Monday, April 21
Grant Miller: Managerial Incentives in Public Service Delivery
Hillemeier, Marianne M., John W. Lynch, S. Harper, and M. Casper. 2003. "Measuring Contextual Characteristics for Community Health." Health Services Research, 38(6): 1645-1717.
Objective. To conceptualize and measure community contextual influences on population health and health disparities. Data Sources. We use traditional and nontraditional secondary sources of data comprising a comprehensive array of community characteristics. Study Design. Using a consultative process, we identify 12 overarching dimensions of contextual characteristics that may affect community health, as well as specific subcomponents relating to each dimension. Data Collection. An extensive geocoded library of data indicators relating to each dimension and subcomponent for metropolitan areas in the United States is assembled. Principal Findings. We describe the development of community contextual health profiles, present the rationale supporting each of the profile dimensions, and provide examples of relevant data sources. Conclusions. Our conceptual framework for community contextual characteristics, including a specified set of dimensions and components, can provide practical ways to monitor health-related aspects of the economic, social, and physical environments in which people live. We suggest several guiding principles useful for understanding how aspects of contextual characteristics can affect health and health disparities.