National Association of County and City Health Officials (NACCHO)
1989, 1992-93, 1996-97, 2005, 2008, 2010, 2013, 2016, 2019
Approximately every three years
Mode of Collection
Census: internet questionnaire.
The National Association of County and City Health Officials (NACCHO) fields the National Profile of Local Health Departments (NACCHO Profile). The Profile collects information on local health department (LHD) infrastructure, workforce, finance, governance, activities and services. It represents the largest, most up-to-date, and reliable source of data on LHDs in the United States. The purpose of the Profile is to provide a comprehensive and accurate description of LHD infrastructure and practice. Data are used by policymakers at the local, state, and federal levels to understand how LHDs improve and protect the health of local communities.
The Profile questionnaire addresses topics such as LHD jurisdiction/governance, partnerships, LHD leadership, workforce size and changes, finance, programs and services, emergency preparedness and response, planning, accreditation, quality improvement, workforce development, public health policy, and informatics.
All health departments in the United States meeting the NACCHO definition of a local health department. Rhode Island is excluded because the state health department operates on behalf of local public health and has no sub-state units.
Every NACCHO Profile study has used the same definition of an LHD: an administrative or service unit of local or state government concerned with health and carrying out some responsibility for the health of a jurisdiction smaller than the state. For the 2016 Profile study, a total of 2,533 LHDs in the United States were included in the study population. The Profile survey included a core questionnaire (sent to all LHDs in the study population) and two module questionnaires (sent to statistical samples of LHDs). 1,930 LHDs (76%) completed the survey. National estimates for all LHDs were computed using appropriate estimation weights to account for differential nonresponse and, for module questions, sampling.
Response Rates and Sample Size
In 2016, for the baseline data, 2,533 LHDs were surveyed. Of these, 1,930 responded, for an overall response rate of 76%.
The Profile is a unique and comprehensive source of information on a variety of LHD characteristics. However, several limitations should be considered when using the results of these studies. The Profile does not provide in-depth information on many of the topics covered. All data are self-reported by LHD staff and are not independently verified. LHDs may have provided incomplete, imperfect, or inconsistent information for various reasons. Comparisons with data from prior Profile studies should be viewed with caution because the study population and the individuals responding on behalf of the organizations may be different for each Profile. In addition, comparisons are not tested for statistical significance.
- National Association of County and City Health Officials: 2016 Profile of Local Health Departments. August 2017. Available at:
- National Association of County and City Health Officials; NACCHO Profile website.