Principles of Public Principles of Public Health-Health-

The Mission, Core The Mission, Core Functions and Ten Functions and Ten Essential ServicesEssential Services

Virginia M. Dato MD MPHVirginia M. Dato MD MPH

Virginia M Dato MD MPHVirginia M Dato MD MPH

Board Certified - Residency Trained Board Certified - Residency Trained Public Health PhysicianPublic Health Physician

Center for Public Health Practice, Center for Public Health Practice, University of Pittsburgh, Graduate School University of Pittsburgh, Graduate School of Public Healthof Public Health

Learning ObjectivesLearning ObjectivesBy the end of the course the By the end of the course the

student will be able tostudent will be able to

To understand the mission of public To understand the mission of public healthhealth

To understand the core functions of To understand the core functions of public healthpublic health

To understand the 10 Essential To understand the 10 Essential Services of Public HealthServices of Public Health

Performance ObjectivesPerformance Objectives

By the end of the course the By the end of the course the student will be able to use the student will be able to use the 10 Essential Services of Public 10 Essential Services of Public Health to develop new Health to develop new solutions to current public solutions to current public health problems. health problems.

““When a committee of the When a committee of the Massachusetts legislature confidently Massachusetts legislature confidently

asserted, on May 22, 1869 that all asserted, on May 22, 1869 that all governments since the time of Moses governments since the time of Moses had made provision to protect the life had made provision to protect the life

and health of their people, the and health of their people, the legislators affirmed a tradition of legislators affirmed a tradition of

corporate responsibility for the welfare corporate responsibility for the welfare of their people.”of their people.”

From Public Health and the State - Changing Views in Massachusetts, 1842-1936 - Barbara Gutman Rosenkrantz Harvard University Press - 1972

The Future of Public The Future of Public Health - 1988Health - 1988

The Committee for the Study of the Future of The Committee for the Study of the Future of Public Health Reviewed the Status of Public Public Health Reviewed the Status of Public Health in AmericaHealth in America

Determined that Public Health was in disarrayDetermined that Public Health was in disarray Articulated the Mission, Substance, Articulated the Mission, Substance,

Organizational Framework and the Three Core Organizational Framework and the Three Core Functions of Public HealthFunctions of Public Health

Mission of Public HealthMission of Public Health

The fulfillment of society’s The fulfillment of society’s interest in assuring the interest in assuring the conditions in which people conditions in which people can be healthy -can be healthy - (The Future (The Future of Public Health) of Public Health)

Organized community efforts Organized community efforts aimed at the prevention of aimed at the prevention of disease and promotion of health. disease and promotion of health. It links many disciplines and rests It links many disciplines and rests upon the scientific core of upon the scientific core of Epidemiology (The Future of Epidemiology (The Future of Public Health)Public Health)

Substance of Public Substance of Public HealthHealth

Encompasses both activities Encompasses both activities undertaken within the formal undertaken within the formal structure of government and structure of government and the associated efforts of the associated efforts of private and voluntary private and voluntary organizations and individuals” organizations and individuals” (The Future of Public Health)(The Future of Public Health)“

The Organizational The Organizational Framework of Public HealthFramework of Public Health

Formal Structure of Formal Structure of Government in the USGovernment in the US

Federal GovernmentFederal Government– commercecommerce

– fundingfunding

– national securitynational security State GovernmentState Government

– primary responsibilityprimary responsibility Local GovernmentLocal Government

– as delegated by the stateas delegated by the state

Core FunctionsCore Functions

AssessmentAssessment Policy DevelopmentPolicy Development AssuranceAssurance

VisionVision

Healthy People in Healthy People in Healthy CommunitiesHealthy Communities

Mission Mission

Promote physical and Promote physical and mental health and mental health and prevent disease, injury, prevent disease, injury, and disability.and disability.

The fundamental obligation The fundamental obligation of agencies responsible for of agencies responsible for population-based health is population-based health is

to:to: Prevent epidemics and the Prevent epidemics and the

spread of disease spread of disease Protect against environmental Protect against environmental

hazards hazards Prevent injuries Prevent injuries

Promote and encourage Promote and encourage healthy behaviors and mental healthy behaviors and mental health health

Respond to disasters and Respond to disasters and assist communities in recovery assist communities in recovery

Assure the quality and Assure the quality and accessibility of health servicesaccessibility of health services

The Ten Essential The Ten Essential Services of Public Health Services of Public Health

AssessmentAssessment

““The Committee for the Study of the The Committee for the Study of the Future of Public Health “recommends that Future of Public Health “recommends that every public health agency regularly and every public health agency regularly and systematically collect, assemble, analyze, systematically collect, assemble, analyze, and make available and make available information on the information on the health of the community,health of the community, including including statistics on health status, community statistics on health status, community health needs, and epidemiological and health needs, and epidemiological and other studies of health problems." other studies of health problems."

The Ten Essential The Ten Essential Services - AssessmentServices - Assessment

Monitor health status to identify Monitor health status to identify community health problemscommunity health problems

Diagnose and investigate health problems Diagnose and investigate health problems and health hazards in the communityand health hazards in the community

Evaluate effectiveness, accessibility, and Evaluate effectiveness, accessibility, and quality of personal and population-based quality of personal and population-based health serviceshealth services

Policy DevelopmentPolicy Development "The committee recommends that every public "The committee recommends that every public

health agency exercise its responsibility to serve the health agency exercise its responsibility to serve the public interest in the development of comprehensive public interest in the development of comprehensive public health policies by promoting use of the public health policies by promoting use of the scientific knowledge base in decision-making about scientific knowledge base in decision-making about public health and by leading in developing public public health and by leading in developing public health policy. Agencies must take a strategic health policy. Agencies must take a strategic approach, developed on the basis of a positive approach, developed on the basis of a positive appreciation for the democratic political process"appreciation for the democratic political process"

The Ten Essential The Ten Essential Services - PolicyServices - Policy

Inform, educate, and empower Inform, educate, and empower people about health issuespeople about health issues

Mobilize community partnerships to Mobilize community partnerships to identify and solve health problemsidentify and solve health problems

Develop policies and plans that Develop policies and plans that support individual and community support individual and community health effortshealth efforts

AssuranceAssurance "The committee recommends that public "The committee recommends that public

health agencies assure their constituents health agencies assure their constituents that services necessary to achieve that services necessary to achieve agreed upon goals are provided, either agreed upon goals are provided, either by encouraging actions by other entities by encouraging actions by other entities (private or public sector), by requiring (private or public sector), by requiring such action through regulation, or by such action through regulation, or by providing service directly”.providing service directly”.

Assurance Part 2Assurance Part 2 The committee recommends that each public The committee recommends that each public

health agency involve key policy makers and the health agency involve key policy makers and the general public in determining a set of high-general public in determining a set of high-priority personal and community-wide health priority personal and community-wide health services that governments will guarantee to services that governments will guarantee to every member of the community. This every member of the community. This guarantee should include subsidization or direct guarantee should include subsidization or direct provision of high-priority personal health provision of high-priority personal health services for those unable to afford them."services for those unable to afford them."

The Ten Essential The Ten Essential Services - AssuranceServices - Assurance

Assure a competent public health and Assure a competent public health and personal health care workforcepersonal health care workforce

Enforce laws and regulations that Enforce laws and regulations that protect health and ensure safetyprotect health and ensure safety

Link people to needed personal health Link people to needed personal health services and assure the provision of services and assure the provision of health care when otherwise health care when otherwise unavailable unavailable

The Tenth Essential The Tenth Essential ServiceService

Impacts Assessment, Policy Impacts Assessment, Policy and Assuranceand Assurance

Research for new insights and Research for new insights and innovative solutions to health innovative solutions to health problemsproblems