Public Health Core Functions
LOUIS ROWITZ, PhD
DIRECTOR
Mid-America Regional Public
Health Leadership Institute
Pyramid of Public Health System Preparedness
Public Health
Response
•Bioterrorism
•Emerging infections
•Other health status
Essential Capabilities
Surveillance
Laboratory
Practice
Basic Infrastructure
Workforce
Capacity &
Competency
Information &
Data Systems
Epidemic
Investigations
Organizational
Capacity
CORE FUNCTIONS:
A PRACTITIONER AND AN
AGENCY PERSPECTIVE
DIAGNOSIS
ASSESSMENT
RULES OF
PROFESSIONAL
PROTOCALS
TREATMENT
POLICY
DEVELOPMENT
ASSURANCE
ASSESSMENT IS…
All the activities involved in community
diagnosis:
• Surveillance
• Needs assessment
• Analysis of cause of problems
ASSESSMENT IS…
•
•
•
•
Collection and interpretation of data
Case-finding
Monitoring and forecasting trends
Research and evaluation
ASSESSMENT DATA SOURCES:
Personal Health Data:
•
•
•
•
Vital statistics
Epidemiology
Health screening
Special disease or
population registries
• Laboratory test data
• Hospital discharge
data
• Research
• Behavioral Risk
Factor Data
ASSESSMENT DATA SOURCES:
Data about community concerns
& resources:
• Health resource
inventory
• Public forums
• Polling
• Special methodsAPEX, PH part 2,
PATCH, MAPP, etc
• Information from
private & non-profit
providers
• Research
Four MAPP Assessments
• Community themes and strengths
assessment
Identifies issues that interest the community,
perceptions about quality of life, and
community assets
Four MAPP Assessments
• Local public health system
assessment
Measures the capacity and performance of
the local public health system-all
organizations and entities that contribute to
the public’s health
Four MAPP Assessments
• Community health status
assessment
Assesses data about health status, quality of
life, and risk factors in the community
Four MAPP Assessments
• Forces of change assessment
Identifies forces that are or will be affecting
the community of the local public health
system
ASSESSMENT DATA SOURCES:
Methods of distribution of
findings:
• Annual vital
statistics report
• Special projects
report
• State health report
• Monographs
• Fact sheets
• Professional
publications
• Media releases
ASSESSMENT DATA SOURCES:
Data on the range & quality of
services:
• Selected treatment management review
data
• Consumer complaint follow-up
information
• Facility & professional licensure data
• Research
ASSESSMENT DATA SOURCES:
Environmental Health Data:
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•
•
•
•
•
Sanitary survey
Air & water monitoring
Public reforms
Facility inspections
Laboratory test data
Research
THE POLICY DEVELOPMENT
PROCESS ENTAILS…
•
•
•
•
Collaboration
Decision-making about problems
Choice of goals and steps to meet them
Conflict resolution and negotiation
THE POLICY DEVELOPMENT
PROCESS:
• Defines health needs
• Sets priority health issues by analyzing the
outcome of assessment
• Develops policies and plans to address the
most important health needs by setting goals
& objectives with measurable objectives
• Develops alternative strategies for
implementing plans
• Identifies necessary & available resources
THE POLICY DEVELOPMENT
PROCESS USES:
• Scientific information
• Data from the assessment process
• Information from concerned citizens &
providers
THE POLICY DEVELOPMENT
PROCESS USES:
• Concepts of political & organizational
feasibility
• Community values
• An open process, involving all private &
public sectors by communicating,
networking & building constituencies
THE ASSURANCE FUNCTION
INVOLVES:
• Implementation of legislative mandates
and statutory responsibilities
• Development of adequate responses to
crises
• Support crucial services that have
worked in the past
THE ASSURANCE FUNCTION
INVOLVES:
• Regulation of services and products
provided in both the public and private
sectors
• Maintain accountability to the people by
setting objectives and reporting on
progress
THE ASSURANCE FUNCTION
INVOLVES:
• Maintenance of a level of service
needed to attain an intended impact or
outcome that is achievable given the
resources and techniques available
ASSURANCE
The Assurance function calls upon
public health agencies to:
• Provide public health nursing services
• Provide environmental health services
• Encourage, purchase or provide
additional population-based services
• Maintain emergency response capacity
ASSURANCE
The Assurance function calls upon
public health agencies to:
• Administer quality assurance
• Help recruit & retain health care
practitioners
• Maintain administrative capacity
THE TEN ORGANIZATIONAL
PRACTICES OF PUBLIC HEALTH
Assessment 1. Assess the health needs of
the community
2. Investigate the occurrence
of health effects and health
hazards in the community
3. Analyze the determinants
of identified health needs
THE TEN ORGANIZATIONAL
PRACTICES OF PUBLIC HEALTH
4. Advocate for public health,
Policy
build constituencies, and
Development
identify resources in the
community
5. Set priorities among
health needs
6. Develop plans and
policies to address priority
health needs
THE TEN ORGANIZATIONAL
PRACTICES OF PUBLIC HEALTH
Assurance
7. Manage resources and
develop organizational
structure
8. Implement programs
9. Evaluate programs and
provide quality assurance
10. Inform and educate the
public
The capacity of the public health system
is its ability to perform the core functions of
assessment, policy development, and
assurance on a continuous, consistent basis
made possible by maintenance of the basic
infrastructure of the public health system,
including human, capital, and technology
resources. The smooth running of the system
requires the application of sound leadership
skills at all levels of the public health system.
-Modified from the
Washington State Public Improvement Plan, March 1994
Public Health in the U.S.
Vision:
Healthy People in Healthy
Communities
Mission:
Promote Physical and Mental
Health and Prevent Disease,
Injury, and Disability
Public Health
• Prevents epidemics and the spread of
disease
• Protects against environmental hazards
• Prevents injuries
• Promotes and encourages healthy
behaviors
• Responds to disasters and assists
communities in recovery
• Assures the quality and accessibility of
health services
Essential Public Health
Services
• Monitor health status to identify
community health problems
• Diagnose and investigate health
problems and health hazards in the
community
• Inform, educate, and empower people
about health issues
Essential Public Health
Services
• Mobilize community partnerships to
identify and solve health problems
• Develop policies and plans that support
individual and community health efforts
• Enforce laws and regulations that
protect health and ensure safety
Essential Public Health
Services
• Link people with needed personal
health services and assure the provision
of health care when otherwise
unavailable
• Assure a competent public health and
personal health care workforce
Essential Public Health
Services
• Evaluate effectiveness, accessibility,
and quality of personal and populationbased health services
• Research for new insights and
innovative solutions to health problems
Source. 1990 Centers for Disease Control and Prevention
Public Health: The foundation of a national health system
Tertiary
Medical
Care
Secondary Medical
Care
Primary Medical Care
Essential Population-Based Public Health Services
•Human Resources Development(Training)
•Information Systems
•Community Planning Systems
Capacity to Deliver Public Health Services
Public Health System Infrastructure
•Human Resources Development (Training)
•Information Systems
•Community Planning Systems
The Future