NACCHO National Profile of Local Health Departments and Forces of Change Survey Series

The National Association of County and City Health Officials (NACCHO) conducts the National Profile of Local Health Departments (commonly referred to as the "Profile study") every three years as a census of local health departments (LHDs). The Profile study represents the largest, most reliable data source on LHDs. This study describes the funding, staffing, governance, and activities of LHDs across the United States, developing a comprehensive and accurate description of LHD infrastructure and practice. The purpose of this survey of local health departments (LHDs) was to advance and support the development of a database for LHDs to describe and understand their structure, function, and capacities.

The Forces of Change Survey is an evolution of NACCHO's Job Losses and Program Cuts Surveys (also known as the Economic Surveillance Surveys) which measured the impact of the economic recession on local health departments' (LHD) budgets, staff, and programs. The Forces of Change Survey continues to measure changes in LHD budgets, staff, and programs and assess more broadly the impact of forces affecting change in LHDs, such as health reform and accreditation. More specifically, the survey collected information about LHD staffing levels, workforce reductions, and changes in budget sizes; provided services or functions; changes in the level of service delivery; billing for clinical services; efforts to help people enroll in health insurance from exchanges under the Affordable Care Act; awareness of and involvement in the State Innovation Models Initiative; participation in the Public Health Accreditation Board's national accreditation program for LHDs; and whether LHDs are part of a combined health and human services agency. For more information, please see the study website.