Scope and Functions of Public Health - Essay Example

Scope of Public Health Public Health The scope and function of public health is really quite large and carries a variety of responsibilities. The challenges include responding to infectious disease outbreaks, large scale industrial accidents, hurricane, tornado and earthquake disasters or any other event that creates mass casualties or major numbers of injuries. The most significant challenge is meeting surge capacity. At the same time, public health covers many non-emergent issues such as nutrition programs, healthcare issues, community public safety and prevention of disease just to name a few. This paper will discuss the scope and function of public health and how public health activities are governed. Health department activities include personal health services, environmental health services, data services, health education and community outreach. It appears from most of the literature that personal health services is a service that is most often being privatized. (Keane, and Ricci, 2001). The health departments and public health in general have taken on a great number of issues that need evidence based interventions. Many of the personal healthcare issues however are being moved to hospitals and other health institutions that have the scope to care for personal health. There are often issues related to emergent public health. An example of this would be the Katrina disaster or the Florida triple hurricane damage. Florida, Georgia, Texas, and Colorado have developed large databases of nurses but have not solved the scope of practice issues that are involved in responding to such disasters. Scope of practice is only one problem. There are also licensure, credentialing and liability issues. Federal employees are covered for these issues under the Federal Tort Claims Act of 2000 for liability as well as injury (Hodge, Mount, Reed, 2000). The Health Resources and Services Administration is working on the creation of volunteer registration systems known as the Emergency System for the Advance Registration of Volunteer Health Professionals (ESAR-VHP). This works as a state run and state based system that allows the registering and veting in advance, health professionals who may be called upon in an emergency. Since 911 there is terrorism and the public health has the scope to be involved as well as leading some of the responses. The APHA in Atlanta in 2001 determined the Guiding Principles for Public Health Response to Terrorism" adding a whole new dimension to what was meant by public health (Satel, 2001). Since this time, there seems to be some disagreement as to the actual priorities of public health. Many would see it as caring for the public during or after a disaster such as 911 and others would see it as protecting the public from disasters and some would see their scope and responsibility as doing such things as creating resolutions in support of national defense. There is also an agenda for social justice which brings the definition of the publics health from being freedom from disease to a complete social well being. Much of this is related to the disparities of health that occur throughout the country based on race, ethnicity and class. Many believe however, that these issues cannot be solved until there is social change so public health must spend its time preventing another 911 and being ready for one if it does occur. Certainly there is confusion even among those that are part of the departments involved. Yet, Public Health has a long and important history in the United States and even with these growing pains have the health of its constituents in mind. Public health, now more often called population health, began being involved in the determinants of health in the 19th century at which time the scope of the departments was quite narrow. The overall function of the public health department was disease. It moved on over the years to disease and accident prevention. In the 1990s there began to be the use of the words evidence based. This brought about a whole new revolution in policy determination. The interventions developed were suddenly developed in a whole different way and research became a major part of the job. This was followed by expansions in policy involving food and food contamination, meat and vegetable inspection and disabilities. These were major only a short time ago and because of the research done by public health, food contamination has decreased and there are new disability laws. Certainly with all of these debates and controversies and the attempt to figure out licensing and policies, one can understand why it is so often stated "health is the result of many interacting factors, it stands in the balance between economic, political and social priorities."(Magnusson, 2007). With that in mind one must remember that funding for public health comes from the taxpayer dollar or Federal government. After 911 and with all of the new challenges such as cancer, diabetes, obesity, chronic disease prevention, HIV, and other infectious diseases as well as food and water safety, bioterrorism and health emergency preparedness that funding would be increased. That is not what has happened. In fact, public health funds have been continually flat or cut over the recent history. On average the Federal government spends $16.52 per person for public health and the states spend an average of $28.92 per person. Needless to say, public health cannot be a priority when those are the kinds of dollars spent to accomplish everything on the list. The government also has a great deal of say about policy making, evaluation of policy, and resource allocation. The Public Health Department itself is set up in such a way that there are many kinds of departments according to what state you are in. For example, in the State of OK, all of the departments are State run departments branching down to the county and city level. Some funding is managed through the city and county level. In the state of Oregon, each county is responsible for their own health department and there is a state health department. Each of the states does have a state department but in some states the jurisdiction of the state department may have nothing to do with the county or city department. In conclusion, it is difficult at this point in time to know just how vast the Public Health is. It includes all of those things previously mentioned plus Biomedical and Behavioral research, disease prevention and health promotion, access to safety net health services, health professions education, mental health and substance abuse, health services research, health care for American Indian and Alaskan Natives and food, drug, and water safety, to name a few. They have added many of these duties since 911 and public policy has gotten more stringent, increasing the need for education as well as surveillance. The Federal government and State governments continue to cut funding while adding all of these responsibilities. The scope gets larger and larger. How is it that scope can expand and do an adequate job on $16.52 per person. When the time comes, will that have been enough? Resources Hodge, J., Mount, J., & Reed, J. (2008). Scope of practice for public health professionals and volunteers. Special Supplement Public Health and the Law. Keane, C., Mars, J., & Ricci, E. (2001). Privatization and the scope of public health: a national survey of local health department directors. American Journal of Public Health. 91(4). 611-620. Satel, S. (2001). Public Health? Forget it; cosmic issues beckon. Wall Street Journal. A16. Solis, H. (2006). U.S. government accountability office finds EPAs lead, copper rule inadequate, may undermine public health protection. US Fed New Service. Read More