To examine the association between local health department (LHD) accreditation and COVID-19 community outcomes, including rates of adult vaccination, hospitalization, and death.
Design:
We examined county level rates of adult vaccination, hospitalization, and death by LHD accreditation status over the course of the COVID pandemic. Additional independent variables included time period, COVID-19 Community Vulnerability Index (CCVI), state public health governance structure, and state policy environment. We used hierarchal linear mixed modeling with random intercept for county level data to account for repeated observations and fixed effects for all other variables.
Setting:
This study examined all communities in the United States of America.
Participants:
LHDs and the communities they serve.
Main Outcome Measures:
Rates of adult vaccination, hospitalization, and death due to COVID-19.
Results:
Among accredited LHDs, the adult population was more likely to be fully vaccinated when compared to unaccredited LHDs (P