1. Part II Participants in Public Health

2. Official and VoluntaryPublic Health Sectors • Official agencies assigned specific responsibilities for a geo-political unit or programmatic area • Private not-for-profit voluntary agencies with commitment to a particular issue or population • Public and private providers of personal care

3. The US has no Cabinet Secretary of Health, unlike most other countries Almost every federal agency has some responsibility that impacts the health of the public Federal Public Health Agencies

5. Federal AgenciesContinued • Environmental Protection Agency • US Department of Agriculture • Department of Labor - Occupational Safety and Health Administration • Department of Veterans Affairs • Department of Transportation

6. Federal AgenciesContinued • Department of Defense • Housing and Urban Development • White House • Office of Management & Budget • Office of Drug Control Policy • Office of AIDS Policy

7. State Public Health Agencies • State public health agency (dept of health, dept of public health) • Umbrella human services agency • Agency on aging (often includes long term care planning/licensing) • Medicaid • Mental health agency

8. State AgenciesContinued • Substance abuse agency • Environment (water, air, soil quality; waste disposal) • Agriculture (food, dairy, pesticides) • State-OSHA • Health planning agency • Health professions licensing bodies

9. Did you know that . . . • South Carolina’s first public health employee was Dr. Fred Williams, in 1908? • The Department of Health and Environmental Control was created in 1973?

10. Local and CommunityPublic Health • County, city or district health departments • County, city or district mental health, substance abuse or environmental agency • Special taxing districts for public hospitals, home health, environmental control or public health • Local zoning authority

11. Did you know that . . . • Orangeburg and Greenwood counties established the first county health departments in the state, in 1915, to combat hookworm? • Every county had a health department by 1936? • County health staff were transferred to the state payroll in 1981?

12. Voluntary Associations • Disease- or issue-specific organizations • Advocacy groups • Professional and industrial organizations • Coalitions with health as only or major topic

13. Hospitals and OtherCare Systems • Access to care is an essential public health service • Health-department-operated hospital, personal care program, or strong relationship with the local provider systems

14. Other Care SystemsContinued • The structure of public health services varies over time and place depending on size and composition of uninsured population and economics and attitudes of care systems • Care systems may join population-focused activities for a variety of reasons

15. Discussion Time • Identify the components of the public health system serving your community • Be sure to include non-governmental participants

16. Summary of Module 1, Part 2 • US public health services may be comprised of federal, state and local governmental agencies, not-for-profit organizations, hospitals and other health care providers, and voluntary associations • The exact structure of the system varies by issue and over time

17. Module Author Kristine M. Gebbie, DrPH, RN Columbia University School of Nursing Center for Health Policy