The Future of the Public's Health in the 21st Century

BOX 3–1 The 10 Essential Public Health Services

Assessment

Monitor health status to identify community health problems
Diagnose and investigate health problems and health hazards in the community

Policy Development

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

Assurance

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

Serving All Functions

Research for new insights and innovative solutions to health problems

SOURCE: Public Health Functions Steering Committee (1994).

ing for this infrastructure at the state and local levels to ensure the availability of the essential health services to all people, and this is a critical concern. The federal government has, however, developed and funded various new programs and organizational units, which, if effectively coordinated, could serve as important components of a more systematic program. The Centers for Disease Control and Prevention (CDC) established (in 1989) the Public Health Practice Program Office and strengthened university-based Centers for Prevention Research (initiated in 1983). CDC also developed Public Health Leadership Institutes (initiated in 1992) at the national and regional levels and the National Public Health Training Network (initiated in 1993). Both programs respond to recommendations to improve the overall leadership competencies of public health practitioners. In 1993, CDC began discussions of a modern and uniform approach to public health surveillance, and it has moved forward with the development of a National Electronic Disease Surveillance Network. More recently, CDC has worked with states to establish the Health Alert Network (initiated in 1999) to improve infor-

Table of Contents

Front Matter R1-R26

Executive Summary 1-18

1. Assuring America's Health 19-45

2. Understanding Population Health and Its Determinants 46-95

3. The Governmental Public Health Infrastructure 96-177

4. The Community 178-211

5. The Health Care Delivery System 212-267

6. Employers and Business 268-306

7. Media 307-357

8. Academia 358-400

Appendix A: Models of Health Determinants 401-405

Appendix B: Models of Collaborative Planning in Communities 406-410

Appendix C: Recommendations from The Future of Public Health 411-420

Appendix D: Healthy People 2010 Objectives for the Public Health Infrastructure 421-422

Appendix E: Competencies for Public Health Workers: A Collection of Competency Sets for Public Health-Related Occupations and Professions 423-440

Appendix F: Data-Gathering Activities 441-460

Appendix G: Agendas for Public Committee Meetings 461-464

Appendix H: Committee Biographies 465-474

Index 475-510