Challenges Facing Public Health in the US - Research Paper Example

Public Administration: Challenges Facing Public Health The public health sector in the United States is a government or public organization that offers its services mainly health care services to the citizens within the United States. It should be noted that this institution have evolved over time and this evolution has led to two forces that drives this sector. The two forces include the perceived and natural importance of threats to health and safety of the population and the ever changing governmental relationships in relations to the public healthcare management (American Public Health Association, 2011). Notably, the public health sector faced a major change especially during the last half of the twentieth century. This period defined a major shifted the management of the public health sector to a highly state centered federalism form a state that weakened fundamental enterprises of the public health sector. The key enterprises that were affected include leadership and coordination that led to development challenges within the public health sector (Turnock, Public health…, 2012). Notably, towards the end of the same century, these challenges led to other threats that included threat of response to these threats and increased expectation of the society. Bioterrorism was among the threats that the United States’ public health sector was to address towards the end of the twentieth century. To address this concern, the public health sector required a well-coordinated public health response system national and within the states as well as in the local levels. However, the same could not have been achieved due to reversed power system that the government deems to be advantageous to all systems or levels (Turnock, 2012). For instance, the state and local systems cannot perform any rapid response systems that have great impact to the victims unless the government gives such directive. Some of the activities the state and the local levels cannot act on unless approved by the central government is placing quarantines and implementing certain health laws. The federalist system in the United States government is an essential point of distribution of responsibilities nationally and to other states, local governments and components, as well as tribal especially with regards to the public health aspiration. However, other than the government noting that each of these components is vital and significant in their own ways and to certain and varying degrees in assuring and addressing health or medical conditions to those levels, they are congregated as units that should take directives from a central point (Lee, Estes, and Rodriguez, 2003). It should be noted that legal and constitutional frameworks of the United States define the fundamental and basic roles and functions of various public healthcare components as it does to other functions and roles of the government. These usually lead to intergovernmental complex web relationships and this is what defines federalism (American Public Health Association, 2011). However, these operational relationships have been noted to influence the overall ability public health sector to promote and protect the health of the citizens or the public. The twentieth shift of the United States to federalism also affected the service delivery and financing of the United States’ public health sector. This shift centered most of the government operations including financing of the public health sector (Turnock, 2012). It should be noted that the role of the public health sector may be small especially to the public (notably, the population health caters for about 10 percent of the American population) but the same is highly fundamental to the entire American population (Turnock, Public health…, 2012). Therefore, it is vital that the societal health resources are distributed disproportionately to the medical care so that the public can access it at their times of need. In the year 2004, only 3 percent of the $1.9 trillion was spent on the health care as an allocation to the public health sector. The same small percentage allocation of finances to the public healthcare systems is true with states. For instance, in the same year, the state of California allocated only 2.4 percent of its expenditure to its public health programs. These small allocations of funds to the public health care systems at in all levels of government have posed great financial challenges to the public health sector. The poor allocations of the finances to the public health care systems are positing numerous changes to the public health workforce including the challenges of funding vital health care programs, resourcing and staffing, inadequate training, as well as distributing health care services to the areas its needed. Notably, the inadequate funding makes it nearly impossible for the public health care systems to respond to health care emergencies is could be the need (American Public Health Association, 2011). Additionally, the government funding problems to the public health care systems seems the major cause of shortage of workers in the public health sectors. From many years, the public health sector has suffered shortage of works. This is not because of the lack of professionalism in this sector, but it is pegged on the shortage of funds to hire more or adequate workforce. Statistically, it is recorded that there has been a decrease of nearly 50,000 work forces since 1980 despite the increase of population of nearly 22 percent (approximately 50 million people) (Joint Meeting… et al, 1998). Other than the decades of low funding of the public health care systems, the 2008 and 2010 economic meltdown further affected the finance records of the public health care systems since the federal government cut down the public health budget. Moreover, on the government move of layout public service workers from their jobs, it is approximated that nearly 44, 000 health worker were relieved from their jobs. These moves further affected the operations of the public health care systems especially at the local and state levels. Insufficient funds and low workforce have proved to be major challenges in the public health sectors (American Public Health Association, 2011). There is too much work on the health workers and this affects the quality of health care service delivery. The America’s public health sector will be facing major and fresh challenges on its public health systems particular the lack of trained personnel in pipeline to take up the jobs at the public health care systems from those who are retiring. In early 2012, it was approximated that 250,000 skilled public health workers were to retire; however, the management at the public health sector was perplexed that no fresh trained persons are in line to take up such positions (Turnock, 2012). Moreover, those that are considered to be working as public health workers are reported to lack adequate trainings and skills for their jobs. For instance, in the year 2001, center for Disease Control and Prevention (CDC), reported that four out of every five of the public health workers lacked formal training in their specific health care activities or the activities that they are providing to the public. In other words, this report indicated most of the health care providers in ten United States are quacks (Turnock, Public health…, 2012). Moreover, the 2008 survey on the same study indicated that only 20 percent of the top executives in the local health departments have a public health degree. Conclusively, it is worth noting that lack of training and education in line with required and vital public health programs with low number of graduates are regarded as historical challenge within the public health sector. Additionally, geographic distribution and workforce diversity are other challenges that are portrayed in the face of public health sector. The public health systems demonstrate high ethnic, racial, and geographic disparities specifically the workforce. The public health care programs are highly underrepresented particularly in the minority enrolment and application compared to other health professions. Public health care system has numerous challenges in that the above discussed are just among the many (American Public Health Association, 2011). However, it is vital to mention that all these challenges among others can be addressed and resolved some within the public health care systems while others through the initiatives of the government. Most of the public health care challenges are seen to be contributed by the government through its federalism mode of governance. The federalism hinders the public health systems to take swift actions in response to vital health care emergencies thereby leading to major health care effects due to the fact that they will ever be waiting for the central government to give direction of such matters. To resolve this challenge, now and in the future, it will be vital for the government to devolve its health care decision making and allow the public health care departments to make decision on their own especially in responding to public health care emergencies (Turnock, Public health…, 2012). Additionally, it will be vital for the government among states and local levels of governance to increase funds allocated to the health sectors so that resources and staffs can be increased in the public health systems for effective and efficient operation of these health care systems. Notably, with increased funding, the public health care system will have adequate resources to train and educate its staff or workforce thereby reducing the historical low numbers of trained and educated public health care workforce particularly on public health care programs. Finally, it is the role of the public health management to ensure that there is equal distribution of health workers in terms of geographic distribution and workforce diversity. References American Public Health Association. (June 2011). The Affordable Care Act’s Public Health Workforce Provisions: Opportunities and Challenges. Washington, DC. Retrieved February 11, 2014, from www.apha.org Joint Meeting on Terms of Employment and Working Conditions in Health Sector Reforms, International Labour Office, & International Labour Organisation. (1998). Terms of employment and working conditions in health sector reforms: Report for discussion at the Joint Meeting on Terms of Employment and Working Conditions in Health Sector Reforms, Geneva, 1998. Geneva: International Labour Office. Lee, P. R., Estes, C. L., & Rodriguez, F. M. (2003). The nation's health. Sudbury, Mass: Jones and Bartlett Pub. Turnock, B. J. (2012). Essentials of public health. Sudbury, MA: Jones & Bartlett Learning. Turnock, B. J. (2012). Public health: What it is and how it works. Burlington, MA: Jones & Bartlett Learning. Read More