The future of urban health: needs, barriers, opportunities, and policy advancement at large urban health departments.

Context: More than 2800 local health departments (LHDs) provide public health services to more than 300 million individuals in the United States. This study focuses on departments serving the most populous districts in the nation, including the members of the Big Cities Health Coalition (BCHC) in 2013.

Objective: To systematically gather leadership perspectives on the most pressing issues facing large, urban health departments.

What gets measured gets done: an assessment of local data uses and needs in large urban health departments.

Context: The epidemiologic shift in the leading causes of mortality from infectious disease to chronic disease has created significant challenges for public health surveillance at the local level.

Objective: We describe how the largest US city health departments identify and use data to inform their work and we identify the data and information that local public health leaders have specified as being necessary to help better address specific problems in their communities.

Design: We used a mixed-methods design that included key informant interviews, as well as a smaller embedded survey to quantify organizational characteristics related to data capacity.