public health department

public health department

The Importance of Public Health Departments

1. The Role of Public Health Departments

Public health is a diverse field, which offers a wide range of possible interventions according to the needs of a particular population or geographical area. Public health can be defined as the science and art of preventing disease, prolonging life, and promoting health through organized efforts, informed choices of society, organizations, public and private, communities, and individuals. Analysis of the determinants of health of a population and the threats it faces makes it possible to define needs and risks. Interventions may be targeted at the whole population, a sub-population, or individuals. This requires an ability to measure and interpret the incidence of disease, morbidity, and mortality, and other health indicators and to derive and interpret the results of epidemiology. This also requires an ability to identify groups at risk, to understand and modify the behaviors of individuals and groups in relation to health, and to provide better and safer environments. Finally, interventions must be evaluated so that there is a process of continuous quality improvement. The growing concern for global health, defined as health needs and risks transcending traditional boundaries, has led to a changing pattern of international aid. This arises from a recognition that many of the 20th-century health achievements in industrialized countries have not been replicated in developing, low, and middle-income countries. Public health has regrettably faced a situation where evidence-based practice and advocacy for health have often not been in agreement, but there now seems to be a better understanding of the need to use evidence to demonstrate the health benefits of underlying social, economic, and environmental policies.

2. Key Functions of Public Health Departments

The most important function is the ability to mobilize community partnerships in order to identify and solve health problems. A community consists of groups of people that may share a common identity and may have some social structure. Often, communities have shared interests and are willing to work together to solve problems and create a healthier environment. By mobilizing these partnerships, public health departments are ensuring that they have adequately addressed the health status and needs of the community. This will make it easier to create and implement comprehensive health strategies and interventions.

1. Link people to needed personal health services and assure the provision of health care when otherwise unavailable. 2. Assure a competent public and personal healthcare workforce. 3. Evaluate effectiveness, accessibility, and quality of personal and population-based health services.

Public health departments across the nation carry out a number of core functions that put the mission of public health into practice. The overall goal is to improve the health of their communities by means of disease prevention, health promotion, and protection of the environment. The programs and services provided by public health departments target different populations and their specific needs. To achieve the best results, these departments use an organized approach that is based on the following four steps:

3. Challenges Faced by Public Health Departments

The second challenge is “Policy and Priority set by Politicians rather than Public Health Professionals”. Throughout recent history in the west, there is now a decrease in national public health financing relative to gross domestic product. This has been due to increasing pressure to spend more wisely. Often, however, it is difficult to discern what is meant by this and where any increases in funding should be spent. This can be disease dependent and the increase in funding, along with what it is spent on, does not always correlate, placing a heavier burden on some health departments. Often, clinical care benefits more and there has been a large shift in moving public health services to clinical care services. A specific example is the changes in Scotland in recent years with healthcare policy and management. Steps to prevent diseases and injury are being informed through developing a common understanding of the problems and finding practical comprehensive solutions to address them.

The first challenge they say is “linking the traditional public health services to clinical care”. By this, Bell is saying that public health has always been linked to preventing diseases. Now, with scientific advances and how diseases are being managed, especially in the western world, public health has the role of prevention. It is often caught up in competing with clinical care in the same methods but on a different disease. Often, clinical care will take priority since public health’s work on prevention is considered a future investment.

Public health departments today are facing many challenges. These challenges vary from country to country and also within countries. Bell and her colleagues from the Bloomberg School at John Hopkins University suggest six challenges that public health departments are going to face in the future.

4. Strategies for Improving Public Health Services

On the healthcare end, the various activities aimed at prevention and cost-effective solutions should have an interface with the funding sources. An example is the treatment of a patient with symptoms of lead poisoning. He will continue to get sick unless he changes his living environment. If a Medicaid program cuts funding for treatment of the lead poisoning without an interfacing prevention program, there is a risk that the patient will seek treatment from another funding source but never get better.

The United States has already adopted the CDC’s vision of public health “Healthy People in a Healthy World” to improve the nation’s health with a 10-year national objective. This is a crucial initiative, but it is imperative that federal, state, local, and tribal public health agencies are held accountable to reach the objectives. Currently, there is no systematic effort to evaluate the public health services funded through federal appropriations to ensure that they are efficient and effective. This means that there is no justified confidence that the money given is being used on programs which are proven to benefit the public’s health. A prospective strategy would be to set objectives each year that are in line with the Healthy People initiative measures and develop an assessment report card for each state on how they have carried out their public health services in the year. Federal funding should then be allocated based on the state’s performances to act as an incentive/penalty and motivate states to improve their public health services. This strategy has been used in New Zealand to initiate public health reforms with good success. A special advisory committee has been formed to evaluate the suitability of this strategy.

Prioritizing and keying in on public health issues can greatly benefit the nation. Nevertheless, there is an incomplete partnership between health and public health, and this obstacle should be overcome. Health care more often is equated with a defined event that can be treated and cured. Measures of outcome and success are centered on these specific events, and an attitude prevails that if a suitable treatment is available, then the prevention is not worthwhile. An example is the practice of treating a drug addict who has become HIV infected from sharing needles, in comparison to preventing the HIV infection in the first place. The patient, payer, and provider of the treatment for the HIV have little vested interest in the prevention of HIV in this case. Now take that sequence of events and look for legislative support for allocation of funds in the two scenarios. One of the largest lobbyists in the US for HIV/AIDS patients is the National Medical Association (NMA) – an influential group of physicians dedicated to the health of African American patients.

5. The Future of Public Health Departments

As mentioned earlier, knowledge in health is key to improving the health of a population. There are many health problems in the world today, and most are complex in nature. Globalization is bringing health problems to the doorsteps of many countries. This places a global responsibility on public health, as public health primarily deals with bettering health at a population level. Terrorism is another health problem without borders. Health has also become a popular card in foreign policies between countries. This is evident through initiatives such as providing funds to developing countries for AIDS drugs. All health-related problems mentioned not only affect the United States but also the rest of the world. As the world becomes smaller, and health problems become more complex, a global knowledge of health issues and their solutions is necessary if we wish to improve the health of populations at home and abroad.

The future of public health is a bright one. The development of public health efforts will be especially important in developing countries. There are three key elements to the future of public health departments. They must be knowledgeable in health, must have the capacity to deliver, and must provide financial and other incentives to keep the best public health professionals in the field.