john marx
University of Pittsburgh, Sociology, Emeritus
Research Interests: Finance, Psychology, Mental Health, Depression, Adolescent, and 15 moreUrban Health, Medicine, Distress, Humans, Needs Assessment, Major Depressive Disorder, Female, Psychological Intervention, Young Adult, Risk factors, African Americans, Adult, Public health systems and services research, Risk Factors, and Psychological Stress
Almost three quarters of the nation's local health departments (LHDs) have privatized some services. About half of LHD directors who privatized services reported cost savings and half reported that privatization had facilitated their... more
Almost three quarters of the nation's local health departments (LHDs) have privatized some services. About half of LHD directors who privatized services reported cost savings and half reported that privatization had facilitated their performance of the core public health functions. Expanded access to services was the most commonly reported positive outcome. Of those privatizing, over two‐fifths of LHDs reported a resulting increase in time devoted to management. Yet, one‐third of directors reported difficulty monitoring and controlling services that have been contracted out. Communicable disease services was cited most often as a service that should not be privatized. There is a pervasive concern that by contracting out services, health departments can lose the capacity to respond to disease outbreaks and other crises.
Research Interests: Business, Program Evaluation, Demography, Public Health, Medicine, and 13 moreHumans, Privatization, Health Services, Public Health Administration, United States, Data Collection, Public health systems and services research, Organizational Innovation, Communicable Disease, Costs and Cost Analysis, personnel staffing and scheduling, Administrative Personnel, and Health Department
Almost three quarters of the nation's local health departments (LHDs) have privatized some services. About half of LHD directors who privatized services reported cost savings and half reported that privatization had facilitated their... more
Almost three quarters of the nation's local health departments (LHDs) have privatized some services. About half of LHD directors who privatized services reported cost savings and half reported that privatization had facilitated their performance of the core public health functions. Expanded access to services was the most commonly reported positive outcome. Of those privatizing, over two‐fifths of LHDs reported a resulting increase in time devoted to management. Yet, one‐third of directors reported difficulty monitoring and controlling services that have been contracted out. Communicable disease services was cited most often as a service that should not be privatized. There is a pervasive concern that by contracting out services, health departments can lose the capacity to respond to disease outbreaks and other crises.
Research Interests: Business, Program Evaluation, Demography, Public Health, Medicine, and 13 moreHumans, Privatization, Health Services, Public Health Administration, United States, Data Collection, Public health systems and services research, Organizational Innovation, Communicable Disease, Costs and Cost Analysis, personnel staffing and scheduling, Administrative Personnel, and Health Department
OBJECTIVES: This study sought to obtain and analyze nationally representative data on (1) privatization of local health department services, (2) local health department directors' beliefs and perspectives on the desirable role and... more
OBJECTIVES: This study sought to obtain and analyze nationally representative data on (1) privatization of local health department services, (2) local health department directors' beliefs and perspectives on the desirable role and focus of health departments, and (3) the influence of these views on privatization practices. METHODS: A stratified representative national sample of 380 local health department directors was drawn, and 347 directors were interviewed by telephone. Logistic regression established the independent effects of various factors on decisions to privatize. RESULTS: Almost three quarters (73%) of the local health departments privatized public health services of some type. The 12% of the directors who believed that local health departments should be restricted to the core public health functions and move entirely out of direct provision of personal health care were more likely to privatize services. The 77% of the directors who believed that local health departme...
Research Interests:
Research Interests:
Objectives. This article presents nationally representative data on the effects of privatization on local health departments (LHDs). Methods. A stratified representative national sample of 380 LHDs was drawn from a national list of 2488... more
Objectives. This article presents nationally representative data on the effects of privatization on local health departments (LHDs). Methods. A stratified representative national sample of 380 LHDs was drawn from a national list of 2488 departments. Telephone interviews were conducted with 347 LHD directors. Results. One half of the directors of LHDs with privatized services reported that privatization helped the performance of core functions. Privatization often resulted in increased time needed for management and administration. More than a third of LHD directors reported concern about loss of control over the performance of privatized functions and services. Conclusions. Privatization is part of a broader shift toward “managing” rather than directly providing public health services, yet privatization often reduces LHDs' control over the performance of services. (Am J Public Health. 2002;92:1178–1180)