Kusuma Madamala, MPH, University of Illinois at Chicago, 605 W. Madison Street, Chicago, IL 60661, 312-902-3305, kmadam1@uic.edu and Michele Issel, PhD, School of Public Health/Division of Community Health Sciences, University of Illinois at Chicago, 1601 West Taylor Street, Rm 619, Chicago, IL 60612.

The purpose of this study was to understand the relationship between service delivery (rowing) and strategic activities (steering) by LHDs. A conceptual framework was presented of a typology of LHDs that perform steering activities and rowing services at five different levels. Significance of study lay in three areas. The relationship between rowing and steering is unknown. Practice patterns may be influenced on the beliefs of the local health administrator (Keane et al., 2001). The optimal presence and role of government in areas outside public health are being explored. Public health also needs to begin examining this role in order to develop improvements to public health management practice. Three secondary datasets, 2001 NACCHO-CityMatCH survey, 2001 ARF and the 1999 NACCHO Infrastructure survey, were used to measure rowing and steering activity. Forty-six percent of LHDs sampled (n=190) were performing a medium level of steering activity. Fifty-two percent of LHDs were performing a medium level of rowing activity. A correlation between rowing and steering was found (r=.318, p<.001).Univariate distribution of the ratio row to steer scores revealed that a majority of LHDs perform approximately equal amounts of rowing and steering. Sixty-two percent of LHDs had ratio z scores in the range of –1 to +1. Nine data driven groups emerged based on rowing and steering performance levels.The results of this study can alert local health administrators and funding bodies and researchers that performing less rowing activities does not necessarily or automatically translate into greater performance of steering activities, and vice versa.

Learning Objectives:

• 1.Recognize the need to understand the relationship between rowing and steering of LHDs
• 2.Define organizational typologies of rowing and steering performance of LHDs.
• 3.Articulate the extent of the relationship between rowing and steering.
• 4.Identify how the environment may influence rowing and steering performance of LHDs.
• 5.Identify recommendations for rowing and steering oriented policies.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.