DOI: 10.3886/icpsr23420.v4
title: National Longitudinal Survey of Public Health Systems (NALSYS), [United States], 1998-2018
title: Version 4

description: Obtaining a better understanding of the organizational and operational attributes of public health delivery systems is a critical step in elucidating pathways for improving public health services. This survey of local governmental public health agencies was conducted to that end, as part of a larger study designed to classify the structural characteristics of local public health delivery systems and to examine variation and change in these characteristics over time. In 1998 and again in 2006, 2012, 2014, 2016 and 2018, local governmental public health agencies serving populations of 100,000 residents or more were surveyed about 20 core public health activities devoted to public health assessment, policy development, and assurance. For each activity, the survey instrument asked agency directors to report whether the activity was performed at all in the agency's jurisdiction and if so, which types of organizations were involved in performing the activity. Response options for the second item consisted of a pre-defined list of organization types, including hospitals, physician practices, health insurers, community health centers, educational institutions, community-based and faith-based organizations, state and local government agencies, and private businesses/employers. The instrument also asked what proportion of the total
community effort for each activity was contributed by the local public health
agency and asked how effectively the activity was performed.
description: A stratified random sample of the nation's largest local governmental public health agencies was
surveyed in 1998, 2006, 2012, 2014, 2016 and in 2018 to ascertain the availability of 20 core public health
activities within their jurisdictions and to identify the types of organizations contributing to each
activity. The attributes of local public health delivery systems were measured using a survey instrument
based on the Local Public Health System Assessment tool developed through a series of research
projects commissioned by the United States Centers for Disease Control and Prevention. These projects identified services and activities regarded as important for protecting and improving public health
at the community level, each of which derived from one of the three core public health functions
of assessment, policy development, and assurance as articulated by the Institute of Medicine.
description: Response Rates: A 71% response rate (n = 354) was achieved in the 1998 survey. The survey was re-administered to the same stratified sample of agencies in 2006, 2012, and 2014, achieving a response rate of 67% in 2006, 68% in 2012, 58% in 2014, 62% in 2016 and 60% in 2018.
description: Presence of Common Scales: The survey instrument was based on the Local Public Health System Assessment tool developed through a series of research projects commissioned by the United States Centers for Disease Control and Prevention.
description: A 100-percent sample of the universe was selected.
description: Datasets: 
DS0: Study-Level Files
DS1: NLSLPHS 1998-2006
DS2: NLSLPHS 1998-2014
DS3: NLSLPHS 1998-2016
DS4: NLSLPHS 1998-2018
description: The universe comprised all 497 local public health delivery systems in the United States that served jurisdictions of at least 100,000 residents during 1996-1997 as identified in the National Association of County and City Health Officials' (NACCHO) 1997 National Profile of Local Health
Departments. Geographically defined, each system is the service area of one of the nation's local governmental public health agencies, which were identified based on NACCHO's definition of a local governmental public health
agency: "an administrative or service unit of local or state government that is concerned with health and carries out some responsibility for the health of a jurisdiction smaller than the state.". Smallest Geographic Unit: Local public health jurisdiction
description: mail questionnaire; self-enumerated questionnaireThe data are organized in panel format with each local health department having one record for each year of the survey in which it responded (1998, 2006, 2012, 2014, 2016, and 2018). Thus, agencies that responded only in 1998 have only one record, while agencies that responded in multiple years have multiple records.Additional information about the survey is available on the Robert Wood Johnson Foundation's Systems for Action website.A randomly assigned agency identification number named ICPSR_ID15 was added to the data, which can be used to link the agency records across the four waves of the survey.