National Longitudinal Survey of Public Health Systems (NALSYS), [United States], 1998-2023 (ICPSR 23420)
Version Date: Jul 7, 2026 View help for published
Principal Investigator(s): View help for Principal Investigator(s)
Glen P. Mays, University of Kentucky;
F. Douglas Scutchfield, University of Kentucky
https://doi.org/10.3886/ICPSR23420.v5
Version V5 (see more versions)
Alternate Title View help for Alternate Title
Summary View help for Summary
Obtaining a better understanding of the organizational and operational attributes of public health delivery systems is a critical step in elucidating pathways for improving public health services. This survey of local governmental public health agencies was conducted to that end, as part of a larger study designed to classify the structural characteristics of local public health delivery systems and to examine variation and change in these characteristics over time. In 1998 and again in 2006, 2012, 2014, 2016, 2018, and 2023 local governmental public health agencies serving populations of 100,000 residents or more were surveyed about 20 core public health activities devoted to public health assessment, policy development, and assurance.
For each activity, the survey instrument asked agency directors to report whether the activity was performed at all in the agency's jurisdiction and if so, which types of organizations were involved in performing the activity. Response options for the second item consisted of a pre-defined list of organization types, including hospitals, physician practices, health insurers, community health centers, educational institutions, community-based and faith-based organizations, state and local government agencies, and private businesses/employers. The instrument also asked what proportion of the total community effort for each activity was contributed by the local public health agency and asked how effectively the activity was performed.
Citation View help for Citation
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Funding View help for Funding
Subject Terms View help for Subject Terms
Geographic Coverage View help for Geographic Coverage
Smallest Geographic Unit View help for Smallest Geographic Unit
U.S. Census Division
Distributor(s) View help for Distributor(s)
Time Period(s) View help for Time Period(s)
Date of Collection View help for Date of Collection
Data Collection Notes View help for Data Collection Notes
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The data are organized in panel format with each local health department having one record for each year of the survey in which it responded (1998, 2006, 2012, 2014, 2016, 2018, and 2023). Thus, agencies that responded only in 1998 have only one record, while agencies that responded in multiple years have multiple records.
- Additional information about the survey is available on the Robert Wood Johnson Foundation's Systems for Action website.
- A randomly assigned agency identification number named ICPSR_ID was added to the data by the Principal Investigators. This ID variable may be used to link the agency records across the datasets.
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Previously, DS1 containing the years 1998 to 2006 was restricted from general use. The decision was made to remove the restrictions from this dataset. It is now publicly available along with the other datasets.
Study Design View help for Study Design
A stratified random sample of the nation's largest local governmental public health agencies was surveyed in 1998, 2006, 2012, 2014, 2016, 2018, and 2023 to ascertain the availability of 20 core public health activities within their jurisdictions, and to identify the types of organizations contributing to each activity. The attributes of local public health delivery systems were measured using a survey instrument based on the Local Public Health System Assessment tool developed through a series of research projects commissioned by the United States Centers for Disease Control and Prevention. These projects identified services and activities regarded as important for protecting and improving public health at the community level, each of which derived from one of the three core public health functions of assessment, policy development, and assurance as articulated by the Institute of Medicine.
Sample View help for Sample
Arm 1 is the original wave comprising a 100% sample of local public health jurisdictions containing 100,000 or more residents in 1997.
Arm 2 is the second wave added in survey year 2014 comprising a stratified random sample of jurisdictions containing less than 100,000 residents in 2013. These jurisdictions were sampled from 12 strata reflecting the four U.S. Census regions, and three population categories (under 10,000 residents; 10,000 to 49,999 residents; and 50,000-99,999 residents).
Arm 3 is the third wave added in survey year 2014 comprising a small number of jurisdictions containing less than 100,000 residents in 2005. This cohort was originally selected for a separate study using a simple random sample of jurisdictions below the identified population threshold of 100,000.
Arm 4 is the fourth wave added in survey year 2018 comprising all jurisdictions located in 5 states that were not included in any of the other cohorts (IN, KY, OH, TX and WA). Arm 4 of the study also includes the 2023 survey.
Time Method View help for Time Method
Universe View help for Universe
Jurisdictions served by public health agencies that operate as units of local or state government, and that serve geographic areas smaller than a state.
Unit(s) of Observation View help for Unit(s) of Observation
Data Type(s) View help for Data Type(s)
Mode of Data Collection View help for Mode of Data Collection
Response Rates View help for Response Rates
- 1998: 71 percent
- 2006: 47 percent
- 2012: 48 percent
- 2014: 48 percent
- 2016: 60 percent
- 2018: 52 percent
- 2023: 25 percent
Presence of Common Scales View help for Presence of Common Scales
The survey instruments were based on the Local Public Health System Assessment tool developed through a series of research projects commissioned by the United States Centers for Disease Control and Prevention. Please see the P.I. Codebooks for additional information and references.
HideOriginal Release Date View help for Original Release Date
2008-12-01
Version History View help for Version History
2026-07-07 DS5, containing data from 1998-2023, was added to the study collection. The added years of data collection prompted a change in the study title. Documentation from the first four datasets were updated to reflect this title change. Also, the restricted access to DS1 has been lifted. It is now publicly available along with the other datasets.
2020-09-23 DS1 was updated to include the full ICPSR suite of statistical packages with standardized variables and value labels and an ICPSR Codebook with question text. DS2 had documentation and data updated to include standardized variable and value labels with question text.
2020-05-05 Datasets 3 and 4 were added, which include survey results from 2016 and 2018.
2018-02-15 The citation of this study may have changed due to the new version control system that has been implemented. The previous citation was:
- Mays, Glen P., and F. Douglas Scutchfield. National Longitudinal Survey of Public Health Systems (NALSYS), [United States], 1998-2023. ICPSR23420-v5. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2026-07-07. http://doi.org/10.3886/ICPSR23420.v5
2018-02-08 Dataset 2 was added, which includes survey results from 2012 and 2014.
2008-12-01 ICPSR data undergo a confidentiality review and are altered when necessary to limit the risk of disclosure. ICPSR also routinely creates ready-to-go data files along with setups in the major statistical software formats as well as standard codebooks to accompany the data. In addition to these procedures, ICPSR performed the following processing steps for this data collection:
- Created online analysis version with question text.
- Checked for undocumented or out-of-range codes.
Weight View help for Weight
DS5 from 1998 to 2023 introduced a sampling weight variable, WGT into the dataset. A weight variable was not included in the previous datasets. This new weight variable reflects the wave, YEARSURVEY, and sampling stratum STRATA, from each participating agency.
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The public-use data files in this collection are available for access by the general public. Access does not require affiliation with an ICPSR member institution.
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One or more files in this data collection have special restrictions. Restricted data files are not available for direct download from the website; click on the Restricted Data button to learn more.