Transcript No Slide Title

Assuring the
Public’s Health
st
in the 21 Century:
A Research Agenda
Congressional Briefing
May 19,2004
Jo Ivey Boufford, MD
1
The Committee’s Vision
Healthy People in Healthy
Communities
2
Causes of Premature Mortality
Environmental
Factors
20%
Genetic Factors
20%
Behavioral
Factors
50%
Inadequate
Access to
Medical Care
10%
3
The Core Function Project: U.S. Public Health Service, 1993
Public Health Expenditures As a
Percentage of Health Expenditures
Public Health
Expenditures
1%
Total Health
Expenditures
99%
The Core Function Project: U.S. Public Health Service, 1993
4
Actual Causes of Premature
Death in the United States in 1990
Deaths
Cause
Estimated
Tobacco
Diet/activity patterns
Alcohol
Microbial agents
Toxic agents
Firearms
Sexual behavior
Motor vehicles
Illicit use of drugs
400,000
300,000
100,000
90,000
60,000
35,000
30,000
25,000
20,000
% of total
Deaths
38%
28%
10%
8%
6%
4%
2%
2%
1%
5
Source: McGinnis & Foege, JAMA 1993
The Essential Public
Health Services
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
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 solution to health problems
6
Source: Public Health Function Steering Committee
The Public Health System
Community
Health care
delivery system
Governmental Public Assuring the Conditions
Health Infrastructure for Population Health
Academics
Employers &
Business
The Media
7
INSTITUTE OF MEDICINE
8
Population-based
Prevention Research
• Addresses health problems that affect large numbers of
people;
• Involves a definable population;
• Evaluates the application and impact of new discoveries on
the actual health of the population; and
• Focuses on behavioral or environmental factors associated
with primary and secondary prevention of disease in
populations; or behavioral, biological, or clinical variations
among populations; or integration of behavioral,
biological, and environmental factors
ASPH (Spencer 2000)
9
Congress and CDC
• Recommendation 31
Increase funding to support CDC
investigator-initiated prevention research
and maintain a strong program of
Centers, Institutes, and Offices (CIO)
generated research, and
• Recommendation 32
Determination of effective funding levels
for Prevention Research Centers
10
NIH
• Recommendation 33
NIH should increase the portion of its
budget allocated to population- and
community- based prevention research
and report this annually to the public
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