Public Health in America
Vision: Healthy People in Healthy Communities
Mission:Promote Physical and Mental Health and Prevent Disease, Injury, and Disability
Public Health
- Prevents epidemics and the spread of disease
- Protects against environmental hazards
- Prevents injuries
- Promotes and encourages healthy behaviors
- Responds to disasters and assists communities in recovery
- Assures the quality and accessibility of health services
Essential Public Health Services
- Monitor health status to identify community health problems
- Diagnose and investigate health problems and health hazards in the community
- 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
- 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
- ·Research for new insights and innovative solutions to health problems
[Adopted: Fall 1994 Source: Public Health Functions Steering Committee
Members
- American Public Health Association · Association of Schools of Public Health
- Association of State and Territorial Health Officials
- Environmental Council of the States
- National Association of County and City Health Officials
- National Association of State Alcohol and Drug Abuse Directors
- National Association of State Mental Health Program Directors
- Public Health Foundation
- U.S. Public Health Service--Agency for Health Care Policy and Research * Centers for Disease Control and Prevention · Food and Drug Administration · Health Resources and Services Administration · Indian Health Services · National Institutes of Health · Office of the Assistant Secretary for Health · Substance Abuse and Mental Health Services Administration--Agency for Health Care Policy and Research * Centers for Disease Control and Prevention · Food and Drug Administration · Health Resources and Services Administration · Indian Health Services · National Institutes of Health · Office of the Assistant Secretary for Health · Substance Abuse and Mental Health Services Administration]
The Public Health Functions Project
(The Ten Essentials in Detail)
Mission: To strengthen the public health infrastructure of the nation.
Major Activities Include:
- Describing essential services of public health
- Documenting public health expenditures
- Defining public health workforce, training, and education
- Establishing public health infrastructure priority area for Healthy People 2010
- Improving public health data
- Facilitating public health communications
- Supporting public health guideline development
Competencies for Providing Essential Public Health Services
Essential Service #1: Monitor health status to identify community health problems.
Competencies:
Analytic Skills
- Define a problem
- Determine appropriate use of data and statistical methods for problem identification and resolution and program planning, implementation, and evaluation
- Select and define variables relevant to defined public health problems
- Evaluate the integrity and comparability of data and identify gaps in data sources
- Understand how the data illuminate ethical, political, scientific, economic, and overall public health issues
- Understand basic research designs used in public health
- Make relevant inferences from data
- Communicate effectively both in writing and orally (unless a handicap precludes one of these forms of communication)
- Present accurately and effectively demographic, statistical, programmatic, and scientific information for professional and lay audiences
- Solicit input from individuals and organizations
- Advocate for public health programs and resources
- Lead and participate in groups to address specific issues
- Use the media to communicate public health information
- Collect and summarize data relevant to an issue
- Define, assess, and understand the health status of populations, determinants of health and illness, factors contributing to health promotion and disease prevention, and factors influencing the use of health services.
- Apply the basic public health sciences, including behavioral and social sciences, biostatistics, epidemiology, environmental public health, and prevention of chronic and infectious diseases and injuries
New - Understand risk assessment and risk communication skills
- Understand how to use public health software packages such as Epi-Info to track, analyze, and present findings of community health problems.
- Design and operate a surveillance system
- Understand analytic skills for survey development and administration
- Understand the role and importance of vita/statistics
- Understand computer/information technology applications
- Know existing sources of data
- Describe problems in terms of time (persistence), magnitude/severity (scope), dispersion/location (place), and co-occurrence/co-morbidity
- Demonstrate ethical (including sensitive, confidential) conduct in practice, research, data collection and storage, and program management
- Effectively function in culturally diverse settings, assess cross-cultural relations, adapt professional behavior to unique needs, assess and promote cultural competence of employee/organization
(These lists of organizational competencies for providing essential public health services were done by the Competency-Based Curriculum Work Group of the Subcommittee on Public HealthWorkforce, Training, and Education. The Work Group began with the universal competencies developed by the Faculty/Agency Forum, divided them into the 10 essential services of public health framework, and added new competencies. Those marked with a * are universal competencies that have been modified.)
Essential Service #2: Diagnose and investigate health problems and health hazards in the community.
Competencies:
Analytic Skills
- Define a problem
- Determine appropriate use of data and statistical methods for problem identification and resolution, and program planning, implementation, and evaluation
- Select and define variables relevant to defined public health problems
- Evaluate the integrity and comparability of data and identify gaps in data sources
- Understand how the data illuminate ethical, political, scientific, economic, and overall public health issues
- Understand basic research designs used in public health
- Make relevant inferences from data
- Communicate effectively both in writing and orally (unless a handicap precludes one of these forms of communication)
- Present accurately and effectively demographic, statistical, programmatic, and scientific information for professional and lay audiences
- Solicit input from individuals and organizations
- Lead and participate in groups to address specific issues
- Use the media to communicate public health information
- Collect and summarize data relevant to an issue
- State policy options
- Articulate the health, fiscal, administrative, legal, social, and political implications of each policy option
- State the feasibility and expected outcomes of each policy option
Cultural Skills
- Understand the dynamic forces contributing to cultural diversity
- Interact sensitively, effectively, and professionally with persons from diverse cultural, socioeconomic, educational, and professional backgrounds and with persons of all ages and lifestyle preferences
- Identify the role of cultural, social, and behavioral factors in determining disease, disease prevention, health promoting behavior, and medical service organization and delivery
- Develop and adapt approaches to problems that take into account cultural differences
Basic Public Health Sciences Skills
- Define, assess, and understand the health status of populations, determinants of health and illness factors contributing to health promotion and disease prevention, and factors influencing the use of health services.
- Understand research methods in all basic public health sciences
- Apply the basic public health sciences including behavioral and social sciences, biostatistics, epidemiology, environmental public health, and prevention of chronic and infectious diseases and injuries
New
- Understand environmental health issues and environmental morbidity factors
- Establish ties with nontraditional public health providers such as school health clinics and occupational safety office in industry
- Utilize risk assessments (i.e., identifying hazardous exposure and health effects)
- Apply laboratory science skills
- Understand study design, including outbreak/cluster investigation
- Facilitate interview (including cultural competence) and qualitative survey methods
- Utilize public relations skills
- Know existing network of consultants and technical assistance and community-based assets to collect and analyze community health data
- Understand relevant legal and regulatory information
- Identify the scientific underpinnings and ascertain strength of evidence from literature, including effectiveness of interventions
- Prepare and interpret data from vital statistics, census, surveys, service utilization, and other relevant special reports
Essential Service #3: Inform, educate, and empower people about health issues.
Competencies:
Communication Skills
- Communicate effectively both in writing and orally (unless a handicap precludes one of these forms of communication)
- Present accurately and effectively demographic, statistical, programmatic, and scientific information for professional and lay audiences (i.e., risk communication)
- Solicit input from individuals and organizations
- Advocate for public health programs and resources
- Lead and participate in groups to address specific issues
- Use the media and advanced technologies to communicate public health information
Cultural Skills
- Understand the dynamic forces contributing to cultural diversity
- Interact sensitively, effectively and professionally with persons from diverse cultural, socioeconomic, educational, and professional backgrounds and with persons of all ages and lifestyle preferences
- Identify the role of cultural, social, and behavioral factors in determining disease, disease prevention, health promoting behavior, and medical service organization and delivery
- Develop and adapt approaches to problems that take into account cultural differences
- Understand psychosocial and behavioral theories (e.g., health belief model)
- Establish measurable goals/objectives
- Understand how public and private agencies within a community operate
- Understand risk assessment and health risk assessment methodologies
- Translate education information into compelling sound "bites"
- Know how to use the legal and political system to effect change
- Understand different theories on education and learning
Essential Services #4: Mobilize community partnerships to identify and solve problems.
NOTE: Competencies needed to identify and solve problems are included in essential services 1, 2, and 5. Therefore, the competencies listed below reflect those needed to mobilize community partnerships.
Competencies:
Communication Skills
- Communicate effectively and persuasively both in writing and orally (unless a handicap precludes one of these forms of communication)
- Present accurately and effectively demographic, statistical, programmatic, and scientific information for professional and lay audiences
- Solicit input from individuals and organizations
- Advocate for public health programs and resources
- Lead and participate in groups to address specific issues
- Use the media to communicate public health information
Cultural Skills
- Understand the dynamic forces contributing to cultural diversity
- Interact sensitively, effectively, and professionally with persons from diverse cultural, socioeconomic, educational, and professional backgrounds and with persons of all ages and lifestyle preferences
- Identify the role of cultural, social, and behavioral factors in determining disease, disease prevention, health promoting behavior, and medical service organization and delivery
- Develop and adapt approaches to problems that take into account cultural differences
New
- Establish ties with nontraditional health providers (such as businesses, managed care organizations and other health care providers, schools, other government agencies, volunteer, and nonprofit organizations, advocacy groups, community groups, hospitals, physicians, insurers, faith and church groups)
- Understand the existing network of consultants and technical assistance and community-based assets to collect and analyze community health data
- Utilize leadership, team building, negotiation, and conflict resolution skills to build community partnerships
- Foster community empowerment, involvement, and power sharing whenever possible in the design, implementation, and research aspects of programs and systems
Essential Services #5: Develop policies and plans that support Individual and community health efforts.
Competencles:
Communication Skills
- Use the media and advanced technologies to communicate public health information
- Collect and summarize data relevant to an issue and test its reliability
- State policy options
- Articulate the health, fiscal, administrative, legal,'social, and political implications of each policy option
Policy & Development Skills/Program Planning Skills.
- State the feasibility and expected outcomes of each policy option
- Utilize current .techniques in decision analysis
- Write a clear and concise policy statement
- Develop a plan to implement the policy, including goals, outcome and process objectives, and implementation steps
- Translate policy into organizational' plans, structures, and programs.
- Identify public health laws, regulations, and policies related' to specific programs
- Develop mechanisms to monitor and evaluate programs for their effectiveness and quality
Cultural Skills
- Understand the dynamic forces-contributing to cultural diversity
- Interact sensitively, effectively, and professionally with persons from diverse cultural, socioeconomic, educational, and professional backgrounds and with persons of all ages and lifestyle preferences
- Identify the role of cultural, social, and behavioral factors in determining disease, disease prevention, health promoting behavior, and medical service organization and delivery
- Develop and adapt approaches to problems that take into account cultural differences
Financial Planning & Management Skills
- Develop and present a budget
- Manage programs within budgetary constraints
- Develop strategies for determining budget priorities
- Monitor program performance
- Prepare proposals for funding from external sources
- Apply basic human relations skills to the management of organizations and the resolution of conflicts
- Manage personnel
- Understand the theory of organizational' structure and its relation to professional practice
New
- Utilize and integrate strategic planning processes, including assessment methodology and modeling when developing policies or community-health plans
- Conduct cost-effectiveness, cost-benefit, and cost-utility analyses
Essential Service #6: Enforce laws and regulations that protect health and ensure safety.
Competencies:
Communication Skills
- Communicate effectively both in writing and orally (unless a handicap precludes one of these forms of communication)
- Present accurately and effectively demographic, statistical, programmatic, and scientific information for professional and lay audiences (i.e., risk communication)
- Use the media and advanced technologies to communicate public health information
Policy & Development Skills/Program Planning Skills
- Collect and summarize data relevant to an issue, including adequate interpretation of historical experiences, activities, and outcomes
- Identify, interpret, and implement public health laws, regulations, and policies related to specific programs
Cultural Skills
- Interact sensitively, effectively, and professionally with persons from diverse cultural, socioeconomic, educational, and professional backgrounds and with persons of all ages and lifestyle preferences
New
- Utilize creative methods for achieving enforcement and regulation of laws that protect health
- Collaborate with other public agencies and organizations (e.g., law enforcement)
- Manage and monitor the enforcement process (including enforcement personnel, compliance, and development of inspection indicators)
- Understand risk assessment and health risk assessment methodologies
Essential Services #7: Link people to needed personal health services and ensure the provision of health care when otherwise unavailable.
Competencies:
Analytic Skills
- Define a problem
- Make relevant inferences from data
Policy & Development Skills/Program Planning Skills
- Collect and summarize data relevant to an issue
- State policy options
- Articulate the health, fiscal, administrative, legal, social, and political implications of each policy option
- State the feasibility and expected outcomes of each policy option
- Decide on the appropriate course of action
- Write a clear and concise policy statement
- Develop a plan to implement the policy, including goals, outcome and process objectives, and implementation steps
- Translate policy into organizational plans, structures, and programs
- Develop mechanisms to monitor and evaluate programs for their effectiveness and quality
Cultural Skills
- Understand the dynamic forces contributing to cultural diversity
- Interact sensitively, effectively, and professionally with persons from diverse cultural, socioeconomic, educational, and professional backgrounds and with persons of all ages and lifestyle preferences
- Identify the role of cultural, social, and behavioral factors in determining disease, disease prevention, health promoting behavior, and medical service organization and delivery
- Develop and adapt approaches to problems that take into account cultural differences
Basic Public Health Sciences Skills
- Define, assess, and understand the health status of populations, determinants of health and illness, factors contributing to health promotion and disease prevention, and factors influencing the use of health services
Financial, Planning & Management Skills
- Develop and present a budget
- Manage programs within budgetary constraints
- Develop strategies for determining budget priorities
- Monitor program performance
- Prepare proposals for funding from external sources
- Apply basic human relations skills to the management of organizations and the resolution of conflicts
- Manage personnel
- Understand the theory of organizational structure and its relation to professional practice
New
- Negotiate contracts for personal health services
- Identify health needs of special and vulnerable populations
- Utilize case management skills to coordinate care
- Coordinate public health and medicine for optimal care
- Provide or ensure provision of comprehensive personal health services, including primary, specialty medical and dental care, and clinical preventive services
- Prepare and implement emergency response plans
Essential Service #8: Assure a competent public health and personal health care workforce.
Competencles:
Analytic Skills
- Determine appropriate use of data and statistical methods for problem identification and resolution and program planning, implementation, and evaluation
Policy & Development Skills/Program Planning Skills (policy = privileging, licensing, quality assurance, credentialing, and accreditation of health professionals and health professions education)
- Collect and summarize data relevant to an issue
- State policy options
- Articulate the health, fiscal, administrative, legal, social, and political implications of each policy option
- State the feasibility and expected outcomes of each policy option
- Decide on the appropriate course of action
- Write a clear and concise policy statement
- Develop a plan to implement the policy, including goals, outcome and process objectives, and implementation steps
- Translate policy into organizational plans, structures, and programs
Cultural Skills
- Interact sensitively, effectively, and professionally with persons from diverse cultural, socioeconomic, educational, and professional backgrounds and with persons of all ages and lifestyle preferences
Develop and adapt approaches to problems that take into account cultural differences
Basic Public Health Sciences Skills
- Understand the historical development and structure of State, local, and Federal public health agencies
Financial Planning & Management Skills
- Understand the theory of organizational structure and its relation to professional practice
New
- Persuasively express to organizational leaders the value and need for training and education
- Know and use contemporary learning technologies
- Understand different theories on education and learning
Essential Service # 9: Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
Competencles:
Analytic Skills
- Evaluate the integrity and comparability of data and identify gaps in data sources
- Understand how the data illuminate ethical, political, scientific, economic, and overall public health issues
- *Understand basic research methodologies used in public health and health services research
- Make relevant inferences from data
Communication Skills
- Communicate effectively both in writing and orally (unless a handicap precludes one of these forms of communication)
- Present accurately and effectively demographic, statistical, programmatic, and scientific information for professional and lay audiences
- Solicit input from individuals and organizations
- Advocate for public health programs and resources
Policy & Development Skills/Program Planning Skills
- Collect and summarize data relevant to an issue
- Identify public health laws, regulations, and policies related to specific programs
- Develop mechanisms to monitor and evaluate programs for their effectiveness and quality
- Understand analytic skills for survey development and administration
Cultural Skills
- Understand the dynamic forces contributing t
o Cultural diversity
- Interact sensitively, effectively, and professionally with persons from diverse cultural, socioeconomic, educational, and professional backgrounds and with persons of all ages and lifestyle preferences
- Identify the role of cultural, social, and behavioral factors in determining disease, disease prevention, health promoting behavior, and medical service organization and delivery
- Develop and adapt approaches to problems that take into account cultural differences
Basic Pubic Health Sciences Skills
- Define, assess, and understand the health status of populations, determinants of health and illness, factors contributing to health promotion and disease prevention, and factors influencing the use of health services
- Understand research methods in all basic public health sciences
- Apply the basic public health sciences, including behavioral and social sciences, biostatistics, epidemiology, environmental public health, and prevention of chronic and infectious diseases and injuries
- Understand the historical development and structure of State, local, and Federal public health agencies
Financial Planning and Management Skills
- Monitor program performance
New
- Understand analytic skills for survey development and administration
- Monitor quality of personal health services provided
- Conduct cost-effectiveness, cost-benefit, and cost-utility analyses
Essential Service #10: Research for new insights and Innovative solutions to health problems
Competencies:
Analytic Skills
- Define a problem
- Determine appropriate use of data and statistical methods for problem identification and resolution and program planning, implementation, and evaluation
- Select and define variables relevant to defined public health problems
- Evaluate the integrity and comparability of data and identify gaps in data sources
- Understand how the data illuminate ethical, political, scientific, economic, and overall public health issues
- Understand basic research designs used in public health
- Make relevant inferences from data
Communication Skills
- *Use the media to communicate and disseminate results of research findings
Cultural Skills
- Understand the dynamic forces contributing to cultural diversity
- Interact sensitively, effectively, and professionally with persons from diverse cultural, socioeconomic, educational, and professional backgrounds and with persons of all ages and lifestyle preferences
- Identify the role of cultural, social, and behavioral factors in determining disease, disease prevention, health promoting behavior, and medical service organization and delivery
- Develop and adapt approaches to problems that take into account cultural differences
Basic Public Health Sciences Skills.
- Define, assess, and understand the health status of populations, determinants of health and illness, factors contributing to health promotion and disease prevention, and factors influencing the use of health services
- Understand research methods in all basic public health sciences
- Apply the basic public health sciences, including behavioral and social sciences, biostatistics, epidemiology, environmental public health, and prevention of chronic and infectious diseases and injuries
- Understand the historical development and structure of State, local, and Federal public health agencies
New
- Identify specific research methodologies relevant to each of the previous nine essential services.
- Conduct collaborative research across multiple disciplines.
- Understand budget processes in order to lobby for resources to investigate innovative approaches to health problems