1. Participants in Public Health Kristine M. Gebbie, DrPH, RN Columbia University School of Nursing Center for Health Policy 630 West 168 th Street, Mail Box 6 New York, NY 10032 (212) 305-1794 kmg24@columbia.edu

2. Developed as part of an Enhanced AHEC Community Partnership for Health Professions Workforce and Educational Reform project funded by the Health Resource and Service Administration (HRSA)

3. OBJECTIVES l List key infrastructure components

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

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

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7. Federal Agencies Continued l Environmental Protection Agency l US Department of Agriculture l Department of Labor - Occupational Safety and Health Administration l Department of Veterans Affairs l Department of Transportation

8. Federal Agencies Continued l Department of Defense l Housing and Urban Development l White House s Office of Management & Budget s Office of Drug Control Policy s Office of AIDS Policy

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

10. State Agencies Continued l Substance abuse agency l Environment (water, air, soil quality; waste disposal) l Agriculture (food, dairy, pesticides) l State-OSHA l Health planning agency l Health professions licensing bodies

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

12. Local and Community Public Health l County, city or district health departments l County, city or district mental health, substance abuse or environmental agency l Special taxing districts for public hospitals, home health, environmental control or public health l Local zoning authority

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

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

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

16. Other Care Systems Continued l 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 l Care systems may join population- focused activities for a variety of reasons

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

18. Summary l 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 l The exact structure of the system varies by issue and over time