DOI: 10.3886/icpsr39351.v1
title: National Profile of Local Health Departments, [United States], 2022
title: Version 1

description: The National Association of County and City Health Officials (NACCHO) conducts the National Profile of Local Health Departments, commonly referred to as the Profile study, every three years as a census of local health departments (LHDs). This study describes the funding, staffing, governance, and activities of LHDs across the United States, developing a description of LHD infrastructure and practice. In the three decades since, NACCHO has conducted an additional nine Profile studies, including in 2022.
description: The purpose of this study is to develop a comprehensive and accurate description of local health department (LHD) infrastructure and practice, and it is one of the only national surveys to collect data from LHDs.
description: The National Association of County and City Health Officials (NACCHO) used a database of LHDs based on previous Profile studies and consults with state health agencies, state associations, and select local health officials to identify LHDs for inclusion in the study population. For the 2022 Profile study, a total of 2,512 LHDs were included in the study population. Rhode Island was excluded from the study because the state health agency operates on behalf of local public health and has no sub-state units.
The NACCHO Profile team developed the 2022 questionnaire by first reviewing the previous Profile questionnaire (i.e., 2019) to determine how each question performed among respondents and what questions should be kept, modified, or deferred to a future Profile questionnaire. The Profile team also reviewed questionnaires from previous years (e.g., 2016, 2013, 2010) to identify whether any questions should be repeated in 2022. Lastly, the team explored developing new questions based on current public health topics. An advisory group comprising of LHD leaders and staff from affiliate organizations including Association of State and Territorial Health Officials (ASTHO), Centers for Disease Control and Prevention (CDC), and Robert Wood Johnson Foundation (RWJF). Researchers and other subject matter experts within NACCHO provided input and feedback on new and revised survey questions. The Profile team piloted the questionnaire among 30 LHDs from March 14, 2022, to March 31, 2022, that resulted in 15 LHDs completing it. The Profile team revised the survey as needed and finalized it for distribution.
NACCHO fielded the Profile questionnaire from June through September 2022 via an e-mail sent to a designated primary contact of every LHD in the study population. The e-mail included a link to a web-based Qualtrics questionnaire, individualized with preloaded identifying information specific to the LHD. NACCHO staff and a nationwide group of Profile study advocates conducted follow-up with non-respondents using e-mail messages and telephone calls. NACCHO also offered technical support to survey respondents through an e-mail address and telephone hotline.
description: Post-stratification (based on 7 population size categories - <b>C0POPCAT7</b>) and finite population correction were used to adjust for item non-response and to account for the fact that population size by category is known and limited in size. Estimates reported by the National Association of County and City Health Officials (NACCHO) are analyzed in Stata wherein a survey design is declared for the dataset using the svyset command. The denominator for each population category is included as a variable in the dataset. Based on the post-stratification weighting technique, Profile results can be viewed as national estimates based on size of LHD population served. Below is the code used in Stata for the svyset:
svyset_n, strata (<b>C0POPCAT7</b>) fpc (<b>CORE_DENOM</b>) poststrata (<b>C0POPCAT7</b>) postweight (<b>CORE_DENOM</b>) vce (linearized) singleunit (missing)
In the 2022 dataset, strata and post-strata aligns with <b>C0POPCAT7</b>; the number of LHDs in the study population within each strata for <b>C0POPCAT7</b> is reflected in <b>CORE_DENOM</b> variable.
description: Response Rates: 37.5%
description: Among the study population, LHDs were selected to receive either the core plus module 1 or core plus module 2 via stratified random sampling. The stratified random sampling was based on a 7-category measure of size of LHD population served (LHDs serving less than 25,000 people, 25,000-49,999 people, 50,000-99,999 people, 100,000-249,999 people, 250,000-499,999 people, 500,000-999,999 people and more than 1,000,000 people served). Modules are supplemental to the core questionnaire and aim to reduce the burden due to survey length. The sampling process for Profile is designed to produce national estimates (for both core and modules) based on size of LHD population served, but not designed to produce any sub-national (e.g., state-level) estimates.
description: Datasets: 
DS0: Study-Level Files
DS1: Public-Use Data
DS2: Restricted-Use Data
description: Local health departments located in the United States. Smallest Geographic Unit: State
description: web-based surveyFor additional information on the National Profile of Local Health Departments series, please visit the NACCHO website.