Building Trust, Resilience, and Healthier Communities through Public Health Accreditation

Posted on February 26, 2025 by Erika G. Martin

This entry is part 4 of 7 in the series Mar 2025

Since the start of voluntary accreditation of U.S. health departments in 2009, an increasing number of health departments have undertaken accreditation to improve quality, accountability, and performance. This effort was prompted by the Institute of Medicine’s 2003 report, The Future of the Public’s Health in the 21^st Century, which called for an exploration of the benefits of public health accreditation. Following the work of a national committee that explored the feasibility and desirability of a national public health accreditation program, the Public Health Accreditation Board was subsequently formed in 2007 as a nonpartisan nonprofit organization to develop, implement, and oversee national accreditation. Currently, approximately 450 state, local, and Tribal health departments are nationally accredited.

Accredited health departments self-report a range of internal and external benefits. In recent surveys of accredited health departments, nearly all health departments indicated that they made the right choice to apply for accreditation or reaccreditation, and that the accreditation process improved the performance of their department. Specific reported benefits of accreditation were:

Stimulation of quality and performance improvement opportunities (100% of health departments surveyed);
Improved ability to identify and address gaps in employee training and workforce development (93%);
Improved accountability to external stakeholders (93%);
Increased use of evidence-based practices for public health programs and/or business practices (93%);
Improved utilization of resources within their health department (71%); and
Improved overall capacity to provide high quality programs and services (80%).

Read the Article Collection on Accreditation in the March issue of JPHMP

The articles in a special section of the March issue of the Journal of Public Health Management & Practice provide additional evidence about the value, impact, and experiences of accreditation. Davis et al. examined the relationship between local health department accreditation and COVID-19 outcomes, finding that after adjusting for social vulnerability, public policy measures, and state public health governance structures, communities with an accredited local health department had a higher percent of adults with full COVID-19 vaccine coverage and a lower COVID-19 death rate. Oberly et al. examined the accreditation experiences of local health departments in Ohio, which has a national public health accreditation mandate, finding numerous benefits and lessons for successful implementation of accreditation mandates elsewhere. Allen, Fifolt, Crenshaw, and colleagues interviewed four small local and Tribal health departments working towards achieving reaccreditation or Pathways Recognition, providing information on topics including strategies for overcoming accreditation challenges and advice for other health departments, experiences related to Quality Improvement and Performance Management, and strategies to motivate staff and keep them informed throughout the process.

In their opening commentary, Kuehnert and Bender, past presidents and CEOs during PHAB’s initial development and growth, describe the evolution of national public health accreditation and its supporting evidence base and make the case that “now is the time” for health departments to initiate and sustain accreditation. Although there is room for additional research for a deeper understanding of the many positive impacts of accreditation, these articles provide a compelling snapshot of improvements in population health outcomes and internal processes.

About the Author

Erika G. Martin: Erika Martin, PhD, MPH, is Vice President of Research and Product Development at the Public Health Accreditation Board. Her research uses quantitative and qualitative methods to evaluate programs and policies, with expertise in public health services and systems, infectious disease, public health data systems and open data platforms, and evidence-based practice. She has extensive experience collaborating with public health partners to transform scientific findings, data, and tools into program impact. Articles she’s written have appeared in leading health and public policy journals such as the New England Journal of Medicine, JAMA, Journal of the American Medical Informatics Association, Health Affairs, American Journal of Public Health, and Journal of Policy Analysis and Management.