Transcript Public Health Responsibilities

Key findings on State
Public Health Agency
Responsibilities from the
2010 Profile of State
Public Health Survey

Key Findings and Top Priorities

Prevention and Health Promotion

Clinical and Diagnostic Services

Surveillance, Regulatory and Legal Functions

Technical Assistance and Training

Research and Evaluation
The essential services provide a
working definition of public health
and a guiding framework for the
responsibilities of local public
health systems.

Full or shared responsibility of federal initiatives

Linkages between people and personal health services

Population-based primary prevention addressing CDC’s
winnable battles

Direct clinical services

Laboratory services for bioterrorism agents

Laws and regulations

Tobacco control and prevention

Evaluation of personal and population-based health
services
Priority
# of Mentions
%
Infrastructure/Capacity/IT/Workforce
40
17%
Quality Improvement
21
9%
Health Promotion/Prevention
18
8%
Obesity, Nutrition and Physical Activity
14
6%
Emergency Preparedness
14
6%
Health Care Reform
13
5%
Communicable Disease Control
13
5%
Environmental Health
11
5%
Tobacco
10
4%
Strategic Planning
10
4%
Disparities
10
4%
Chronic Disease Control
10
4%
Funding and Mitigating Cuts
10
4%
Other Priorities
37
19%
Federal Initiative
# of SHAs
addressing
%
Maternal and Infant Health Services, Prenatal
Care, Title V
49
96%
Preventive Health and Health Services Block
Grant (CDC)
49
96%
CDC Preparedness Grants
48
94%
National Cancer Prevention and Control
Program Grant (CDC)
48
94%
Women, Infants and Children Program (USDA)
48
94%
HIV Pharmacies (ADAP)
46
90%
HRSA Preparedness Grants
46
90%
Injury Prevention (CDC)
46
90%
Vital Statistics (NCHS)
46
90%
Health Professionals Shortage Area
Designations (HPSA)
45
88%
Essential Public Health Services
3.
4.
5.
Inform, educate and empower
people about health issues
Mobilize community partnerships
and action to identify and solve
health problems
Develop policies and plans that
support individual and
community health efforts
100
90
80
70
88%
84%
82%
80%
78%
78%
60
50
40
30
20
10
0
Area of service
75%
69%
69%
67%
100
90
80
Percent
70
60
50
40
30
20
10
0
Vaccine order management and
inventory distribution (2010)
Administration of vaccine to
population (2010)
Childhood
Adult
International Travel
Immunizations
Immunizations
Immunizations
92
98
24
46
42
14
100
90
80
Percent
70
60
50
40
30
20
10
Health Service
78%
0
57%
49%
49%
47%
100
90
80
70
Percent
60
50
40
30
20
10
Health Activity
0
90%
88%
73%
71%
69%
63%
61%
53%
53%
45%
100
90
80
70
Percent
60
50
40
42%
30
27%
20
10
Priority
13%
0
State and
Cessation
Health
community
intervention
communication
interventions
intervention
10%
8%
Administration and Surveillance and
management
evaluation
100
90
80
Percent
70
60
50
40
30
20
10
Component
0
98%
88%
84%
73%
63%
61%
41%
35%
31%
8%
14%
100
90
80
Percent
70
60
50
76%
71%
67%
61%
40
30
20
10
Activity
78%
0
39%
31%
27%
24%
22%
Essential Public Health Services
2.
7.
Diagnose and investigate health
problems and health hazards in
the community
Link people to needed personal
health services and assure the
provision of health care when
otherwise unavailable
Activities to Ensure Access to Health Care Services
# of
SHAs
%
Health Disparities or Minority Health Initiatives
43
84%
Provide Financial Support to Primary Care Providers
38
75%
Rural Health
37
73%
Emergency Medical Services
26
51%
Institutional Certifying Authority for Federal
Reimbursement
25
49%
Outreach and Enrollment for Medical Insurance
20
39%
State Children’s Health Insurance Program (SCHIP)
16
31%
Faith-based Health Programs
15
29%
Tribal Health
14
27%
State Provided Health Insurance (Not Supported
by Federal Funds)
5
10%
Health Insurance Regulation
3
6%
100
90
80
Percent
70
60
50
40
30
20
10
Screening 0
Service
71%
61%
59%
57%
47%
33%
31%
25%
25%
24%
24%
14%
10%
100
90
80
70
Percent
60
50
57%
55%
40
30
20
10
Disease
59%
0
31%
22%
14%
18%
8%
8%
8%
8%
6%
Clinical Services
# of SHAs Providing
%
Oral Health
29
57%
Rural Health
21
41%
Pharmacy
19
37%
Sexual Assault Victims Services
17
33%
Mental Health Education and Prevention Services
16
31%
State Nursing Home Eligibility Determination
16
31%
Substance Abuse Education and Prevention Services
16
31%
Domestic Violence Victims Services
13
25%
Managed Care (Medical Homes)
12
24%
Mental Health Treatment Services
12
24%
Disability
9
18%
Physical Therapy
9
18%
Substance Abuse Treatment Services
9
18%
Child Protection Services / Medical Evaluation
8
16%
Home Health Care
8
16%
Correctional Health
7
14%
Disability Determination
6
12%
100
90
80
Percent
70
60
96%
94%
94%
82%
78%
70%
50
40
30
20
10
Lab Service
0
34%
24%
Essential Public Health Services
1.
6.
Monitor health status to identify
and solve community health
problems
Enforce laws and regulations that
protect health and ensure safety
Data Collection, Epidemiology and Surveillance Activities
# of
SHAs
%
Behavioral Risk Factors
49
96%
Communicable/Infectious Diseases
49
96%
Reportable Diseases
49
96%
Vital Statistics
49
96%
Cancer Incidence
48
94%
Chronic Diseases
48
94%
Perinatal Events or Risk Factors
48
94%
Food-borne Illness
47
92%
Morbidity Data
47
92%
Environmental Health
45
88%
Injury
45
88%
Syndromic Surveillance
41
80%
Adolescent Behavior
40
78%
Uninsured Outreach and Enrollment for Medical Insurance
26
51%
100
90
80
70
Percent
60
50
52%
40
30
20
24%
24%
24%
22%
20%
Nurses
Physicians
Physician
Dentists
Pharmacists
10
Profession
0
(any level)
assistants
Other health
professionals
100
90
80
Percent
70
60
50
63%
56%
40
30
20
17%
10
13%
15%
Contracts with
Works with
Other arrangement
0
Employs attorneys Assigned attorneys
and has own legal
and legal staff by
outside,
attorneys employed
dept
state’s Attorney
independent
by local government
General
attorneys for legal
matters
Description of Public Health Legal Counsel Structure
Percent
Service
100
90
80
70
60
50
40
30
20
10
0
94%
94%
92%
77%
63%
2%
Formal opinions
Assists in
Informal advice Represents the
Determines
drafting laws,
organization in which entities
statutes,
all legal matters to litigate or
regulations,
enforcement
policies and
enforcement
actions
prosecute
Other
arrangement
Essential Public Health Services
8.
Assure competent public and
personal health care workforce
Percent
100
90
80
70
60
50
40
30
20
10
0
QI/PM/
Data
Public Health
Policy
Workforce
Accreditation
Management
Law
Development
Issues
Emergency responders
67
51
55
57
53
Hospitals
76
51
51
51
43
Laboratories
75
47
35
33
22
51
47
41
49
33
Local public health agencies
73
75
75
73
73
Other
35
22
29
25
22
Statewide nonprofit/community–
based organizations
100
90
80
Percent
70
60
50
88%
86%
82%
82%
78%
76%
61%
40
30
20
10
Topic
90%
0
31%
6%
90
80
85%
70
70%
Percent
60
50
52%
40
44%
30
20
22%
10
Profession
0
Physicians
Dentists
Nurses
Mid-level
Providers
Other
Essential Public Health Services
9. Evaluate effectiveness,
accessibility and quality of
personal and population-based
health services
10.Research for new insights and
innovative solutions to health
problems
100
90
80
Percent
70
60
50
40
91%
89%
85%
77%
70%
51%
49%
45%
30
20
10
Activity
0
2%
Type of Research Study
# of SHAs
reporting
Mean
Median
Min
Max
All Studies
36
32.1
12
2
217
Led by State Health Agency
21
17.9
7
1
114
Includes Participation with a
Researcher Based at a
University or Research
Institute
32
22.8
7.5
1
151
Includes Formal Agreement
to Conduct Joint Studies on
a Recurring Basis
19
10.7
5
1
50
State public health agencies
perform a broad range of activities
encompassing the ten essential
public health services. Budget cuts
are reducing the agencies’ ability
to provide these essential services.