Core-Functions-and-Essential-Services-The-University-of-Iowa-核心功能与基本的服务-爱荷华大学-P课件

CoreFunctionsandEssentialServices

IDPHEducationTomNewton,KenSharp,JoyRueberTenGreatPublicHealthAchievements1900-2019PublishedintheMMWR2019.Foundthatpeoplelive30yearslongerthantheydid100yearsagoandthat25ofthoseyearscanbeattributedtoPublicHealthPublicHealthSuccesses1.Vaccinations2.SaferWorkplaces3.SaferandHealthierfoods4.Motor-vehiclesafety5.Controlofinfectiousdiseases6.Heartdiseaseandstroke7.FamilyPlanning8.TobaccoUse9.Mothersandbabies10.FluoridationofdrinkingwaterTheInstituteofMedicine(1988)definespublichealthas:Activitiesthatsocietyundertakestoassuretheconditionsinwhichpeoplecanbehealthy.Thisincludesorganizedcommunityeffortstoprevent,identify,andcounterthreatstothehealthofthepublic.Anotherwaytolookatit…“Fordecades,publichealthhadbeenthestepchildcladinragsintheworldofmedicine,eclipsedbynovelsurgeriesandthedramaoftheemergencyroom…..Thebigproblemisthatwhenpublichealthissuccessful,nothinghappens,becausewe’vepreventeditfromhappening.”–Aboostershotforpublichealth,StephenSmith,BostonGlobe1/7/2019Onemorethingtonote:USPublicHealthServicehasestimatedthatalthoughUShealthexpendituresincreasedby210%between1981and1993,theproportionoftheseexpendituresusedforpopulationbasedPHmeasures,includingEH,declinedby25%.PublicHealth’sInfrastructure–AStatusReportCDC–March2019Inatestofe-mailcapacity,only35%ofmessagestolocalhealthdepartmentsweredeliveredsuccessfully.Atleastonelocalhealthdepartmentsaiditdoesn’tcomplywithreportablediseasenotificationbecauseittakesalongdistancephonecall.PublicHealth….inthebeginning6,500yearsagoinancientSumerpipeshavebeenlocatedindicatingsewersystems5,000yearsagoinEgyptthepriestlyministerofthestatehadthedutyofinspectingthewatersupplyforthewholelandevery10days-Sanitarian’sHandbook–BenFreedman197718thand19thCenturyPublicHealth-USAProtectingthepublic’shealthwastheresponsibilityofthesocialelite.Statesmenactinginpublic’sinterestvs.politiciansansweringtoaconstituentgroup.Menofpropertyandwealthwerebelievedtobeindependentofspecialinterestsandthereforecapableofdisinterestedjudgment.PrinciplesofPublicHealthPractice,201918thand19thCenturiescontinued….EpidemicdiseasesweretheconsequenceofafailuretoobeythelawsofnatureandGod.Policefunction–portcitiesQuarantinecausedeconomicproblems.Causeofdiseaseunknown-healthregulationswrittenandrevisedinresponsetopoliticalinfluenceorpressurefrommerchants–notnecessarilyinresponsetoshiftsinscientificthinking.Theword“health”doesnotappearintheUSConstitution,thereforehealthbecamearesponsibilitytobeexecutedbythestates.September17,1787TheBoardofHealth1793,firstboardofhealthestablishedinPhiladelphia–thenationalcapitalhadtobeshutdownduetoayellowfeverepidemic1850,LemuelShattuck’sReportoftheSanitaryCommissionofMassachusettscalledforestablishmentofstateandlocalhealthdepartmentstoorganizepubliceffortsaimedatsanitaryinspections,foodsanitation,vitalstats,andservicesforinfantsandchildren.EstablishmentofIowa’sLocalBoardsofHealth

In1866,theLocalHealthLawwasadopted.DesignatedmayorandtowncouncilortownshiptrusteesasLBOH.LBOHhadauthoritytoestablishregulationsforpublichealthandsafety,tocontrolnuisances,andtoregulatesourcesoffilthandcausesofsicknessincommunities.StateBoardofHealthinIowa1880-StateBoardofHealthlawestablishedto:CollectvitalstatisticsEstablishdutiesoflocalboardsPunishneglectofdutiesMostlyadvisory–localboardshadauthority1967NewLocalHealthActChapter137oftheCodeofIowaEachcountyrequiredtoestablishaBOH–onememberhadtobeaphysicianlicensedbytheStateofIowa.BOStoappointothermembers.Acitywithapopulationof25,000+couldestablishacityboardofhealth.Countiesandcitieswerealsoallowedtoformdistrictboardsofhealth.IDPHHistory1924establishedDivisionsincluded:ContagiousandInfectiousDiseaseVenerealDiseaseHousingSanitaryEngineeringVitalstatisticsExaminationsandLicensesLate1920’sDivisionofPublicHealthEducationDivisionofMaternalandChildHealth(6thinthenation)1931DivisionofPublicHealthNursing1948DivisionofHospitalLicensureEstablishmentofpositionclassificationandsalaryscale1953DivisionofGerontology,Health,andChronicDisease1970EnvironmentalprogramstoDNR1982HomecareaidetransferredfromDHS1986HealthfacilitiesregulationtoDIADept.ofSubstanceAbusemovedtoIDPH2019GamblingtreatmentprogramtoIDPH2019StateMedicalExaminer’sOfficemovedtoIDPHUniquefeaturesofPublicHealthBasisinsocialjusticephilosophyInherentlypoliticalinnatureDynamic,everexpandingagendaLinkwithgovernmentGroundedinthesciencesUseofpreventionasaprimestrategyUncommoncultureInstituteofMedicine(IOM)Private,non-governmentalagencyAuthorsareunpaidvolunteerexpertsProvideobjective,timelyauthoritativeinformationandadviceconcerninghealthandsciencepolicytothegovernment,thecorporatesector,theprofessionsandthepublic.TheFutureofPublicHealthInstituteofMedicine(IOM)report–1988Foundafragmentedsystem–notabletofulfillnecessaryfunctionsStated1/3oftheUSpopulationiseffectivelyservedbypublichealthIdentifiedthe3corefunctionsofpublichealthTheFutureofthePublic’sHealthinthe21stCentury-IOM,2019Recommended6areasofactionandchange:1.Adoptingapopulationhealthapproachthatconsidersthemultipledeterminantsofhealth.2.Strengtheningthegovernmentalpublichealthinfrastructure,whichformsthebackboneofthepublichealthsystem.3.Buildinganewgenerationofintersectoralpartnershipsthatalsodrawontheperspectivesandresourcesofdiversecommunitiesandactivelyengagetheminhealthaction.4.Developingsystemsofaccountabilitytoassurethequalityandavailabilityofpublichealthservices.5.Makingevidencethefoundationofdecisionmakingandthemeasureofsuccess.6.Enhancingandfacilitatingcommunicationwithinthepublichealthsystem(e.g.,amongalllevelsofthegovernmentalpublichealthinfrastructure,betweenpublichealthprofessionalsandcommunitymembers.)TheCoreFunctionsAssessmentPolicyDevelopmentAssuranceAssessmentEnsureslimitedresourcesareusedeffectivelyPolicyDevelopmentPayattentiontoqualityofprocessanddecisionsmadeRaisequestionsotherpeoplewon’torcan’taskIncludethepublicBuildbridgesAssuranceMaintainserviceHaveintendedimpactMakesurehealthservicesareavailableASSESSMENTPolicyDevelopment

Assurance*AssessmentPolicyDevelopmentAssurance*starthere

Vision:HealthyPeopleinHealthyCommunitiesMission:PromotePhysicalandMentalHealthandPreventDisease,Injury,andDisabilityPublicHealthPreventsepidemicsandthespreadofdiseaseProtectsagainstenvironmentalhazardsPreventsinjuriesPromotesandencourageshealthybehaviorsRespondstodisastersandassistscommunitiesinrecoveryAssuresthequalityandaccessibilityofhealthservices2019PHFunctionsSteeringCommitteeEssentialPublicHealthServicesMonitorhealthstatustoidentifycommunityhealthproblemsDiagnoseandinvestigatehealthproblemsandhealthhazardsinthecommunityInform,educate,andempowerpeopleabouthealthissuesMobilizecommunitypartnershipstoidentifyandsolvehealthproblemsDeveloppoliciesandplansthatsupportindividualandcommunityhealtheffortsEnforcelawsandregulationsthatprotecthealthandensuresafetyLinkpeopletoneededpersonalhealthservicesandassuretheprovisionofhealthcarewhenotherwiseunavailableAssureacompetentpublichealthandpersonalhealthcareworkforceEvaluateeffectiveness,accessibility,andqualityofpersonalandpopulation-basedhealthservicesResearchfornewinsightsandinnovativesolutionstohealthproblemsIAC641.77Rolesandresponsibilitiesoflocalboardsofhealth.AssessmentMonitorhealthstatus.Diagnoseandinvestigatehealthproblemsandhazards.Evaluateeffectiveness,accessibility,andquality.1.Monitorhealthstatustoidentifyandsolvecommunityhealthproblems:MakeanaccuratediagnosisIdentificationofthreatsAssessmentofhealthneedsTimelycollection,analysis,andpublicationofinformationPayattentiontovitalstatsandhealthstatusofpopulationswhomayneedmoreservicesCollaborate2.Diagnoseandinvestigatehealthproblemsandhealthhazardsinthecommunity:-Identifyepidemiolgicemerginghealththreats-Haveaccesstoa

qualitypublichealthlaboratory-Havethe

capabilitytousemoderntechnology,conductrapidscreening,andhighvolumetestingifneeded-Haveactiveepidemiologyprograms-Havethe

capacityforinvestigationofoutbreaksandpatternsofchronicdiseaseandinjury3.Evaluateeffectiveness,accessibility,andqualityofpersonalandpopulation-basedhealthservices:-Provideongoingevaluationofhealthprograms-Completeananalysisofhealthstatusandutilizationdata-ProvideinformationnecessarytoallocateresourcesandreshapefundsPolicyDevelopmentDeveloppoliciesandplansEnforcelawsandregulationsResearchnewinsights4.Developpoliciesandplansthatsupportindividualandcommunityhealthefforts:ProvideleadershipdevelopmentPlanatthelocalandstatelevelDevelopandtrackmeasurablehealthobjectivesConductjointevaluationswiththemedicalsystemDevelopcodes,regulations,andlegislation5.EnforcelawsandregulationsthatprotecthealthandensuresafetyEnforcesanitarycodesProtectdrinkingwaterEnforcecleanairstandardsProvidetimelyfollow-upMonitorqualityofmedicalservicesConductatimelyreviewofnewapplications6.Researchfornewinsightsandinnovativesolutionstohealthproblems:-Linkwithinstitutionsofhigherlearningandresearch-DevelopaninternalcapacitytomounttimelyepidemiologicandeconomicanalysesandconductneededhealthcareservicesresearchAssuranceLinkpeopletoneededservicesAssureacompetentworkforceInform,educate,andempowerpeopleMobilizecommunitypartnerships7.Linkpeopletoneededpersonalhealthservicesandassuretheprovisionofhealthcarewhenotherwiseavailable:AssureeffectiveentryforsociallydisadvantagedpeopleintosystemProvideculturallyandlinguisticallyappropriatematerialsandstaffProvideongoingcaremanagementProvideorrefertotransportationservicesProvidetargetedhealthinformationtohighriskgroupsProvidetechnicalassistanceforworksitehealthpromotion/diseasepreventionprograms8.Assureacompetentpublicandpersonalhealthcareworkforce:Attend/provideeducationandtrainingProvideanefficientprocess