Impact of Local Boards of Health (LBoH) Governance Functions on Local Health Departments (LHDs) Policy Making or Advocacy Activities

LHDs play an instrumental role in improving the health of their communities through administrative duties and delivery of essential public health services. LBoHs, a supporting element in the governing structure of public health impact policy-making and advocacy for LHDs. The purpose of the research is to examine the extent of the impact of LBoH governance functions on LHDs policy or advocacy activities for obesity or chronic diseases. For this study, we analyzed and linked data from the 2016 NACCHO Profile Study to the 2015 LBoH National Profile. LBOH performance of governance functions on the overall taxonomy scale (p=0.003), governance subscale (p=0.009), non-governance subscale (p=0.000) was significantly impactful on LHDs policy-making or advocacy activities for obesity or chronic diseases but not on the policy-development subscale (0.246). LBoH performance of governance functions was significantly impactful on the overall taxonomy scale, the governance subscale, the non-governance subscale but not on the policy development subscale (with the exception of three) for the following policy or advocacy activities: community level urban design and land use policies to encourage physical activity (p=0.000, 0.000, 0.000, 0.059), active transportation options (p=0.000, 0.000, 0.000, 0.146), school or child care policies that encourage physical activity (p=0.000, 0.000, 0.000, 0.017), school or child care policies that reduce availability of unhealthy foods (p=0.000, 0.000, 0.000, 0.145), expanding access to recreational facilities (p=0.001, 0.004, 0.000, 0.433), nutritional labeling (p=0.000, 0.000, 0.000, 0.044), increasing retail availability of fruits and vegetables (p=0.000, 0.000, 0.000, 0.201), and policies to promote breastfeeding (p=0.001, 0.002, 0.000, 0.254). In conclusion, LBoH governance functions impact the governance and advocacy activities of LHDs in different, yet oftentimes, significant ways. Contributions of this study would be of interest to public health, LBoH and LHDs to show the impact of LBoH governance functions on LHD policy and advocacy activities to improve population health.