Public Health Shortage Areas in Pennsylvania

A Barrier to Health Information


  • Alberto J. F Cardelle
  • Deidre Holland



One of the essential functions of public health services is to “inform, educate, and empower people about health issues” (CDC 1994). Throughout the United States, the tendency is to have decentralized public health systems that leave the decision-making and a significant part of the financing to local county and municipal governments. This strong reliance on local government financing and control translates into extreme variations in per capita expenditures and access. This paper examines whether or not individuals residing in areas without a centralized public health infrastructure have more difficulty accessing health information to help them make informed decisions about healthy living and lifestyle choices. The paper compares the ease and accuracy of accessing basic public health information in counties and municipalities without a Local Health Department (LHD) as compared to counties and municipalities served by a LHD. The study examines the case of Pennsylvania, because the state has the lowest ratio of public health workers per person in the country (Gebbie 2000), and it has only 10 LHDs covering six counties and four municipalities. The study found that in areas without a LHD, residents had to make 20% more calls and received useful information in only 64% of the inquiries. This is compared with locales served by LHDs which required fewer calls in order to receive useful information, and in which useful information was attained 100% of the time. This assessment shows that the potential for callers to receive useful public health information in areas without a LHD was impacted by both the higher number of calls that were required and in the diversity of places to which callers were referred. In locales without LHDs, the caller was much more likely to be referred to a non-public health entity, and was statistically less likely to get to speak to a public health professional early on in their inquiry.






Part I. Critical Issues in Pennsylvania’s Public Health System