CHAPTER 11 Public Health-The Health of the Commun your local health department?
ID: 396878 • Letter: C
Question
CHAPTER 11 Public Health-The Health of the Commun your local health department? Where is it based and what are its functions? of Health and Human Services 2006). The attack on the Twin Towers of the World Trade Center in 2001 and subsequent threat of anthrax and the devastation of the Gulf Coast from . How much do you know about your state health depa Hurricane Katrina in 2005, have all made the importance of emergency preparedness plans apparent. The CDC publishes guidelines not only for public health organizations, but also for individuals, health care facilities, and businesses What is its organizational structure. who heads it what are its responsibilities? Does your local or state health department have a emergency preparedness plan? SUMMARY Public health remains a core function of the United States health care system. The amount of attention paid to public health has vacillated throughout history. yet its functions have continued and expanded. Water and air safety continue to be vital responsibilities of public health. Many infectious diseases have been contained (small pox, measles, polio), and yet others have emerged, providing new challenges to the public health system. Health departments promote vaccination of appropriate sectors of the population to control infectious disease, yet not everyone in the target populations receives vaccinations. Not all state and local health departments receive the necessary fund- ing to function at their highest levels. Much of the funding is dependent upon the emphasis that public health receives from the federal government late Several different agencies of all three levels of government and in communities work in diverse areas of public health needs The federal level provides most of the grants and regulatory functions for public health. State and local health departments provide most of the hands-on functions. The needs of the growing numbers of those without insurance place a heavy burden on public health services and the safety net hospitals around the United States. Public health concerns have moved from acute and infectious illness to a focus on the increase in chronic illnesses, especially diabetes and obesity among adults and children. Perhaps one of the greatest challenges in our time is to coordinate these efforts of various levels of government and efforts of community groups to provide the most efficient and effective set of comprehensive services to some of the neediest of our population. ACTIVITY-BASED LEARNING How much do you know about your local health department? Referring back to Figure 11-1, what is the jurisdiction ofExplanation / Answer
There are three tiers of health departments, the federal health department, state health department and local health department. In relation with state and local government, the federal government provides states with funding to ensure that states are able to retain current programs and are able to implement new programs. The coordination between all three health departments is critical to ensure the programs being implemented are well structured and suited to the corresponding level of health department. The state sets up the regulations and health policies whereas the local health departments are the ones implementing the health policies and services. The United States Department of Health and Human Services (HHS) aims to protect the health of all Americans and provide essential human services, especially for those who are least able to help themselves. These federal programs consist of social service programs, civil rights and healthcare privacy programs, disaster preparedness programs, and health related research. HHS offers a variety of social service programs geared toward persons with low income, disabilities, military families, and senior citizens.
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, passes laws and regulations, sets policies and standards, provides technical assistance and resources to state and local health systems, provides protection against international health threats, supports biomedical and health services research, and supports international efforts toward global health. The federal government is able to do all of these mainly through two delegated powers which are, the power to regulate interstate commerce and the power to tax and spend for the general welfare. States are the principal governmental entity responsible for protecting the public's health in the United States. They conduct a wide range of activities like collect and analyze information, conduct inspections, 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 crises. Each state agency is directed by a health commissioner or secretary of health. Each also has a state health officer, who is the top public sector medical authority in the state. In many states, the state health officer is the director of the state health agency. In some states, the state health officer works for the director, who is an administrator of a larger agency or department. State health officers are appointed either by the governor, the State Board of Health, or an agency head. Local health departments are the front line of public health agencies. They are generally responsible for direct delivery of public health services to the population of the nation. They conduct communicable disease control programs, provide screening and immunizations, 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 services. Local health departments carry out their activities under authority delegated by their state or by local jurisdictions. Directors of local health agencies are generally appointed by the leaders of the jurisdiction for which they work, county supervisors, city and town councils, or the mayor. Some local health directors are employees of or appointed by the state health department. In most states, local health department directors are required to have a valid license to practice medicine in the state, but many allow non-physicians to act as local health directors if they have adequate public health or administrative experience. Local health departments vary in jurisdiction and authority. Some health departments serve a single county and some serve groups of counties, some are municipalities and some serve city & county combinations. Local health departments also differ in organization, size, and the programs they operate. Many are separate agencies, but some are divisions of health and human services agencies. Many are also the local environmental agency, others share this responsibility with other local agency. Some are district offices of a larger agency, while some operate satellite offices of their own. They may serve only a few hundred people, or hundreds of thousands. The activities carried out by these local agencies are similar, in spite of tremendous variation in services rendered, there are some similarities in local health 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. Most are also involved in assessment: collecting data and conducting communicable disease control programs and inspections. Few local health departments are involved in planning, regulating, setting local policies, and conducting research. A portion of federal block grant money is passed on by states to local agencies. In general, about one third of the staff of local health departments are administrative or support personnel, about one third are registered nurses, and the other third are sanitarians. There is an average of one physician for every 30 local health department employees. Some of the programs those can be highlighted are, health and social science research, preventing disease, including immunization services, assuring food and drug safety, medicare (for elderly and disabled Americans) and medicaid (for low-income category), health information technology, financial assistance and services for low-income families, improving maternal and infant health, including a nurse home visitation to support first-time mothers, head start (preschool education and services), faith-based and community initiatives, preventing child abuse and domestic violence, substance abuse treatment and prevention, services for older Americans, including home-delivered meals, comprehensive health services for native Americans, assets for independence, medical preparedness for emergencies, including potential terrorism, child support enforcement and many more.