Structural Changes to Local Public Health: Benefits and Challenges
Abstract
PURPOSE: Structural changes to local health departments (LHDs) can occur for various reasons, and have the potential to impact both the delivery of public health services and the public health workforce. Although changes have been highlighted in the media, little is known about the potential impacts of these changes on local public health, particularly changes that have occurred since the COVID-19 pandemic. METHODS: A structured search process was used to locate publicly available news articles that described LHD structural changes that took place from 2020-2025 in the United States. A total of 16 structural changes that met study inclusion criteria were identified. Using the search results, 17 interviews were conducted with 19 participants who were involved in the identified changes to their local public health system since 2020. Interviews explored LHD structures prior to and post change, impacts to the workforce and services, and challenges and benefits after the structural change, among other topics. All interviews were conducted via Zoom using a semi-structured guide, recorded, and professionally transcribed. A rapid coding approach was used to identify key themes. To ensure consistency between coders, double coding was conducted with 20% of the interviews. RESULTS: LHDs experienced both benefits and challenges due to structural changes, including impacts to the workforce. Broader benefits included increased service availability to the community and improvements in efficiency. Challenges included misunderstandings between local government and public health, funding concerns, and administrative burden, among others. Specific to the workforce, benefits included job growth, increased productivity, and innovation opportunities, while challenges reflected turnover, increased anxiety, and low morale among staff. DISCUSSION: Study findings could assist public health agencies in better anticipating potential benefits and challenges resulting from structural changes. This presents them with the opportunity to mitigate expected challenges, as well as capitalize on future benefits.
Start Time
15-4-2026 9:00 AM
End Time
15-4-2026 12:00 PM
Room Number
Culp Ballroom 316
Poster Number
25
Presentation Type
Poster
Presentation Subtype
Posters - Competitive
Presentation Category
Health
Student Type
Graduate and Professional Degree Students, Residents, Fellows
Faculty Mentor
Stephanie Mathis
Structural Changes to Local Public Health: Benefits and Challenges
Culp Ballroom 316
PURPOSE: Structural changes to local health departments (LHDs) can occur for various reasons, and have the potential to impact both the delivery of public health services and the public health workforce. Although changes have been highlighted in the media, little is known about the potential impacts of these changes on local public health, particularly changes that have occurred since the COVID-19 pandemic. METHODS: A structured search process was used to locate publicly available news articles that described LHD structural changes that took place from 2020-2025 in the United States. A total of 16 structural changes that met study inclusion criteria were identified. Using the search results, 17 interviews were conducted with 19 participants who were involved in the identified changes to their local public health system since 2020. Interviews explored LHD structures prior to and post change, impacts to the workforce and services, and challenges and benefits after the structural change, among other topics. All interviews were conducted via Zoom using a semi-structured guide, recorded, and professionally transcribed. A rapid coding approach was used to identify key themes. To ensure consistency between coders, double coding was conducted with 20% of the interviews. RESULTS: LHDs experienced both benefits and challenges due to structural changes, including impacts to the workforce. Broader benefits included increased service availability to the community and improvements in efficiency. Challenges included misunderstandings between local government and public health, funding concerns, and administrative burden, among others. Specific to the workforce, benefits included job growth, increased productivity, and innovation opportunities, while challenges reflected turnover, increased anxiety, and low morale among staff. DISCUSSION: Study findings could assist public health agencies in better anticipating potential benefits and challenges resulting from structural changes. This presents them with the opportunity to mitigate expected challenges, as well as capitalize on future benefits.
