Measuring the authority of local public health directors in the context of organizational structure: An exploratory, multimodal approach

Kimberly J.Miner Gearin, Allison M.Rick Thrash, Renee Frauendienst, Julie Myhre, M. Elizabeth Gyllstrom, William J. Riley, Janelle Schroeder

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Context: Studies have reported a relationship between the organization of public health services and variability in public health practice at the local and state levels. A national research agenda has prioritized practice-based research to understand pathways that lead to this variation and examine the impact of these differences on outcomes. Objectives: To measure the extent to which Minnesota local health directors report having key authorities and examine the relationship between organizational structure and authority of local health directors. Design: Multimodal. Setting: Minnesota local health departments. PARTICIPANTS:: Directors of Minnesota local health departments. Main Outcome Measure(S):: Director authorities. Results : Most Minnesota local health directors reported having 6 key authorities related to budget preparation and modification and interaction with local elected officials (n = 51, 71%). Twelve directors (16%) reported that they have 4 or fewer of the 6 authorities. The authority most commonly reported as lacking was the authority to initiate communication with locally elected officials (n = 15, 21%). The percentage of directors who reported having all 6 authorities was higher among those in stand-alone departments (82%) than those in combined organizations (50%). Conclusions : This descriptive study illustrates that emerging practice-based research networks can successfully collaborate on small-scale research projects with immediate application for systems development. Study findings are being used by local public health officials to help articulate their role, aid in succession planning, and inform elected officials, who need to consider the public health implications of potential changes to local public health governance and organization. More studies are needed to refine measurement of authority and structure.

Original languageEnglish (US)
Pages (from-to)545-550
Number of pages6
JournalJournal of Public Health Management and Practice
Issue number6
StatePublished - Nov 1 2012
Externally publishedYes


  • health director authority
  • local health department
  • local health department structure
  • practice-based research

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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