TABLE 2—

Differences in the Percentage of Local Health Department Revenue Source by Time and Rurality: United States, 2010 and 2016

LHD Revenue Source	2010 (n = 1828), %	2016 (n = 1699), %	Percentage Point Difference (2016–2010)	DID
Local
Urbana	36.7	45.7	9.0	Ref
Large ruralb	28.3c	33.5c	5.2	3.80
Small rurala	26.7c	35.6c	8.9	0.10
State
Urbana	21.3	17.3	−4.0	Ref
Large rural	19.5	22.2c	2.7	−6.70**
Small rurala	23.3	19.9d	−3.4	−0.60
Federal pass through
Urbanb	21.3	18.6	−2.7	Ref
Large rural	21.9	21.4d	−0.5	−2.20
Small rural	22.0	23.2c	1.2	−3.90*
Federal direct
Urban	4.4	3.7	−0.7	Ref
Large rurala	4.2	1.3c	−2.9	2.20*
Small rurala	3.8	1.3c	−2.5	1.80
CMS
Urbana	14.6	7.9	−6.7	Ref
Large rurala	24.1c	15.7c	−8.4	1.70
Small rurala	24.5c	17.6c	−6.9	0.20
Private foundation
Urbanb	1.4	0.9	−0.5	Ref
Large rural	2.0	1.2	−0.8	0.30
Small rural	1.9	1.3	−0.6	0.10
Private insurance
Urban	1.4	1.4	0.0	Ref
Large ruralb	2.2d	3.3c	1.1	−1.10*
Small rural	4.7c	4.5c	−0.2	0.20
Patient fees
Urbana	3.3	1.5	−1.8	Ref
Large rural	4.5d	3.7c	−0.8	−1.00
Small rurala	5.1c	3.6c	−1.5	−0.30
Nonclinical fees
Urban	12.0	10.7	−1.3	Ref
Large rural	9.1d	7.9d	−1.2	−0.10
Small rural	4.1c	3.9c	−0.2	−1.10
Other
Urbana	5.5	3.3	−2.2	Ref
Large rurala	6.2	2.2	−4.0	1.80
Small rural	5.7	4.2	−1.5	−0.70

Note. CMS = Center for Medicare and Medicaid Services; DID = differences in differences; LHD = local health department. Values derived from Stata MARGINS command following unadjusted regression model.

^aP < .01 change between 2010 and 2016.

^bP < .05 change between 2010 and 2016.

^cP < .01 compared with urban.

^dP < .05 compared with urban.

^*P < .05 DID; **P < .01 DID.