Increase the proportion of local public health agencies that are accredited — PHI‑02 Data Methodology and Measurement

About the National Data


Baseline: 13.4 percent of local public health agencies were accredited as of December 2019

Target: 17.0 percent

Number of local public health agencies that are nationally accredited.
Number of local public health agencies.
Target-setting method

Percentage point improvement

Target-setting method details
Percentage point improvement from the baseline using Cohen's h effect size of 0.10.
Target-setting method justification
Trend data were evaluated for this objective, but it was not possible to project a target because the Healthy People 2030 Workgroup Subject Matter Experts (SMEs) did not consider the projected values realistic based on current knowledge. A percentage point improvement was calculated using Cohen's h effect size of 0.1. This method was used because the SMEs viewed this as an ambitious yet achievable target given knowledge of current applicants to the accreditation program and expected participation in reaccreditation.


Methodology notes

To be accredited, public health agencies must submit documentation to demonstrate conformity with approximately 100 consensus Standards and Measures, which are based on the 10 Essential Public Health Services, to the Public Health Accreditation Board (PHAB). That documentation is reviewed by a team of peers who also conduct a site visit. That team of peer site visitors develops a report describing the public health agency's conformity with the Standards and Measures. PHAB's Accreditation Committee reviews the report and makes a determination about accreditation status.

A PHAB-accredited public health department is accredited for five years. During those five years, health departments must submit annual reports describing how they are addressing priority areas for improvement. Additionally, these reports provide PHAB with a way to ensure the health department continues to be in conformity with the accreditation requirements outlined in the PHAB Standards and Measures. When initial accreditation expires, the health department must apply for, and successfully complete, the reaccreditation process in order to maintain accreditation status. The requirements and the process for reaccreditation have been designed to ensure that accredited health departments continue to evolve, improve, and advance, thereby becoming increasingly effective at improving the health of the population they serve. Reaccreditation utilizes a modified self-study model that requires health departments to use narratives to describe how the activities are being implemented, reviewed, and revised, as well as to note the health department's advancements towards achieving a culture of quality improvement. The domains are the same as those in initial accreditation, but the reaccreditation measures are fewer and different (105 in initial accreditation and 31 in reaccreditation). Reaccreditation also requires health departments to report on population health outcomes, which will help to inform and document the evidence for how accreditation contributes to changes in health outcomes.

The numerator reflects local health departments that have current accreditation status, as of the time of reporting. This includes public health agencies that have achieved initial accreditation and those that have maintained their accreditation through the reaccreditation process. Those that do not get reaccredited or have let accreditation status lapse will not be included within the numerator. The numerator includes those accredited via all PHAB application processes for local public health units, including single local health department application processes, multijurisdictional application processes, and local units within centralized state application processes.

The denominator is the total number of possible applicants to PHAB from each state and is based on the likely unit of applicant (e.g., district, county). This denominator will be monitored and may be adjusted over time, as changes in public health structures occur (e.g., consolidation of public health departments) or new plans develop for application processes to PHAB. Based on this work, the current denominator being used is 2,309.


Comparable HP2020 objective
Retained, which includes core objectives that are continuing from Healthy People 2020 with no change in measurement.

1. Effect size h=0.1 was chosen to correspond with 10% improvement from a baseline of 50%.