Considering Consolidation to Build Stronger Local Health Departments Public Deposited

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Last Modified
  • February 27, 2019
  • Berg, Jamie
    • Affiliation: Gillings School of Global Public Health, Public Health Leadership Program
  • Local public health departments are facing extreme budget cuts, which are forcing departments to eliminate programs, staff, and reduce the level of services they are providing to their communities. This works against the mission of improving the health of communities. The expectations and demands of public health are increasing, yet funding to support programs is decreasing. Consolidation of local health departments is one solution to retaining staff and services, while trying to operate with restricted budgets. Consolidation could help relieve the burden on taxpayers and still provide the services that people want, need, and deserve. There are many potential opportunities associated with consolidation such as: achieving possible cost savings; increasing capacity of services and providing essential services; being better prepared for public health emergencies and future state mandates; and reducing duplication of services. While there are many opportunities linked with consolidation, there are many concerns and hardships as well, such as loss of local control, minimal cost savings, individual community needs not being a priority, negotiating a contract among multiple communities, and the overall feeling that change can be difficult. Consolidation may work for smaller health departments who are geographically close, have similarities in their populations, and are common in per capita wealth. When deciding whether to consolidate, a formal decision process should be followed. Strong leadership must be present, as well as support from elected officials, boards of health, residents of the communities, and staff members.
Date of publication
Resource type
Rights statement
  • In Copyright
  • Paper type: Research or research design
  • Evarts, Lori
  • Claire, Sue Le
  • Master of Public Health
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2011
Deposit record
  • b6f6bdeb-f0b9-4907-a2ad-769b5d2e1080

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