Variation in delivery of the 10 essential public health services by local health departments for obesity control in 2005 and 2008

Objectives: To describe and compare the capacity of local health departments (LHDs) to perform 10 essential public health services (EPHS) for obesity control in 2005 and 2008, and explore factors associated with provision of these services. Methods: The data for this study were drawn from the 2005 and 2008 National Profile of Local Health Department surveys, conducted by the National Association of County and City Health Officials. Data were analyzed in SAS version 9.1 (SAS Institute Inc, Cary, North Carolina). Results: The proportion of LHDs that reported that they do not provide any of the EPHS for obesity control decreased from 27.9% in 2005 to 17.0% in 2008. In both 2005 and 2008, the 2 most frequently provided EPHS for obesity control by LHDs were informing, educating, and empowering the people (EPHS 3) and linking people to needed personal health services (EPHS 7). The 2 least frequently provided services were enforcing laws and regulations (EPHS 6) and conducting research (EPHS 10). On average, LHDs provided 3.05 EPHS in 2005 and 3.69 EPHS in 2008. Multiple logistic regression results show that LHDs with larger jurisdiction population, with a local governance, and those that have completed a community health improvement plan were more likely to provide more of the EPHS for obesity (P < .05). Conclusions: The provision of the 10 EPHS for obesity control by LHDs remains low. Local health departments need more assistance and resources to expand performance of EPHS for obesity control. Future studies are needed to evaluate and promote LHD capacity to deliver evidence-based strategies for obesity control in local communities.