It is important, as we move forward in health care, that public health has a more prominent role in our health care system. Public health in the United States is no longer responsible specifically for disease containment. It has taken on a new role in recent years.
A big part of that role is prevention. While public health still has to manage disease control, it’s new role of providing the public with knowledge and the means for preventing disease and illness is a huge, yet exciting endeavor. As we move forward in health care, prevention is going to be a necessity. Let’s look at some of the ways public health has changed over the years and how that relates to health care delivery.
Traditionally, public health was created primarily to deal with disease control and outbreak containment. As medicine advanced in its ability to prevent such outbreaks, the role of public health shifted. With this shift the new term “population health” has appeared. “One definition for population health, provided by Kindig (2007), is that population health “is a conceptual framework for thinking about why some populations are healthier than others”.” (Bradford, 2008, p. 1)
This term in public health refers to the broad need for preventative measures aimed at target groups or populations. The mission of Public health care today is to “promote physical and mental health; and to prevent disease, injury, and disability (www.healthcare.gov).” So what does that mean?
RUNNING HEAD: PUBLIC HEALTH 3 “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, and also assures the quality and accessibility of health services” (www.health.gov). The essential public health services include:
* 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 * 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.
* Link people to needed personal health services and assure the provision of health care when otherwise unavailable * Assure a competent public health and personal health care workforce * Evaluate effectiveness, accessibility, and quality of personal and population-based health services * Research for new insights and innovative solutions to health problems RUNNIN HEAD: PUBLIC HEALTH 4
With all of these new responsibilities, it is evident that support from all other parts of the healthcare system are essential to the success of the public (population) health mission. For example, the public health organizations alone cannot determine community health problems without the necessary reporting by neighborhood physicians. It is crucial that public health and the health care delivery system work together to reach these goals.
Traditionally, the health care delivery sector has focused on the treatment, rather than prevention, of illness and disease. In order for these two sectors of the health care system to work together there needs to be a common goal of prevention.
“Progress on public health problems in a democratic society requires agreement about the mission and content of public health sufficient to serve as the basis for public action. There is [however], no clear agreement among public decision-makers, public health workers, private sector health organizations and personnel, and opinion leaders about the translation of a broad view of mission into specific activities” (The Future of Public Health, p. 108).
Public health roles have already changed significantly over the years. Its role is advancing as medicine, environmental controls, and education about medical conditions and disease continue to advance. However, its ability to accomplish these goals is extremely hampered by the lack of cooperation from the above mentioned parts of the health care system. RUNNING HEAD: PUBLIC HEALTH5
A good example of organizations working together is a family health center, where in the dental offices there are federal guidelines that promote full-body treatment. In order to comply, the medical history of a new patient is thoroughly reviewed at their first visit and their blood pressure is taken at every visit. If there are any red flags, these patients are referred to the medical office (also affiliated with the health center), in the same building, for follow-up and recommendations or treatment if needed. This example shows one way public health can work to promote a healthier community. It also requires patients to take responsibility for their own care.
While public health cannot control what populations as a whole may do, it can educate the public as to the hazards of their physical environment. This idea could encompass so many factors that public health has a great deal of expanding to do in order to cover all of the possible risk factors. Some of the issues (taken from The Future of Public Health, p. 113) that public health needs to address include: * Job and family stress
* Promotion of hazardous products
* Encouragement of risk-taking behavior and violence through TV programs, movie, and other popular media. * Peer pressure for substance abuse
* Premature sexual behavior
* School failure
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“To deal with these factors, the scope of public health will need to encompass relationships with other social programs in education, social services, housing, and income maintenance (Future of Public Health, p. 112).”
There is a trend, however, in our society to focus on treating illness and disease rather them preventing them in the first place. Programs such as Jump rope for the heart encourage exercise in those who participate, usually school children, to strengthen their heart; while the majority of the proceeds from such programs go to treatment of heart disease, rather than prevention. If programs such as this coupled with public health to prevent such disease there would be less incidence and therefore more of that funding could be spent on prevention.
It is all about ending a vicious cycle that the United States, as a whole, has created. We have not been given the tools to prevent, or educated enough, on disease prevention. As we move forward, Public health has some big shoes to fill. It is going to take the cooperation of the healthcare sector as a whole in team with public health to make this work. Public attitudes toward change are going to have to adjust. And populations as a whole need to be educated and willing to use the services provided. Prevention is a key factor to the future success in public health.
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Cohen, Jennifer A. (2008). Challenges and Successes in Reducing Health Disparities: Workshop
Summary Roundtable on Reducing Disparities. National Academies Press.
Institute of Medicine Staff. (04/1988). Future of Public Health. National Academies Press.
Jacobs Kronenfeld, Jennie. (10/2008). Research in the Sociology of Health Care, Volume 26:
Care for Major Health Problems and population Health Concerns: Impacts on Patients,
Providers and Policy. Emerald Group Publishing Ltd.
Schaeffer, Leonard D. (2009). HHS in the 21st Century: Charting a New Course for a Healthier
America. National Academies Press.
U.S. Department of health and Human Services. www.healthcare.gov. Searched for “mission of
Public health care”.