个计划领域中服务范围变化的变化进行了调查。1993年至2005年，LHD领导层对首席执行官的纪律进行了研究。研究人群：我们的样本包括558个县或多县“通用本地区域”，代表了LHD及其辖区的县级数据。结果：在临床医生中担任LHD的首席执行官与减少黑白死亡率差异之间存在着显着的有益关系。从1993年至2005年，以临床医生（通常为护士或医师）为主要负责人的当地卫生部门在其辖区中（15-44岁）的年轻人（15-44岁）的黑白死亡率差异显着降低与具有非临床医生领导者的LHD相比。结论：LHD的首席执行官作为临床医生的纪律似乎与LHD实践对减少黑白死亡率差异的影响有着显着的关系。这项研究表明，LHD领导层的纪律可能是考虑与影响健康差异的当地公共卫生能力相关的重要因素。有必要对这些关系中起作用的机制进行进一步的研究。

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