TABLE 3—
Local Public Health System and Sociodemographic Characteristics Associated With County-Level STD Incidence: US Longitudinal Study of Local Public Health Systems, 2006
| Model 1 |
Model 2 |
Model 3 |
Model 4a |
|||||
| Characteristics | b | P | b | P | b | P | b | P |
| Local health department jurisdiction population, log | 0.10 | .007 | 0.12 | .005 | 0.02 | .559 | 0.02 | .603 |
| Local public health system type | ||||||||
| Distributed conventional (Ref) | 1.00 | … | 1.00 | … | 1.00 | … | 1.00 | … |
| Concentrated comprehensive | 0.14 | .26 | 0.30 | .059 | 0.20 | .056 | … | … |
| Independent comprehensive | 0.30 | .055 | 0.43 | .016 | 0.23 | .046 | … | … |
| Concentrated limited | 0.07 | .597 | 0.25 | .169 | 0.12 | .287 | … | … |
| Distributed limited | −0.12 | .457 | −0.19 | .403 | 0.03 | .832 | … | … |
| Other | −0.09 | .637 | −0.01 | .976 | 0.06 | .642 | … | … |
| Proportion of all essential services contributed by select system partnersb | … | … | … | … | … | … | 0.09 | .011 |
| Jurisdiction type | ||||||||
| County (Ref) | 1.00 | … | 1.00 | … | 1.00 | … | 1.00 | … |
| City and county | 0.37 | .004 | 0.25 | .105 | 0.15 | .184 | 0.14 | .197 |
| City or town | 0.37 | .061 | 0.12 | .647 | −0.04 | .819 | −0.13 | .501 |
| Multicounty | −0.17 | .142 | −0.27 | .074 | −0.11 | .324 | −0.12 | .272 |
| Governance | ||||||||
| No local board of health (Ref) | 1.00 | … | 1.00 | … | 1.00 | … | 1.00 | … |
| Board of health, no governing role | −0.03 | .81 | −0.32 | .062 | −0.11 | .345 | −0.12 | .291 |
| Board of health, governing role | −0.23 | .036 | −0.50 | < .001 | −0.29 | .003 | −0.29 | .002 |
| Local health department resources | ||||||||
| Expenditures per capita, log | 0.11 | .133 | 0.05 | .318 | 0.05 | .284 | ||
| Local (city and county) revenue, % | −0.07 | .333 | 0.01 | .763 | 0.03 | .429 | ||
| Health educators per 100 000 population | −0.01 | .85 | −0.04 | .3 | −0.05 | .278 | ||
| Epidemiologists per 100 000 population | 0.00 | .954 | −0.03 | .417 | −0.02 | .48 | ||
| Sociodemographic variables,% | ||||||||
| Black | 0.37 | < .001 | 0.38 | < .001 | ||||
| Population aged 18–24 y | −0.07 | .152 | −0.06 | .209 | ||||
| Male–female ratio | −0.10 | < .001 | −0.10 | < .001 | ||||
| Median household income | −0.41 | < .001 | −0.42 | < .001 | ||||
| Suburban commute index | 0.07 | .146 | 0.06 | .18 | ||||
| Owner-occupied housing | −0.09 | .081 | −0.10 | .047 | ||||
| Urban population | 0.25 | < .001 | 0.23 | < .001 | ||||
| Persons in poverty | −0.15 | .095 | −0.16 | .075 | ||||
| Death rate per 100 000 population | −0.20 | < .001 | −0.20 | < .001 | ||||
| Model statistics | ||||||||
| Constant | 5.92 | < .001 | 6.05 | < .001 | 5.92 | < .001 | 6.02 | < .001 |
| Model fit (AIC) statistic | 563.60 | 330.50 | 233.30 | 224.65 | ||||
Note. AIC = Akaike information criterion; STD = sexually transmitted disease.
a
Model 4 is a sensitivity analysis. The model replaces the local public health system type variables with a variable measuring the proportion of all essential services contributed by select system partnersb and includes physician organizations, hospitals, community health centers, and faith-based organizations—organizations considered critical to STD prevention and control activities.