The Board is composed of 11 members that reasonably reflects the population makeup of the county. By law, the 11 members include: one physician licensed to practice medicine in the State, one licensed dentist, one licensed optometrist, one licensed veterinarian, one registered nurse, one licensed pharmacist, one county commissioner, one professional engineer, and three representatives of the general public. The members are appointed by the Durham County Board of Commissioners.

The Board of Health may adopt a more stringent rule in an area regulated by the Commission for Health Services or the Environmental Management Commission where, in the opinion of the Durham County Board of Health, a more stringent rule is required to protect the public health. Otherwise, the rules of the Commission for Health Services or the rules of the Environmental Management Commission shall prevail over local Board of Health rules.

The regular meetings of the Board of Health are the 2nd Thursday every other month beginning in January. There is no meeting in December. Meetings are held in the department's auditorium at 5pm and are open to the public.