Local Health Department Priority Setting: An Exploratory Study

Priority setting is an integral part of the community health assessment process since it helps direct the allocation of limited public health resources among competing needs. There is a recognized need for a systematic mechanism to prioritize community health issues in objective, data-driven, quantifiable measures. This exploratory study examined the extent to which data-driven objective criteria were considered important to public health officials in North Carolina and, specifically, the extent to which they chose between objective and subjective criteria in establishing public health priorities. The differences between the health officers' practice (criteria they actually used) and their preferences (criteria thought to be important) were also assessed. It was found that NC health directors generally used subjective criteria more often than objective criteria when deciding on the most important health issues in their communities. A considerable segment of the respondents, however, considered objective criteria more important, even though subjective criteria were the dominant influence in their actual practice of priority setting. Our preliminary results suggest that officers' education and tenure may influence their practice and preferences. Perceived and real barriers to the use of data-driven objective criteria for priority setting are an important topic for future public health research.