Evaluating local public health performance at a community level on a statewide basis.

As part of efforts to develop a surveillance system to evaluate local public health performance, six state health departments surveyed local health departments in their states. Overall, 370 respondents (94 percent) returned completed surveys. Based on responses to 26 indicators, the mean percent community performance of the three core functions of public health was 56 percent of the potential score. Scores were also calculated for perceived adequacy of performance and for each of 10 practices linked to the three core functions. Variations in performance were related to population size, state, and administrative relationship of local jurisdictions to the state. These results suggest local public health performance can be evaluated at a community level on a statewide basis using a relatively small number of indicators.