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Historical Perspective

Modern public health function is best traced to the early nineteenth century, when government responded to social impacts of economic development. Gradual improvements in life expectancy, which began as growth accelerated, stalled by the 1820s. This reflected the impact of rapid industrialization and urbanization which led to poor neighborhood and housing environments, occupational health risks in unregulated workplaces and heightened prevalence of communicable diseases, including tuberculosis, typhoid and cholera. (Martin, Lock & Hogarth, 2014).

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This brief video that gives an explanation of Public Health.

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Epidemiology is the Cornerstone of Public Health

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Purpose of Epidemiology  in Public Health

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Purpose of Epidemiology  in Public Health

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Epidemiology is commonly considered the methodologic backbone for the fields of public health and outcomes research because its practitioners describe patterns of disease occurrence, identify risk factors and etiologic determinants, and demonstrate the usefulness of interventions. Like most aspects of science, epidemiology is in rapid flux. Several factors that are influencing and will continue to influence epidemiology and the health of the public include factors fundamental to framing the discipline of epidemiology.

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Epidemiology   the backbone of public health

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Role & Responsibilities of Community & Public Health

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Role & Responsibilities of Community & Public Health

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The Role and Responsibilities of Community and Public Health

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(Department of Health) WA Health training

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What is local government's role in public health

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Bloland, P., Simone, P., Burkholder, B., Slutsker, L., & De Cock, K. M. (2012). The role of public health institutions in global health system strengthening efforts: the US CDC's perspective. PLoS medicine, 9(4), e1001199. Retrieved from https://doi.org/10.1371/journal.pmed.1001199

Florida Department of Health. (2021). About Us. Retrieved from http://www.floridahealth.gov/about/index.html

Martin, G., Lock, K., & Hogarth, S. (December 2014). Public Health and English local government: historical perspectives on the impact of ‘returning home’, Journal of Public Health, Volume 36, Issue 4, Pages 546–551, https://doi.org/10.1093/pubmed/fdt131

Rene, P. L. (December 16, 2016). Fighting for the Uninsured: Government’s Role in Public Health. American Society for Public Administration. Retrieved from https://patimes.org/fighting-uninsured-governments-role-public-health/

Starks, M. (October 13, 202). 10-Essential-Public-Health-Services. National Network of Public Health Institutes. Retrieved from https://nnphi.org/top-5-issues-to-consider-at-the-intersection-of-behavioral-health-and-public-health-2020-update/10-essential-public-health-services/

Teitelbaum, J. B., & Wilensky, S. E. (2021). Essentials of Health Policy and Law - Fourth Edition. Jones & Bartlett Publishers.

Tulchinsky, T. H., & Varavikova, E. A., in The New Public Health (Third Edition), (2014). ScienceDirect. History of Public Health. Retrieved from History of Public Health - an overview | ScienceDirect. Retrieved from https://www.sciencedirect.com/science/article/pii/B978012415766800001X

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Fighting for the Uninsured: Government’s Role in Public Health

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Organization

The United States Public Health Service includes the

(1) Centers for Disease Control

(2) the National Institutes of Health

(3) the Food and Drug Administration

(4) the Health Resources and Services Administration

(5) the Alcohol, Drug Abuse, and Mental Health Administration; and

(6) the Agency for Toxic Substances and Disease Registry

The Centers for Disease Control, the main assessment and epidemiologic unit for the nation, directly serves the population as well as providing technical assistance to states and localities.

The National Center for Health Statistics within the Centers for Disease Control is the main authority for collecting, analyzing, and disseminating health data.

The Agency for Toxic Substances and Disease Registry, also an assessment unit, focuses on environmentally related diseases.

The National Institutes of Health, the primary research arm of the government, both conducts research and supports research projects across the nation.

The Food and Drug Administration directly tests and assesses safety of food, drugs, and a wide variety of consumer goods and sets standards for safe use of these items.

The Health Resources and Services Administration is primarily concerned with resources development and health manpower.

The Alcohol, Drug Abuse, and Mental Health Administration concentrates on developing programs and setting standards in these areas.

Other major division of the Department of Health and Human Services concerned with public health activities is the Health Care Financing Administration, which operates the Medicare and Medicaid programs. The federal government directly finances health services for elderly Americans through the Medicare program and provides grants to the states through the Medicaid program to assist them in financing health services for poor Americans. A large portion of Medicaid money also goes to finance long-term care for the elderly.

States are the principal governmental entity responsible for protecting the public's health in the United States. They conduct a wide range of activities in health. State health agencies collect and analyze information; conduct inspections; plan; set policies and standards; carry out national and state mandates; manage and oversee environmental, educational, and personal health services; and assure access to health care for underserved residents; they are involved in resources development; and they respond to health hazards and crises.

States carry out most of their responsibilities through their police power, the power "to enact and enforce laws to protect and promote the health, safety, morals, order, peace, comfort, and general welfare of the people."

Despite major differences in organization and responsibilities among the state agencies, there are some consistencies in programs handled by the states. For example, nearly all states have programs for Vital Statistics and in Epidemiology. Most conduct planning, and many have planning units and most have regulatory responsibilities. Almost all states conduct Environmental Safety Programs in Sanitation and in Water Quality. And almost all states are involved in the personal health services. In assuring health services, states reported a variety of activities in inspection, licensing, regulation, health education, environmental health, personal health services, and resources development.

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Public Health System in the United States

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There are several organizations of health agencies with unique function, roles, and responsibilities of allocation of resources at the Federal, State, and Local Level.

Federal

The Federal Government plays a large role in the public health system in the country. It surveys the population's health status and health needs, sets policies and standards, passes laws and regulations, supports biomedical and health services research, helps finance, and sometimes delivers personal health services, provides technical assistance and resources to state and local health systems, provides protection against international health threats, and supports international efforts toward global health.

The top federal unit responsible for public health is US Department of Public Health Services in the Department of Health and Human Services.

The second major unit is Health Care Financing Administration which is also in the Department of Health and Human Services.

Other Federal departments with agencies responsible for health are Food and Nutrition Services in Department of Agriculture, the Office of Special Education and Rehabilitative Services of the Department of Education, and the Environmental Protection Agency.

Organizations

The United States Public Health Service includes the

Centers for Disease Control

National Institutes of Health

Food and Drug Administration

Health Resources and Services Administration

Alcohol, Drug Abuse, and Mental Health Administration

Agency for Toxic Substances and Disease Registry

The Centers for Disease Control (CDC), the main assessment and epidemiologic unit for the nation, directly serves the population as well as providing technical assistance to states and localities.

The National Center for Health Statistics within the Centers for Disease Control is the main authority for collecting, analyzing, and disseminating health data.

The Agency for Toxic Substances and Disease Registry, also an assessment unit, focuses on environmentally related diseases.

The National Institutes of Health, the primary research arm of the government, both conducts research and supports research projects across the nation.

The Food and Drug Administration directly tests and assesses safety of food, drugs, and a wide variety of consumer goods and sets standards for safe use of these items.

The Health Resources and Services Administration is primarily concerned with resources development and health manpower.

The Alcohol, Drug Abuse, and Mental Health Administration concentrates on developing programs and setting standards in these areas.

The other major division of the Department of Health and Human Services concerned with public health activities is the Health Care Financing Administration, which operates the Medicare and Medicaid programs. The federal government directly finances health services for elderly Americans through the Medicare program and provides grants to the states through the Medicaid program to assist them in financing health services for poor Americans. A large portion of Medicaid money also goes to finance long-term care for the elderly.

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The role of public health institutions in global health system strengthening efforts: the US CDC's perspective

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Public health is a critical part of the larger concept of health systems and has been defined as “what we as a society do collectively to assure the conditions in which people can be healthy.

The contribution that strengthening of public health systems makes to strengthening health systems in general has been inadequately described.

The contribution that strengthening of public health systems makes to strengthening health systems in general has been inadequately described.

A Central Role for Public Health

Public health or more specifically, prevention-oriented population health may be a relatively small component in any health system compared, for example, to provision of individual-level curative health services. The core functions of public health and the contribution of public health practice to any health system are central to that system functioning effectively. The diagram above highlight six core functions of public health that we feel have the widest influence on the effectiveness of the health system itself. Health systems are certainly complex, and specific activities need to address and adapt to local contexts, (Bloland, Simone, Burkholder, Slutsker & De Cock, 2012).

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Local Health Departments are the "front line" of Public Health Agencies. They are largely responsible for direct delivery of public health services to the Population. They conduct communicable disease control programs; provide screening and immunizations; collect health statistics; provide health education services and chronic disease control programs; conduct sanitation, sanitary engineering, and inspection programs; run school health programs; and deliver maternal and child health services, public health nursing services, mental health services, and other home care and ambulatory care services.

Local health departments carry out their activities under authority delegated by their state or by local jurisdictions. State legislatures may delegate authority to local agencies to conduct activities in the state interest. In doing so, legislatures may delegate local health departments only to carry out administrative functions of the state, such as enforcing the state public health code, or they may empower city and town governments with regulatory or rule-making powers.

Despite tremendous variation in services rendered, there are some similarities in local health department programs. Local health departments can be characterized as mainly involved in providing health education, environmental health services, and personal health services and in conducting inspections.

Programs and Services

Infant, Child & Adolescent Health – KidCare; Breastfeeding; Children’s Medical Services, School Health, Healthy Start

Community Health – Refugee Health; Food Access; Dental Health

Emergency Preparedness & Response – Community Preparedness, Disaster Response Resources

Immunization – Provider Information for COVID-19 Vaccine

Men’s Health – Reproductive Health

Public Health Laboratories – Laboratory Services, Biosafety Outreach

WIC (Women, Infant & Children) – Nutrition Materials, Nutrition education and counseling, Breastfeeding support

Chronic Disease Prevention

Women’s Health – Family Planning, Pregnancy

Licensing & Regulation

The Department of Health is responsible for the regulation of health practitioners for the preservation of the health, safety, and welfare of the public. The Licensing and Regulation section provides information relating to professional, facility, and permit licensing along with information on enforcement.

Statistics & Data

Health Statistics – Annual Cancer Reports

Emergency Medical Operations – Trauma Registry

Environmental Public Health – Inspection Reports, Radon Data, Environmental Public Health Tracking

Licensure & Monitoring

E-FORCE – The Florida Prescription

Population Surveillance – Behavioral Risk Surveillance System (BRFSS)

Vital Statistics

Request Vital Statistics Research Data

Environmental Health – Healthy Environments

Air – Air Monitoring, Carbon Monoxide, Mold, Radon

Water – Beach Water Quality, Drinking Water, Public Swimming Pools

Contaminants – Biomedical Waste, Hazardous Waste Sites, Lead Poising, Radiation Control

Community – Group Care Facilities, Migrant Farmworkers, Mosquito Preventions, Rodents

Community Safety – Body Piercing, Chemicals, Mobile Home Parks, Recreational Diving, Tanning Facilities, Tattooing

Disease & Conditions (Epidemiology)

Disease Prevention – Stress, Drowning, Suicide

Injury Prevention – Dog Bites Prevention, Tobacco Free Florida, Falls

Disease Surveillance – Food and Water-borne Outbreak, Influenza Surveillance

Health Departments: Information on COVID-19

https://www.cdc.gov/coronavirus/2019-ncov/php/index.html

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Dr. Norman Oliver, Virginia's Health Commissioner, discusses the approach states and territories should take to funding for the public health workforce; ASTHO Chief Medical Officer Dr. Marcus Plescia reacts to a new CDC/Trust for America's Health report on obesity in the U.S.; and ASTHO releases the findings of its annual scan of issues important to state and territorial health agencies.

ASTHO Statement: ASTHO encourages immediate action to address the rising obesity rates in the wake of COVID-19 ASTHO: Workforce resources

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28: Supporting the Public Health Workforce

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Listen to this episode from Public Health Review Morning Edition on Spotify. Dr. Norman Oliver, Virginia's Health Commissioner, discusses the approach states and territories should take to funding for the public health workforce; ASTHO Chief Medical Officer Dr. Marcus Plescia reacts to a new CDC/Trust for America's Health report on obesity in the U.S.; and ASTHO releases the findings of its annual scan of issues important to state and territorial health agencies.