• Public health;
  • public health informatics;
  • organization and administration;
  • public health surveillance;
  • computer communication networks


Public health organizations increasingly face the need to be able to share data among themselves and ultimately with other providers. We examined what factors contribute to public health organizations' data exchange capabilities.

Data Sources

National Association of County and City Health Officials' 2008 National Profile of Local Health Departments survey was linked to the Association of State and Territorial Health Official's 2007 Profile of State Public Health Survey.

Study Design

We conducted a cross-sectional analysis of organizational factors associated with gaps in data sharing between state health agencies (SHAs) and local health departments (LHDs) in the areas of childhood immunizations, vital records, and reportable conditions.

Data Collection

Based on reported information system (IS) capabilities, we created a binary variable that measured whether bidirectional data sharing was structurally possible between an LHD and its respective SHA.

Principal Findings

The proportion of LHDs experiencing a data sharing gap was 34.0 percent for immunizations, 69.8 percent for vital records, and 81.8 percent for reportable conditions. Increased SHA technological capacity and size reduced the odds of gaps.


Improving the IS capabilities of public health agencies may be the key to their remaining relevant in the currently evolving health care system.