Public Health Services and Systems

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Part III

• Public Health Services and Systems

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Report on the Futureof Public Health

• Institute of Medicine, 1988
• Impact on public health practice and
  practitioners included
• stimulus for public health system research
• stimulus to strengthen the system
• new vocabulary for describing the system

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IOM 1988 Report, Continued

• Mission of Public Health
• Assuring healthy conditions
• Focus on community-wide concerns
• Organize efforts to address health concerns

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IOM 1988 Report, Continued

• Core Functions of Public Health
• Assessment
• Policy development
• Assurance

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Public Health in America

• The IOM core functions paradigm is helpful but
  does not communicate well outside the public
  health world
• Public health and interest in the health of
  populations were almost lost during the 1993-4
  health reform debates
• Public Health in America was written to provide
  a statement for general use

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Public Health in America

• The Vision
• Healthy People in Healthy Communities
• The Mission
• Prevent disease and injury
• Promote physical and mental health

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Responsibilities of Public Health

• Prevent epidemics and the spread of disease
• Protect against environmental hazards
• Prevent injury

• Promote and encourage healthy behavior
• Respond to disasters and assist in recovery
• Assure quality and accessibility of health
  services

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Public health is a continuous process that is
supported by management developed by research
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Essential Services of Public Health

• Monitor health status
• Investigate outbreaks
• Inform the public
• Support coalitions
• Develop policy
• Enforce regulations

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Essential Servicesof Public Health

• Link people to care or provide care
• Prepare the workforce
• Assure quality, accessible, effective services
• Research for new solutions

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Core Functionsand Essential Services

• Assessment
• Monitor health
• Diagnose problems

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Did you know that . . .

• To diagnose diseases, the SC public health
  laboratory was established in 1909?
• South Carolina got its first epidemiologist, Dr
  GE McDaniel, in 1935?

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Core Functionsand Essential Services

• Policy Development
• Inform and educate the public
• Mobilize community partnerships
• Develop policies and plans

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Did you know that . . .

• 1950s pollution control policies were developed
  in partnership with the Development Board and the
  Textile Manufacturers Association?
• Public health boards designing public health
  budgets and programs are carrying out a process
  similar to an individual giving informed consent
  for a medical procedure?

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Core Functionsand Essential Services

• Assurance
• Enforce laws and regulations
• Link people to needed care and assure care when
  otherwise unavailable
• Evaluate effectiveness, accessibility and quality
  of health services

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Did you know that . . .

• To assure services, the first public health nurse
  was hired in 1903?
• To limit health hazards in the 1940s, privies
  were built for 18.20?
• The WIC program brought 16 nutritionists to the
  state in 1973?

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Discussion Time

• How can practicing health professionals
  participate in assessment, policy development or
  assurance at the local level?

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Core Functionsand Essential Services

• Research is an essential service that supports
  all of the core functions
• Leadership and management of the system transcend
  the functions and services

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Did you know that . . .

• Healthy People is our national visionary
  planning process for improving the nations
  health?
• The goals of HP2010 are to increase years of
  healthy life and eliminate disparities in health?
• Turning Point is SCs state-wide, interactive
  process for transforming public health in the new
  century?

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Forces Shaping Public Health

• Public attitude toward government
• Federalism and devolution of responsibility
• The economy
• Environmental policy
• Changes in personal care and financing systems

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Discussion Time

• How can a public health perspective strengthen
  the perspectives dominant in your profession?

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SummaryModule 1, Part 3

• The vision of public health is healthy people in
  healthy communities.
• The mission of public health is to prevent
  disease and injury and promote physical and
  mental health.
• The core functions of public health are
  assessment, policy development and assurance.

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Module Author
Kristine M. Gebbie, DrPH, RN Elizabeth Standish
Gill Associate Professor in Nursing Columbia
University School of Nursing Director Center for
Health Policy