Relationships between local public health agency functions and agency leadership and staffing: a look at nurses.

UNLABELLED: The United States is facing a severe shortage of well-trained public health workers, and public health nursing is the discipline with the greatest shortage. A local public health agency's (LPHA's) staffing and leadership characteristics are critical in determining its programs, performance, and capacity. A better understanding of the relationship between specific staffing and leadership characteristics and public health programs is needed to address this capacity challenge. METHOD: Data from the 2005 National Profile of Local Health Departments, were examined to identify associations between an LPHA's nursing workforce and the specific activities performed by LPHAs. RESULTS: LPHAs with a nurse as senior executive had a greater breadth of immunization, maternal/child health, and prevention activities than their nonnurse-led counterpart LPHAs, particularly in rural areas. Nurse-led LPHAs were less likely, however, to have a broad level of environmental health and regulation activities or to have recently conducted community assessment and planning activities. CONCLUSIONS: Both LPHA nurse leaders and nursing staff play an important role in the provision of LPHA services, and a shortage of LPHA nursing leaders and staff, particularly in rural areas, will likely have a major impact on certain LPHA programs unless steps are taken to address these challenges.