Healthy Communities New Partnerships for the Future of Public Health (1996) / Chapter Skim
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Public Health and the Community
Public Health and the Community
Pages 31-42
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From page 31... ...
Many of the relevant entities are based in and focus their attention on the community in question (Box 9~. Others, such as state health departments, federal agencies, managed care organizations, and national corporations that have a broader scope than a single community, often play an essential role in determining local health status (IOM, in press)
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From page 32... ...
The first panel session focused on public health functions at the community level. Parcel members included the chief executive officer of DeKalb County, the director of the DeKalb County Health Department, the president of the DeKalb County Local Board of Health, a liaison with the state department of health, and members of community-based organizations.
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From page 33... ...
POLICY DEVELOPMENT IN PUBLIC HEALTH The Future of Public Health defined policy development as "the process by which society makes decisions about problems, chooses goals and the proper means to reach them, handles conflicting views about what should be done, and allocates resources." This definition suggests that partnerships between public health agencies and community-based organizations are essential if policy development is to be successful. The Future of Public Health, however, notes that fragmentation is pervasive and persistent in public health.
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From page 34... ...
Traditionally, public health was seen as the province of the public health department; but increasingly, government agencies are contracting with private community-based providers to carry out service programs (Baker et al., 1994~. In substance abuse, HIV/AIDS, childhood disabilities, and many other areas, there are a growing number of sophisticated organizations that are directly providing personal preventive and care services In recent years, community advisory boards, planning groups, and coalitions have become common in public health.
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From page 35... ...
More specifically, it proved a highly effective way of realizing the potential of public health's core functions. One of the key lessons learned was that genuine partnership with and by members of the community significantly enhances public health education, research, and service including that which occurs in the practice agencies.
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From page 36... ...
Among current activities, FACED now transports community residents for health care appointments, coordinates the work of seven "church health teams," orients local residents to services offered through community agencies, trains and develops other organizations, and delivers tobacco use prevention programming. Over the four years of the CBPH partnership, wide gaps in culture, race, trust, orientation, and history have been bridged among team members whose experience working jointly now forms the foundation for work with an expanded network of community residents and organizations.
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From page 37... ...
The misdeeds of government officials are often printed on the front pages of newspapers. In addition, the number of large, technically oriented public agencies and private industries have increased, while at the same time public support for large-scale scientific and technological developments has decreased.
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From page 38... ...
For example, addressing the problem of lead poisoning prevention involves a coordinated strategy among governmental public health agencies, the medical community, environmental, occupational health, and housing agencies, business, labor, and the general public as well as the public education system. For other problems, the solutions seem more straightforward, yet the scientific evidence about the efficacy and cost-effectiveness of solutions has been elusive (Council on Linkages, 1995~.
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From page 39... ...
Thus the benefits of medical care are often more tangible and concrete, while the benefits of public health are more diffuse and less well appreciated. A key struggle for governmental public health leaders and those in the private and nonprofit sectors with an economic, ethical, or philosophical interest in the public's health is making the benefits of community-based, population-wide public health activities and initiatives more recognizable, and finding allies who will speak on behalf of these initiatives and the unique role for governmental public health agencies in carrying out these initiatives.
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From page 40... ...
CONCLUSIONS In its discussions with community group representatives and public health officials, the committee heard of many innovative and effective approaches to community partnerships and collaboration that are consistent with widespread themes regarding community development and "reinventing government." Broader application and further development of these new approaches to collaboration within government twin legislators, boards of heals, and nonhealth agencies) and with community partners to achieve public heals goals should be encouraged.
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From page 41... ...
Thus, the committee reasserts the critical findings of The Future of Public Health that governmental public health agencies have a unique function in the community: "to see to it that vital elements are in place and that the [public health] mission is adequately addressed." These elements include assessment, policy development, and assurance.
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