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State Legislation and Local Health Departments in New Jersey

The major purpose of this study was to determine the extent to which local health departments of New Jersey had achieved compliance, particularly in the area of health education, with the Local Health Services Act of 1975 and the resulting updated Recognized Public Health Activities and Minimum Standards of Performance for Local Boards of Health which became effective April, 1978. The intent was to improve local health services by increasing the area covered by full time health officers and by mandating expansion of services, including health education. In addition, the legislature provided funding for crucial purposes through The Public Health Priority Fund Act of 1977.

A questionnaire was developed from a statement by statement review of the standards and the professional literature. Field tests of the questionnaire at three New Jersey health departments and committee review resulted in final revision.

All health departments (112) named on a list obtained from the New Jersey State Department of Health were the subjects of this survey. The questionnaire was mailed to the remaining 109 departments. Ninety four (86%) of the mailed questionnaires were returned. The data analyzed were the responses to the 97 completed questionnaires. In addition to frequencies and percentages tabulated for the gathered data, cross tabulations of variables were made and analyzed using the chi-square statistic and the Pearson product moment correlation coefficient, as appropriate.

Findings and Conclusions. (1) Thirty three (34%) of the questionnaire respondents reported organizational changes in their health departments in attempts to comply with the updated standards. (2) No significant correlation between per capita expenditure and the size of the populations served by the departments was found. (3) One hundred and twenty four professionals were hired in order to comply with the standards, including 20 health educators and 13 full time health officers. (4) Compliance with the standards was also achieved by the sale and purchase of health services between departments. Forty six (47%) departments sold and 52 (53%) purchase services. (5) No significant relationships were found between a conservative or liberal political climate and per capita expenditure of the health departments. (6) Departments serving large populations were more likely to have health educators on staff than departments serving smaller populations. (7) Approximately two thirds of the respondents reported minimum educational requirements for health educators which were equally divided between bachelor’s degree, master of public health and other master’s degrees. (8) Funds were provided through budget allowances and health priority funding for health education activities mandated by the updated minimum standards by 86% to 96% of the departments, depending on the activity. (9) Health departments with health educators on staff are more likely to have determined their health education needs and are more likely to have planned specific health education programs from these needs, as required, than departments without health educators on staff. (10) Sixty-seven respondents contributed personal comments regarding problems in complying with the guidelines. The most frequently mentioned were: insufficient funds for the health department activities, lack of leadership and assistance given the local health departments by the State Department of Health and lack of support and/or understanding given local health departments by their governing body.

The findings of this study as reviewed and analyzed indicate extensive compliance with the Local Health Services Act.