Public health at center stage: New roles, old props

Health Affairs

Volumn 25, Issue 4, 2006, Pages 911-922

  Beitsch, Leslie M ^a   Brooks, Robert G ^a   Menachemi, Nir ^a   Libbey, Patrick M ^b  

^a FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE   (United States)

^b NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CHRONIC DISEASE; DISASTER PLANNING; FORECASTING; HEALTH CARE PLANNING; HEALTH SERVICE; HUMAN; INFECTION CONTROL; MANPOWER; ORGANIZATION; ORGANIZATION AND MANAGEMENT; PROFESSIONAL STANDARD; PUBLIC HEALTH; PUBLIC HEALTH SERVICE; PUBLIC RELATIONS; UNITED STATES;

CHRONIC DISEASE; COMMUNICABLE DISEASE CONTROL; COMMUNITY HEALTH PLANNING; DECISION MAKING, ORGANIZATIONAL; DISASTER PLANNING; FORECASTING; HEALTH SERVICES NEEDS AND DEMAND; HUMANS; INTERINSTITUTIONAL RELATIONS; PROFESSIONAL ROLE; PUBLIC HEALTH; PUBLIC HEALTH ADMINISTRATION; STATE HEALTH PLANS; UNITED STATES;

EID: 33746895802     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.25.4.911     Document Type: Article

References (31)

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2. "The Government Performance Project: A Case of Neglect," Governing, February 2004, http://www.governing.com/gpp/2004/public.htm (accessed 17 April 2006).
3. CDC, "Ten Great Public Health Achievements";
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5. CDC, "Profile of State and Territorial Public Health System, 1991," October 1991, http://wonder.cdc.gov/wonder/sci_data/misc/type_txt/ stprof91.asp (accessed 1 June 2006);
6. National Association of County and City Health Officials, "Local Public Health Agency Infrastructure: A Chartbook" (Washington: NACCHO, 2001);
7. L.M. Beitsch et al., "Structure and Functions of State Public Health Agencies," American Journal of Public Health 96, no. 1 (2006): 167-172;
8. and L. Beitsch et al., "Roles of Local Public Health Agencies within the State Public Health System," Journal of Public Health Management Practice 12, no. 3 (2006): 217-231.
9. G. Alleyne, "Threat to a Public Good" (Editorial), Perspectives in Health 7, no. 1 (2002).
10. The complete NACCHO questionnaire can be viewed online at http://www.naccho.org/topics/infrastructure/2005Profile.cfm (accessed 17 April 2006).
11. U.S. Census Bureau, "Interim Projections of the Total Population for the United States and States: April 1, 2000 to July 1, 2030," http://www.census.gov/population/projections/SummaryTabA1.pdf (accessed 17 April 2006).
12. Beitsch et al., "Structure and Functions";
13. and Beitsch et al., "Roles of Local Public Health Agencies."
14. The complete ASTHO survey results can be found at http://www.astho.org/ pubs/2005SalarySurveyComplete.pdf (accessed 15 May 2006).
15. Centralized control indicates that local public health agencies are units of the state health department, whereas decentralized agencies are functional units of local government. The mixed/shared designation reflects an intermediate relationship and governance structure that differs from either extreme.
16. From the standpoint of structure at the state level, there was significant variation only for organizational configuration across U.S. census geographic regions (data not shown). For example, southern states tended to be centralized, while midwestern states exhibited a preference for decentralization (South, 43.8 percent; Midwest, 83.3 percent; p = .02). Conversely, nearly all of the local agency configurations and governance components surveyed differed significantly by region and state population size.
17. Institute of Medicine, The Future of Public Health (Washington: National Academies Press, 1988).
18. Relatively limited variations were noted between states with regard to programs and functions (data not shown). However, food safety (p = .02) and tobacco control (p = .02) were more likely to be activities of smaller-population states, whereas substance abuse programs were often the full responsibility of public health in western states (p = .05). By contrast, for local agencies, all of the selected functions in Exhibit 2 were significantly different from the perspective of both regions and size, except for mental health services, which did not vary by state population size.
19. S. Heffler et al., "U.S. Health Spending Projections for 2004-2014," Health Affairs 24 (2005): w74-w86 (published online 23 February 2005; 10.1377/hlthaff.w5.74);
20. and C. Smith et al., "National Health Spending in 2004: Slowdown Led by Prescription Drug Spending," Health Affairs 25, no. 1 (2006): 186-196.
21. U.S. Census Bureau, Statistical Abstract of the United States: 2006, 125th ed., http://www.census.gov/statab/ www (accessed 1 June 2006);
22. and U.S. Department of Justice Bureau of Justice Statistics, "Nation Spends $167 Billion on Criminal and Civil Justice Services," Press Release, 2 May 2004, http://www.ojp.usdoj.gov/bjs/pub/press/jeeus01pr.htm (accessed 17 April 2006).
23. CDC, "Profile of State and Territorial Public Health System, 1991."
24. NACCHO, "Local Public Health Agency Infrastructure."
25. Beitsch et al., "Structure and Functions";
26. and Beitsch et al., "Roles of Local Public Health Agencies."
27. M. Barry and R. Bialek, "Tracking Our Investments in Public Health: What Have We Learned?" Journal of Public Health Management Practice 10, no. 5 (2004): 383-392;
28. S. Hearne, L. Segal, and M. Earls, "Ready or Not? Protecting the Public's Health from Diseases, Disasters, and Bioterrorism" (Washington: Trust for America's Health, 2005);
29. and UnitedHealth Foundation, "America's Health: State Health Rankings" (Minnetonka, Minn.: UnitedHealth Foundation, 2004). TfAH per capita data are based upon 2003-04 budget information; the UnitedHealth Foundation used 2002 data for its calculations.
30. Canadian Institute for Health Information, National Health Expenditure Trends 1975-2005, Table C.1.2, 7 December 2005, http://secure.cihi.ca/cihiweb/ dispPage.jsp?cw_page=media_07dec2005_e (accessed 1 June 2006).
31. NACCHO, "Local Public Health Agency Infrastructure."