10 The Public Health System: The Government’s Role

Objectives Define the concept of public health and give examples of public health activities. Explain the role of government in public health. List two or more national (federal) public health agencies. Explain the role of boards of public health and licensing/regulatory boards.

Objectives (cont.) Describe at least one major government initiative to protect the public’s health. Identify the key reporting obligations that health professionals are mandated to uphold.

What Is Public Health? Being healthy is more than just not being sick. It is a state of well-being in our bodies, our minds, and our lives. Public health is the well-being of everyone in neighborhoods, communities, states, and countries. The goal of public health is to protect the community from the hazards of group life.

What is Public Health? (cont.) Curative medical care focuses on making us feel better when we are already ill. Public health focuses on prevention efforts to keep us from getting sick in the first place. Public health impacts policies and laws and helps promote well-being on a societal and often global level.

The History of Public Health Recorded 4,000 years ago in India and in the classical era of the Greek and Roman civilizations. Quarantine was instituted in the Middle Ages.

The History of Public Health (cont.) 1700s and 1800s in the U.S. Creation of boards of health for containing disease Setting sanitary standards Protecting from diseases (infectious) Health departments began in Massachusetts Seamen taxed to provide care

The History of Public Health (cont.) By 1900, there were 40 state health departments. Today, every state has a health department and a public health laboratory.

Key Public Health Functions Three key functions of public health: Assessment of the health of the community Policy development Assurance of the public health

Key Public Health Functions (cont.) Assessment: determining the health needs of the community Policy development: the collective decision about what actions are most appropriate for the health of the state or nation Assurance: making sure the necessary actions are actually taken

Key Public Health Functions (cont.) Epidemiology: the study of the history of a disease and its distribution throughout a society Epidemiologists: investigate where a disease outbreak occurred, who it affected, and how and when

Key Public Health Functions (cont.) In public health, surveillance refers to the continuous search for and documentation of disease Monitoring: the use of surveillance data to determine changes in the number of infected persons

Key Public Health Functions (cont.) State health departments are required by law to report on cases of specific diseases or conditions. As of 2009, 72 diseases had to be reported at the national level.

Role of Government in Public Health Federal government has the ability to tax people to provide for the “general welfare”. The federal government has the ability to regulate commerce. The Department of Health and Human Services (DHHS) is the U.S. government’s principal department protecting the health of the nation.

Role of Government in Public Health (cont.) Key Agencies: The Food and Drug Administration (FDA) The Centers for Disease Control (CDC) The Health Resources and Services Administration (HRSA) The Centers for Medicare and Medicaid Services (CMS) The Substance Abuse and Mental Health Services Administration (SAMHSA)

Role of Government in Public Health (cont.) At the state level, there are two kinds of public health bodies: Boards of health State health departments Boards of health are the policymaking bodies. State health departments promote the public’s health and implement public health laws.

Role of Government in Public Health (cont.) Two models of a state health department: A freestanding agency that reports directly to the state governor Part of a larger institution, such as the state’s Department of Health and Human Services

Role of Government in Public Health (cont.) State Health Departments Licensing and regulatory boards help protect the public’s health by basic standards of care, cleanliness, and safety Local health departments serve an individual county, city, or region

Other Public Health Partners Organizations like the Red Cross, March of Dimes, and the American Cancer Society play an important role. Foundations are not-for-profit organizations that raise money in support of their programs. Community-based organizations often go directly to the person needing services.

Past Successes and Future Challenges Achievements: Vaccination Safer workplaces Healthier mothers and babies Control of infectious diseases Coronary heart disease and stroke prevention programs Safer and healthier foods

Past Successes and Future Challenges (cont.) Achievements: (cont.) Family planning Motor vehicle safety Fluoridation of drinking water Recognition of tobacco as a health hazard

Past Successes and Future Challenges (cont.) Public Health Challenges Changing patterns of disease Increasing numbers of chronic conditions New and emerging infections Injuries Violence Curable genetic diseases