Participants%20in%20Public%20Health

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Participants inPublic Health
Kristine M. Gebbie, DrPH, RN Columbia University
School of Nursing Center for Health Policy 630
West 168th Street, Mail Box 6 New York, NY
10032 [phone] kmg24_at_columbia.edu
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Developed as part of an Enhanced AHEC Community
Partnership for Health Professions Workforce and
Educational Reform project funded by the Health
Resource and Service Administration (HRSA)
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OBJECTIVES

• List key infrastructure components

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Official and VoluntaryPublic Health Sectors

• Official agencies assigned specific
  responsibilities for a geo-political unit or
  programmatic area
• Private not-for-profit voluntary agencies with
  commitment to a particular issue or population
• Public and private providers of personal care

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Federal Public Health Agencies

• The US has no Cabinet Secretary of Health, unlike
  most other countries
• Almost every federal agency has some
  responsibility that impacts the health of the
  public

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Click for larger picture
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Federal AgenciesContinued

• Environmental Protection Agency
• US Department of Agriculture
• Department of Labor - Occupational Safety and
  Health Administration
• Department of Veterans Affairs
• Department of Transportation

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Federal AgenciesContinued

• Department of Defense
• Housing and Urban Development
• White House
• Office of Management Budget
• Office of Drug Control Policy
• Office of AIDS Policy

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State Public Health Agencies

• State public health agency (dept of health, dept
  of public health)
• Umbrella human services agency
• Agency on aging (often includes long term care
  planning/licensing)
• Medicaid
• Mental health agency

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State AgenciesContinued

• Substance abuse agency
• Environment (water, air, soil quality waste
  disposal)
• Agriculture (food, dairy, pesticides)
• State-OSHA
• Health planning agency
• Health professions licensing bodies

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Did you know that . . .

• South Carolinas first public health employee was
  Dr. Fred Williams, in 1908?
• The Department of Health and Environmental
  Control was created in 1973?

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Local and CommunityPublic Health

• County, city or district health departments
• County, city or district mental health, substance
  abuse or environmental agency
• Special taxing districts for public hospitals,
  home health, environmental control or public
  health
• Local zoning authority

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Did you know that . . .

• Orangeburg and Greenwood counties established the
  first county health departments in the state, in
  1915, to combat hookworm?
• Every county had a health department by 1936?
• County health staff were transferred to the state
  payroll in 1981?

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Voluntary Associations

• Disease- or issue-specific organizations
• Advocacy groups
• Professional and industrial organizations
• Coalitions with health as only or major topic

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Hospitals and OtherCare Systems

• Access to care is an essential public health
  service
• Health-department-operated hospital, personal
  care program, or strong relationship with the
  local provider systems

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Other Care SystemsContinued

• The structure of public health services varies
  over time and place depending on size and
  composition of uninsured population and economics
  and attitudes of care systems
• Care systems may join population-focused
  activities for a variety of reasons

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Discussion Time

• Identify the components of the public health
  system serving your community
• Be sure to include non-governmental participants

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Summary

• US public health services may be comprised of
  federal, state and local governmental agencies,
  not-for-profit organizations, hospitals and other
  health care providers, and voluntary associations
• The exact structure of the system varies by issue
  and over time