Currently, a variety of Canadian health centres =, laboratories, and branches now report to the CPHO (PHAC 2006). These include: Centre for Emergency Preparedness and Response (CEPR) Infectious Disease and Emergency Preparedness (IDEP) Laboratory for Foodborne Zoonosis Office of Public Health Safety National Microbiology Laboratory Pandemic Preparedness …
• The Office of Personnel Management Human Resources Management offers human resource guidance to various government agencies which serve millions of U.S. citizens (3). • The agency has a responsibility of ensuring that it gives advice that will help the agencies in recruiting, selecting, training, and retaining a skilled workforce to offer ...
• The Office of Personnel Management Human Resources Management offers human resource guidance to various government agencies which serve millions of U.S. citizens. • The agency has a responsibility of ensuring that it gives advice that will help the agencies in recruiting, selecting, training, and retaining a skilled workforce to offer the ...
Apr 24, 2014 · Health represents a dynamic state with habits that promote health and lowering risk of any diseases “The future of public health” Mission: The fulfillment of society’s interest in assuring the conditions in which people can be healthy Substance: Organized community efforts aimed at the prevention of disease and the promotion of health ...
The primary site of activity for most public health interventions is within individual communities or neighborhoods. This locale is where the members of the population and the public health practitioners interact. For issues that are unique to the community or do not spread beyond the community, the local approach is effective. However, many public health problems extend beyond local borders, for example toxic waste spills, infec-tious diseases, wars, and natural disasters. Any of these problems may require involve-ment of counties, states, the nation, or even other countries to fully understand the scope of the problem and respond to it. National and global organizations can often facilitate communication among the affected populations, provide access to expertise not available locally, and coordinate efforts to respond. The most effective responses to public health problems are those that involve local, state, national, and international partners.Many international outbreaks of infectious disease often begin as a single episode of illness or injury that quickly spread if not contained. In the case of an outbreak of a new viral disease, public health organizations at all levels need to minimize the spread of the disease and reduce the mortality and morbidity rates because of interdependence and the global nature of our world today. More than at any other time in history, trade, travel, and communication span the globe and connect populations in ways never imagined 100 years ago. It has been said that an infectious disease outbreak in any part of the world can be in a person’s backyard half a world away within 24 hours. Luckily, information about an approaching virus can be transmitted even faster via web and telecommunications, so a population can prepare if it is warned. ThatSARS-inspired is where case thebegins—asingle patient who has an unknown respiratory illness. The case is designed to show how this disease impacts patients and practitioners in other continents. What starts as a local outbreak quickly becomes a global health issue.
The U.S. Department of Health and Human Services (HHS) is the principal national organization charged with both protecting health and providing essential human services for Americans. As a federal program, the HHS serves more as a source of policy, guid-ance, and funding but does not directly administer the programs.- Administration is delegated to state health departments or their designees. Therefore, HHS works with state and local (i.e., county or city) governments to ensure information and services reach the public. The support often comes in the form of financial resources, technical assistance, education, and goals for the program. It has been estimated that almost one-fourth of the federal budget is spent on HHS programs, which indicates the size of the department and the focus on keeping residents healthy 9and productive.
Because so many public health issues occur across borders, an international system or network is needed to coordinate efforts and transfer information. As the SARS case will show, the spread of a contagious, infectious disease can be worldwide. Only a global effort to mitigate the spread of the disease will stop the outbreak before it becomes a full-blown pandemic (a global outbreak of disease). This section will look at the various international organizations that share information and coordinate actions across borders as well as some of their key functions.
The 10th Amendment to the U.S. Constitution made state governments the primary protectors of the health of people living within their borders. A state may undertake a myriad of activities to meet this responsibility, including the creation of an administra-tive agency called the health department (or public health agency). Activities conducted by the state health department in one state may be quite different that those in another due to differences in state priorities, politics, and ability to delegate to local governments.
It came into existence as a result of coordinating regional efforts to control the spread of infectious disease through increased sea travel.4 At the time, global air travel did not exist, so disease outbreaks were generally contained within a continent or region. When WHO was created in the 1940s, the PAHO assumed the role of the “Re-gional Office of the Americas.” The headquarters for PAHO are in Washington, DC, where staff members focus their efforts on getting member nations to collaborate on in-ternational health issues that are found in the Americas.4 As a regional office for WHO, PAHO has the same issues associated with voluntary membership and compliance with policies and standards as its parent organization. Although PAHO is primarily linked with WHO, it also serves other agencies of the United Nations (e.g., World Bank). The mission of PAHO is to improve the health of the people in the Americas and to strengthen health systems from local to national levels. It does this by promoting health care programs that increase access and add efficiency to systems, promoting education and social communications, reducing the spread of transmissible diseases and chronic diseases, and fighting outbreaks of disease in countries in the Americas.4 Vulnerable populations such as mothers, young children, poor, elderly, and refugees or displaced individuals are the target groups for health improvement. Focus areas for interventions are the safety of the blood supply, safe drinking water, sanitation, and tobacco use. To accomplish its mission, PAHO partners with other UN and WHO agencies, national public health agencies, and private, non-governmental organizations.
Yi was not aware of a concurrent international effort to isolate and identify the virus that caused SARS. News reports about the disease and international efforts were still limited in his hometown and did not describe the international team of 11 leading research labs that were working on the genetic sequence of the virus. During a business trip to Singapore, he learned that the virus was a coronavirus from the same group of viruses that also causes the common cold. The newly identified virus had been named SARS co-V. Apparently, it was a small germ; those face masks he had shipped from the United States could not block it. From his con-versations with other businessmen, Yi learned that the disease was now appearing all around the world. It was interesting to hear stories about how various countries were taking different approaches to detecting and controlling the SARS outbreaks (Figure 3.6).
Yi Chen is a 52-year-old male who was born and raised in the Guangdong province of south-ern China. His work as a shrimp salesman requires travel to many communities within his sales region. He averages six trips a month via the local train system. During those trips, he often stays at nice hotels where businessmen from countries also lodge. He chats with other travelers as he enjoys his after dinner cigarette and cup of beer.
This report eventually led to the establishment of the first public agency for health, the New York City Health Department, in 1866. During this same period, boards of health were established in Louisiana, California, the District of Columbia, Virginia, Minnesota, Maryland, and Alabama.
In Chapter 1, the committee found that the current public health system must play a critical role in handling major threats to the public health , but that this system is currently in disarray. Chapter 2 explained the committee's ideal for the public health system—how it should be arranged for handling current and future threats to health.
Edwin Chadwick, a London lawyer and secretary of the Poor Law Commission in 1838, is one of the most recognized names in the sanitary reform movement. Under Chadwick's authority, the commission conducted studies of the life and health of the London working class in 1838 and that of the entire country in 1842.
During the past 150 years, two factors have shaped the modern public health system: first, the growth of scientific knowledge about sources and means of controlling disease; second, the growth of public acceptance of disease control as both a possibility and a public responsibility.
Current values also emphasize state responsibility for most health and welfare programs. Block grants were implemented in 1981, consolidating the federal grants-in-aid to the states into four major groups and cutting back the amount of grant money (some of the cuts were restored in 1983).
The federal role in health also became more prominent. A strong federal government and a strong government role in ensuring social welfare were publicly supported social values of this era.
The Sanitary Problem . With increasing urbanization of the population in the nineteenth century, filthy environmental conditions became common in working class areas, and the spread of disease became rampant. In London, for example, smallpox, cholera, typhoid, and tuberculosis reached unprecedented levels.
If the judiciary is the least suited branch of government to develop health policy in many areas, the legislature may be the most suited. The legislature is thought to be impartial and publicly accountable; it has the capacity to collect full information from a wide range of objective sources; part of its mandate is to protect and promote the health of the public; and it has the power to engage in a lengthy and deliberative process in enacting legislation.
Whether society seeks to reform the health care system, to restrict or to expand women's choices to receive an abortion, or to authorize or to criminalize physician-assisted dying, it has no precise means by which to test for the "correct" approach. Health policy decisions often reflect choices between competing values, as well as assessments of available data. Interest groups, including organizations representing various health care professionals, select their values and evaluate data through their own lenses. Clearly, groups comprised of highly expert and well-intentioned professionals often make markedly different decisions about health policy.
The Supreme Court's decision in Cruzan provided an impetus for the move to legislative policymaking on the right to die. 36 In Cruzan, the U.S. Supreme Court upheld the decision of the Missouri Supreme Court to adopt a clear and convincing evidence standard for the termination of life-sustaining treatment.
However, many medical and surgical organizations (e.g., the American Medical Association) favored the classification of HIV infection as a sexually transmitted disease. This would authorize greater use of compulsory testing, reporting, and contact tracing.
Moreover, the federal courts exercise their powers only to resolve "cases" or "controversies" (Article III).
The executive branch of government brings to health policy formation many of the same benefits as the legislature. The executive branch can be both objective and accountable. Certainly, the chief executive is a political party figure subject to many of the ingrained ideologies that many politicians bring to their decision making. Yet, as the head of his or her party, the chief executive may be free to divert from party political positions or to change those positions. The executive branch, moreover, usually has many agencies concerned with health and social policy. Individuals who work in those agencies often are not connected to political parties and bring a wide body of knowledge and expertise to their fields. This creates enormous possibilities for impartial, accountable, and comprehensive assessments of health policy.
The United States is a highly diverse and complicated society. Many groups "weigh in" on significant health policy issues. America's expansive range of policymaking bodies and groups seeking to influence policy render it impossible to offer a systematic and comprehensive analysis of health policy formulation.