As noted in Chapter 3, these national objectives are very ambitious and may even be based on poor estimates of true incidence. Clearly, the United States has a longer way to go in reaching its 2010 objectives than originally anticipated. The Committee’s estimate of 8.5 fatal poisonings per 100,000 population (Chapter 3) is far above the national 2010 objective of 1.5, and even higher than the 1997 estimate of 6.8 used as a baseline. Furthermore, our estimate of nonfatal poisonings of 530 per 100,000 population in 2001 (Chapter 3) is nearly twice the national 2010 objective of 292 and again even higher than the 1997 baseline estimate of 349 nonfatal poisonings per 100,000. These findings suggest that national efforts to reduce poisonings and fatalities must be more strongly linked to the nation’s overall agenda for health promotion and disease prevention. In this chapter we develop the argument for how incorporating the Poison Prevention and Control System into the broader public health system will accomplish this health improvement.

CORE PUBLIC HEALTH FUNCTIONS

Since the publication of the 1988 Institute of Medicine (IOM) report, The Future of Public Health, the public health system has addressed the charge of “disarray” in the field by focusing scientific and technical knowledge into three core functions needed to improve the health of the public: assessment (e.g., monitoring health status of a population, surveillance to detect disease outbreaks), policy development (e.g., development of partners, implementation of legislation), and assurance (e.g., education of the public and providers, standards and regulations to promote quality services, provision of direct health care services). These three core functions are helpful in describing the components of an integrated Poison Prevention and Control System at the federal, state, and local levels in the United States as they relate to the public health system.

Assessment

Data collection and analysis on a populationwide basis serves to monitor health status in order to identify and plan solutions for community health problems; characterize and investigate health problems and health hazards in the community; evaluate effectiveness, accessibility, and quality of personal and population-based health services; and carry out research for new insights and innovative solutions to health problems and conditions. According to the Centers for Disease Control and Prevention’s (CDC’s) Updated Guidelines for Evaluating Public Health Surveillance Systems (2001b, p. 2), “public health surveillance is the ongoing, systematic collection, analysis, interpretation, and dissemination of data regarding a



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