This policy-related study examines primary care delivery methods in reducing population health disparities. We use postneonatal mortality as an indicator of population health within counties to study the effects of using contracted service providers compared to direct provision of primary care by county health departments in improving health equity. We analyzed postneonatal mortality data colle...

About NACo – The Voice of America's Counties The National Association of Counties (NACo) is the only national organization that represents county governments in the United States. Founded in 1935, NACo provides essential services to the nation's 3,066 counties. NACo advances issues with a unified voice before the federal government, improves the public's understanding of county government, assi...

In this study we use data envelopment analysis (DEA), and an extension of DEA called value efficiency analysis (VEA), to explore the “production” of quality of life within counties in the mid-Atlantic region and the extent to which production frontiers and efficiency differ between rural and urban counties. These methods allow us to identify counties that are inefficient in their quality of lif...

We examine the relationship between state legislative representation and public finances. Baker v. Carr and subsequent court cases led to the equalization of population in U.S. state legislative districts. Analysis of state transfers to counties finds strong evidence that the equalization of legislative representation had a large effect on the distribution of state money. First, crosssectional ...

This paper tests whether the strength of the "spring spike" in birth defects is related to agricultural production and urban location using Texas Birth Defects Registry data for the period 1996-2007. We find evidence of a spike in birth defects among children conceived in the spring and summer, but it is more pronounced in urban non-agricultural counties than in other types of counties. Further...

OBJECTIVES We tested the association between the availability of primary care and income inequality on several categories of mortality in US counties. METHODS We used cross-sectional analysis of data from counties (n=3081) in 1990, including analysis of variance and multivariate ordinary least squares regression. Independent variables included primary care resources, income inequality, and so...

Retirement counties and Destination counties generally attract migrants, especially older adults and family age migrants. Many are adjacent to metropolitan areas or have natural amenities, which attract people. Destination counties tend to attract people at all ages and face development challenges due to rapid growth. Retirement counties experience considerable out-migration of young adults cou...

OBJECTIVE The objective of this study was to test whether the association between primary care and income inequality on all-cause, heart disease and cancer mortality at county level differs in urban (Metropolitan Statistical Area-MSA) compared with non-urban (non-MSA) areas. STUDY DESIGN The study consisted of a cross-sectional analysis of county-level data stratified by MSA and non-MSA areas...