MODULE 16: PUBLIC HEALTH INFRASTRUCTURE IN THE UNITED STATES: AN INTEGRATED SYSTEM Public Health Infrastructure in the United States: An Integrated System Jennifer Ibrahim, PhD, MPH Associate Professor College of Health Professions and Social Work, Temple University
Learning Objectives Define the public health infrastructure at the local, state, and federal levels and their core functions. Describe the emerging public health workforce demands and how academic institutions are meeting those demands. Identify the key areas of public health services research and data to evaluate health department structure and performance. Discuss practical examples of health department performance, including health assessments and improvement plans. 2
HP2020 Objectives Goal: To ensure that Federal, State, Tribal, and local health agencies have the necessary infrastructure to effectively provide essential public health services. PHI-3 Increase the proportion of Council on Education for Public Health (CEPH) accredited schools of public health, CEPH accredited academic programs, and schools of nursing (with a public health or community health component) that integrate t Core Competencies for Public Health Professionals into curricula. PHI-14 Increase the proportion of State t and local l public health jurisdictions that conduct a public health system assessment using national performance standards 3
MODULE 16: PUBLIC HEALTH INFRASTRUCTURE IN THE UNITED STATES: AN INTEGRATED SYSTEM Part 1: Public Health Infrastructure at the Local, State and Federal Levels 4
Health Care: Micro Perspective 5 Components of Healthcare System: 1) Facilities Me 2) Healthcare Workers 3) Providers 4) Financing 5) Education/training and research Specialist Primary Care Provider Emergency Room Other Goods: -Pharmaceuticals -Durable Medical Goods -??? Other Considerations: -Quality -Equity -Efficiency Hospital Rehabilitation Facility Nursing Homes 5 Payers
The Institution of Public Health 6 Source:
Local Public Health Health Department Board of Health Mayor City Council Health Inspectors Health Educators Local Health Responsibilities: -Surveillance -Sanitation -Hygiene -Health education and prevention -Enforcement of Public Health Laws 7 -Policy development and recommendations
Local Health Agency Associations strengthen and improve public health governance 8
Local Health Agency Associations National Association of City & County Health Officials 9
State Public Health Infrastructure Different structures by state Core Responsibilities: Licensure and certification Records and statistics (birth and death) Community health outreach Prevention & Promotion Programs Disease Control Access to health (Board of Insurance) Enforcement of Public Health laws ** linkages with Governor, Legislature, Courts 10
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State Health Department Association Association of State and Territorial Health Officials 12
Federal Public Health Infrastructure Source: http://www.hhs.gov/about/orgchart/ 13
National Institutes of Health National Cancer Institute (NCI) National Eye Institute (NEI) National Heart, Lung, and Blood Institute (NHLBI) National Human Genome Research Institute (NHGRI) National Institute on Aging (NIA) National Institute on Alcohol Abuse and Alcoholism (NIAAA) National Institute of Allergy and Infectious Diseases (NIAID) National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) National Institute of Biomedical Imaging and Bioengineering (NIBIB) 14
National Institutes of Health National Institute of Child Health and Human Development (NICHD) National Institute on Deafness and Other Communication Disorders (NIDCD) National Institute of Dental and Craniofacial Research (NIDCR) National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 15 National Institute on Drug Abuse (NIDA) National Institute t of Environmental Health Sciences (NIEHS) National Institute of General Medical Sciences (NIGMS) National Institute of Mental Health (NIMH) National Institute of Neurological Disorders and Stroke (NINDS) National Institute of Nursing Research (NINR) National Library of Medicine (NLM)
Federal level: Alphabet Soup Department of Health and Human Services - FDA (Food and Drug Administration) - CDC (Center for Disease Control and Prevention) - USPHS (US Public Health Service) - HRSA (Health Resources and Services Administration) - CMS (Centers for Medicare and Medicaid Services) - SAMHSA (Substance Abuse and Mental Health Services Administration) - IHS (Indian Health Service) - AHRQ (Agency for Health Care Research and Quality) - NIH (National Institute of Health) - AoA (Administration on Aging) - OSG (Office of the Surgeon General) 16
Federal Level: Not all in one Agency Responsibility for environmental health is scattered throughout h t the federal government Environmental Protection Agency (EPA) NIH National institute of Environmental Health CDC National Center for Environmental Health OSHA (Occupational Safety and Health Administration) USDA (Department of Agriculture) NHTSA (National Highway Traffic Safety Administration) 17
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Professional Organizations American Medical Association American Nursing Association American Public Health Association American College of Preventive Medicine American Hospital Association American College of Physicians Association for Prevention Teaching and Research and many more 20
Voluntary Health Organizations Local, state, and national levels Examples: -American Heart Association, American Lung Association, American Cancer Society -Red Cross - Visiting Nurses Association -Many y more 21