Assessing the performance of local public health systems: a survey of state health agency efforts.

Throughout the past decade, growing attention has focused on ways to monitor the performance of local public health organizations and ensure the adequacy of their services. We surveyed representatives of the nation's state health agencies during 1997 to examine their processes for local public health performance assessment. Eighty-eight percent of agencies reported some involvement in assessment activities. Of these agencies, 50 percent reported having an assessment process that was currently operative. States reported using a diversity of assessment methods. Results suggest that states are developing performance assessment processes that are tailored to local resources, needs, and priorities.