Evaluating Inclusiveness in Multi-Sector Community Health Networks: The Case of Tribal Organizations
Data Sources. We used 2018 National Longitudinal Survey of Public Health Systems data, a nationally-representative cohort of U.S. public health systems.
Study Design. Social network analysis measures were computed to indicate the extent of tribal organization participation in public health networks. Two-part regression models estimated predictors of tribal inclusion.
Data Collection. A stratified random sample of local public health agencies were surveyed with a 71% response rate, yielding 574 respondents. An additional cohort of non-random respondents were surveyed upon request of their respective state health departments (n=154). These respondents were included in the sample yielding a final sample size of 728 local public health systems representing 1,048 U.S. counties.
Principal Findings. Tribal organizations participated in 15.7% of public health networks. When an AI/AN-serving health facility was present in the region, tribal organizations participated in 30.7% of public health networks. Networks with tribal inclusion were more comprehensive in terms of the breadth of sectors and social services participating in the network, and the scope of public health activities provided [OKM1] relative to networks without tribal inclusion. The likelihood of tribal inclusion increased significantly with the size of the American Indian and Alaska Native (AI/AN) population in urban communities, presence of an AI/AN-serving health facility in the region, and geographic proximity to reservation land (p<0.05). Tribal organizations had strongest ties with hospitals and community health centers, and organizations that provide housing services.
Conclusions. The vast majority of community health networks do not report inclusion of tribal organizations. Even when AI/AN-serving health facilities are present, reported inclusion of tribal organizations remains low.
Owsley, K. M., Bauer, K., & Mays, G. P. Evaluating Inclusiveness in Multi-Sector Community Health Networks: The Case of Tribal Organizations.
Owsley, Kelsey M., Kyla Bauer, and Glen P. Mays. “Evaluating Inclusiveness in Multi-Sector Community Health Networks: The Case of Tribal Organizations” (n.d.).
Owsley, Kelsey M., et al. Evaluating Inclusiveness in Multi-Sector Community Health Networks: The Case of Tribal Organizations.