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Public Health: What It Is and How It Works, Fourth Edition

Public Health: What It Is and How It Works, Fourth Edition. Chapter-by-Chapter Power Point Slides Links to Internet-based resources. Chapter 5 Core Functions and Public Health Practice. Chapter 5 Will Help You To:. explain the "governmental presence in health" concept

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Public Health: What It Is and How It Works, Fourth Edition

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  1. Public Health:What It Is and How It Works, Fourth Edition Chapter-by-Chapter Power Point Slides Links to Internet-based resources

  2. Chapter 5Core Functionsand Public Health Practice

  3. Chapter 5 Will Help You To: • explain the "governmental presence in health" concept • identify and describe public health's core functions and essential services • discuss how public health core functions are operationalized in practice • describe approaches to improving state-local public health systems

  4. What Public Health Does: Then and Now

  5. Private Nonprofit Associations Educational Institutions Official Public Health Agencies Personal Health Services Industry Other Public Sector Private Industry Community- Based Organizations The Public Health System

  6. Voluntary Agencies Social Services Churches Nursing Facilities Home Health MDs MCO Group Practices Employers MCO MDs Integrated Community Health System Group Practices Hospitals Health Department MCOs Nursing Facilities MCO Hospitals CHCs/MHCs Drug Treatment Mental Health

  7. Public Health Functionsbefore the IOM Report • 1914: first review of state and local public health activities (Chapin and AMA) • 1920-1970: APHA focuses on governmental public health infrastructure (Winslow, Emerson, etc.); emphasis on “Basic Six” Services • 1950-1988: new challenges, health care safety net, “governmental presence in health”

  8. Public Health Practice and Core Functions after the IOM Report • IOM Report: nation has lost sight of its public health goals; found public health system in considerable “disarray” • Healthy People 2000 • APEX-PH • Core Functions and Essential Public Health Services • National Public Health Performance Standards

  9. IOM’s Future of Public Health • Public Health Mission • “…assuring conditions in which people can be healthy.” • Substance of Public Health • “…organized community efforts aimed at the prevention of disease and the promotion of health.”

  10. IOM’s Future of Public Health • Governmental Role • “The governmental public health agency has a vital function: to see to it that vital elements are in place and the the mission is being adequately addressed.” • Core Functions of Public Health • Assessment • Policy Development • Assurance

  11. Translating Public Health Functions into Practice • Assessment: What Should Be Done? • Decisions based in values • Policy Development: What Will Be Done? • Decisions based on resources and priorities • Assurance: How Can We Best Do It? • Decisions based on scientific evidence

  12. What Public Health Does • Prevent epidemics and spread of disease • Protect against environmental hazards • Prevent injuries • Promote and encourage healthy behaviors • Respond to disasters and assist communities in recovery • Assure the quality and accessibility of health services

  13. How Public Health Works: Essential Services

  14. Monitor Health Status • Ongoing assessment of community health status • Identification of threats to health • Determination of health service needs • Attention to special high risk populations • Identification of community assets & resources • Interpretation & communication • Multisectoral information systems

  15. Diagnose and Investigate • Early identification of unusual event patterns • Access to public health lab capabilities • Active infectious disease and environmental surveillance activities • Technical and human resource capacity for thorough investigation

  16. Inform, Educate, Empower • Community organization • Social marketing and targeted communication • Access to health information • Collaboration with health care providers on health messages and programs • Joint health education efforts with media, schools, churches, work sites, etc.

  17. Mobilizing Partnerships • Convening and facilitating partnerships • Undertaking defined health improvement planning efforts and projects • Building coalitions to draw upon the full range of potential human and material resources to improve community health

  18. Develop Policies and Plans • Leadership development at all levels • Systematic community-wide planning for health improvement • Developing & tracking goals and objectives • Joint evaluation with medical care system • Development of policy and legislation to achieve public health goals

  19. Enforcing Laws & Regulations • Enforcement of sanitary codes • Protection of drinking water supplies • Enforcement of clean air standards • Animal control • Follow-up of hazard investigations • Monitor quality of medical care • Review of new drugs, biologics & devices

  20. Link to & Assure Care • Assurance of effective access and entry • Culturally appropriate materials and staff • Ongoing care management • Transportation services • Targeted outreach & education for special populations

  21. Assure Competent Workforce • Education, training, assessment of personnel • Efficient processes for licensure & credentialing • Lifelong learning models • Active partnerships with professional training programs • Continuing education for management and leadership development

  22. Evaluate Effectiveness, Accessibility and Quality • Assessing program effectiveness • Understanding why interventions work or don’t work in a specific setting • Providing information necessary for allocating resources and reshaping programs

  23. Research and Innovation • Participation in and support for full continuum of innovation • Ongoing linkage with institutions of higher learning • Internal capacity to mount timely epidemiologic & economic analyses and conduct health services research

  24. Basis for Public Health Practice EPHS… • Linked to the core functions • Cyclical and continuous processes • Managed at the systems level • Enhanced through active research • Organizing framework for individual and collective practice

  25. 21st Century CommunityPublic Health Practice • Community health needs assessments • Asset mapping • Community health improvement models and initiatives • APEXPH evolves into MAPP

  26. Unique Features of Public Health: Common Bond

  27. It’s about communities….

  28. Core Function Performance • Performance assessment tools and instruments • Healthy People 2000 Objective 8.14: 90% of population to be served by LHD effectively carrying out public health’s core functions • Assessments find serious gaps in meeting national targets

  29. Discussion • Review the organization of health responsibilities in Illinois (or another state of your choice) and then describe how the essential public health services are delegated and carried out among various offices and agencies of state government (not just by the state health department) in that state. You can access the State of Illinois web site directly or through the site for the Illinois Department of Public Health. • (For other states, the official state web site is usually "http://www.state.stateinitials.us"....for Illinois this would be http://www.state.il.us).

  30. Discussion • You are the new administrator at your local health department and the recently elected county board president has directed you to develop new health-related initiatives that will improve the health of the county's residents. Briefly describe how would you approach this charge.

  31. Discussion • Summarize the Board of Health meeting that you recently attended. Identity the name of the Board of Health whose meeting you attended, the date, and authorities and roles that you attribute to that Board of Health based on what you observed at the meeting. Basically you will answering the question, "How does this Board of Health influence the health of the population within its jurisdiction?"

  32. Additional Resources • Healthy People 2010 Toolkit: A Field Guide to Health Planning. Public Health Foundation; 1999 • Invisible Safety Net Video: Part 3--Core Functions University of Washington School of Public Health and Community Medicine, Northwest Center for Public Health Practice; 1994 • Mobilizing for Action through Planning and Partnerships (MAPP). NACCHO, 2000 • National Public Health Performance Standards Program. CDC Public Health Practice Program Office, 2000. • Practice of Public Health. Turnock BJ. Chapter in Encyclopedia of Public Health by Breslow L, editor. New York NY; MacMillian; 2000 • Public Health Functions Web Site. Public Health Functions Project • The Past and Future of Public Health Practice. Fee E and Brown TM. AJPH 2000:909(5):690-691

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