DEFINING COMPREHENSIVE PUBLIC HEALTH DELIVERY SYSTEMS

and delivery of core public health activities in a nationally representative cohort of communities across the U.S. The NLSPHS uses a validated survey instrument administered to the local public health official in each sampled community to measure the following attributes: (1) Availability of recommended activities: Whether or not each of 20 recommended public health activities is performed in the community. These 20 activities are based on the Institute of Medicine’s Core Public Health Functions definitions and reflect high-value practices recommended by a series of expert panels convened by the U.S. Centers for Disease Control and Prevention. These activities are closely aligned with the federal government’s Essential Public Health Services Framework and a more recently developed set of Foundational Public Health Capabilities called for by the Institute of Medicine in its 2012 consensus report. (2) Organizational contributions: Which types of organizations in the community contribute to performing each of the 20 recommended public health activities. For each activity, a pre-defined check-list of 15 types of organizations is used, along with open-ended response options. For each type of organization, a contribution measure is constructed that indicates the proportion of the 20 recommended activities to which the organization contributes in each community. These measure