Robert Wood Johnson Foundation grants to help local health departments streamline data

Betty Bekemeier, UW associate professor of nursing, recently received two major grants from the Robert Wood Johnson Foundation to address the gap in consistent, standardized public health data. Bekemeier and her team seek to streamline data collection for local health departments and then help practitioners and researchers use that data to analyze the success of public health endeavors through population health outcomes and financial feasibility.
“Our nation’s public health systems are threatened and eroding, in part because we have lacked the consistent data and, therefore, the evidence to articulate and demonstrate what public health systems do to protect the people’s health and assure healthy communities.”

Measuring public health investment

The first grant, “Developing and evaluating strategies for a nationwide uniform chart of accounts (COA) to measure public health investment and spending,” will look at ways to support local health departments to adopt a model of data organization and fiscal reporting that can be replicated nationwide. Currently, the U.S. public health system is made up of about 2,800 local health departments that vary by state in size and structure. These health departments often rely on a variety of disparate resources for pulling together and analyzing data regarding budgetary expenditures, program activities and health outcomes—making it difficult to compare one local health department to another or for quality improvements to occur across states. Without uniform data systems that can help monitor public health finances and service activity, our vital prevention systems remain hidden and poorly understood for what they can contribute to widespread health improvement and advancing health equity in American communities.

Bekemeier and her team will work with 20 health departments in four states to find a way to report their expenditures and revenues using a uniform COA. Bekemeier and team will analyze the data collected to test its reliability, consistency and accuracy for advancing a uniform accounting system to help monitor the amount spent on prevention and how it was spent.
“The prospect of more uniform reporting would mean that public health leaders could finally have a way to measure what prevention costs … and ultimately, what it saves. Without a sense of this, it’s hard to advocate for what communities need and for how important these resources are for keeping people healthy,” Bekemeier said.

Expanding delivery measures

Bekemeier’s second grant, “Building a sustainable model for advancing standardized public health services measures,” will support the expansion of a common set of public health service delivery measures into state and local data systems across the U.S. An online dashboard will organize and present local health department data so that state and local public health leaders can make informed, evidence-based decisions. The grant evolved from previous studies by Bekemeier and her team that helped establish standardized public health service measures and to make the case for the critical need for demonstrating what health departments do and the impact they make in communities.

Together, these two new grants will promote the development of uniform public health financial and service data that could provide a comprehensive picture of public health spending and the effectiveness of prevention efforts in communities.

Positive change in healthcare reform, although well-intentioned, is difficult to achieve when a fractured and complex U.S. public health system cannot accurately convey and compare the cost and benefit of its work. By working with local public health practice partners, Bekemeier is committed to offering researchers, public health leaders, and policy-makers access to meaningful and comparable “big data” that will help demonstrate the power of prevention, support system improvements and drive healthier policy.