Variation in Public Health Leadership and Organizational Structure - Essay Example

Public Health Leadership Variation in public health leadership and organizational structure at the federal, and local levels The general well being of a nation depends largely on the quality and type of health care services available. The kind of leadership and organizational structures put into place geared towards provision of better health care services to the public also determines the health or general well being of the public. There are three levels through which health care is provided to the public. These include the federal, state, and local levels. This paper focuses on the differences in public health leadership and organizational structure at the federal, state, and local levels. This paper also compares and contrasts the roles and responsibilities of the chief executive or key leader for each level. Federal level To understand the differences in leadership and organizational structures at all the levels, it is important to use a specific country as a point of reference, in this case, the US. According to Scutchfield and Keck (2009), there are several organizations at the federal or national level responsible for public health in the US. Some of these include the Center for Disease Control (CDC) and Food and Drug Agency (FDA). These national organizations are led by directors. These organizations have analogous arrangements and constitutions. These directors exert massive control at all health activities at the national level. In other words, these individuals are responsible for managing all health activities at the federal level. Subsequently, they support and promote methodical investigations and explorations in regard to health issues of public concern. In addition, these directors establish and uphold effective associations and linkages with other organizations at the national, state, and local levels. It is of significance to assert that these directors take part in creating national health strategies as well in their implementation, and also ensures the competence and efficiency or helpfulness of all health care sectors at the national level. State level Branches of health care at this level are structured in a self-governing or autonomous manner and they are a function of the state governments. Leadership varies greatly at all the three levels though they are all involved in providing support for health delivery systems. At the state level, there are key powers accountable for establishing strategies, courses of actions, or guiding principles in relation to health matters, placing precedence on health issues, gathering relevant information as well as scrutinizing it, providing monetary support, and supervising localized actions in relation to health care. According to Hyde and Shortell (2012), "Approximately sixty percent of all state public health departments are governed by a board or council of health" (p. 32). These panels or leadership committees at the state level are involved in disseminating information regarding established courses of actions, offering counsel to voted and nominated health executives in relation to implementation of strategies for public health, and creating state health care laws. Leadership committees at the state level are made up of health care providers, members of the public, consumers, experts in the business field, and teachers in health related field. It is important to posit that the main role or duty of these committees at the state level is mainly to govern. At this level, democratically elected executives and other public representatives play a significant role in organizing heath care related activities. State governments are responsible for endorsing financial plans in relation to health care, pass rules and guidelines related to health at the state level, establish and decide on health care charges, and also institute levies and other excise duty appropriate to sustain health care systems at the state level (Beitsch et-al, 2006). Local level Most health care systems at this level are structured centrally though some of them operate separately. In other words, most health care services at the local level are offered by state organizations. Leadership at the local level is also a responsibility bestowed to local health committees. These health committees participate or takes part in the formulation of health care strategies and plans of actions at the local level. The composition of these committees is similar to that of the state as they comprise of individuals from various disciplines such as teachers, health care providers or professionals, members of the public, as well as specialists in trade and industry (Hyde and Shortell, 2012). Comparing and contrasting roles and responsibilities of the chief executive or key leader at the federal, state, and local levels Similarities The President is the chief executive at the federal level of government. He appoints a member of the cabinet responsible for the implementation of health strategies passed by the national assembly. In the US, the key leader at the federal level is in charge of the Department of Health and Human Services (HHS). According to Veenema (2007), s/he oversees methodical investigations aimed at identifying ways to avoid or avert epidemics, s/he guarantees the harmlessness of all types of foods and drugs through overseeing relevant research, and is also responsible for national health insurance activities geared towards improvement of the general health of the population at the national level. The Governor is the chief executive of the State government. The governor appoints a member of his or her cabinet as a health director responsible for public health matters at the state level. This individual ensures the provision of financial aid for all activities related to health at the state level. According to Weissert and Weissert (2012): States are responsible for the funding and coordination of public health functions, the financing and delivery of personal health services, environmental protection, regulation of providers of medical care and the technology they employ, regulation of the sale of health insurance for their own employees and retirees and plays a pivotal role in educating and credentialing health care professionals (n.p). This shows the similarity between the key leaders in health matters at the national and state level. The key leaders at these levels are responsible for health insurance of their employees, funding health care activities at each level, providing permits for health institutions at each level, and organizing and managing all health related activities at each level. Subsequently, the local government appoint a director of health responsible for all health activities at the local level. In view of the roles and responsible off the health director at the local level, one can draw a number of similarities between the roles of the key leaders at national, state, and local levels. The local director of health offers advice and solutions to the local governments in terms of epidemics. When the community is faced with an emergency issue, s/he gives directions regarding disaster preparedness and appropriate solutions. The health directors at the national and state levels also have similar roles. They give advice and solutions in terms of epidemics and disasters relating to health to the national and state governments respectively. All the three leaders at each of the levels works hand in hand with the Judiciary and other law enforcement agencies in order to maintain health among the members off the public (Veenema, 2007). For instance, they seek the assistance of the police when a member of the public has a medical condition that risks the lives of others when s/he refuses to take medication. There are also other similarities. For instance, the key leaders at each level of government encourages and as well endorse affiliations between all other organizations associated with public health particularly Non-Governmental Organizations (NGOs) (Scutchfield and Keck, 2009). This means that these leaders ensures that all the relevant organizations work together in a bid to provide better health care to the members of the public. Differences There are a number of differences in the roles of directors of public health at each level of government. These differences can best be illustrated through elucidating their powers in times of emergencies or epidemics. The local government is considered to be nearer to the local communities. When a community if faced by a health issue, the director of health at the local level responds first to the problem. Therefore, his or her powers are restricted to the local level. The executive at the state level i.e. the governor only becomes involved directly when the health issue overwhelms the limited resources at the local level. S/he has more powers than the local director as s/he is in charge of health issues at the state level. The health director or the executive in charge at the local level can only defer or implement new rules during epidemics only with the authorization of the State. On the other hand, the governor has no authority to declare a health issue as a national disaster as his powers are only restricted within his or her state. The President is the supreme authority in cases of emergencies relating to public health (Veenema, 2007). He is the only one who can approve the employment of federal resources to combat a health issue. Conclusion In conclusion, there are agencies at the national level led by directors, such as the CDC and FDA. These agencies are responsible for conducting research related with national health issues of public concern. The President is the chief executive if all issues relating to the federal government. At the state level, the governor is in charge. Health issues at the state is managed by a health committee responsible for all health related activities at the state level. Some of these activities include health insurance and offering financial assistance to health institutions. At the local level, there is also a local health committee with its own director. S/he is responsible for health activities at the local level. Leaders at all the three levels of government involve coordinating with other relevant bodies in relation to health matters, and offering advice and solutions to health problems at all the levels of government. References Beitsch, L. M., Brooks, R. G., Grigg, M., & Menachemi, N. (2006). Structure and Functions of State Public Health Agency: America Journal of Public Health, 96(1): 167-172. Hyde, J. K., & Shortell, S. M. (2012). The Structure and Organization of Local and State Public Health Agencies in the US. American Journal of Preventive Medicine, 42(5): 29-41. Scutchfield, F. D., & Keck, W. (2009). Principles of Public Health Practice, 3rd Edition. Stamford, USA: Cengage Learning. Veenema, T. G. (Eds.). (2007). Disaster Nursing and Emergency Preparedness: For Chemical, Biological, and Radiological Terrorism and Other Hazards. New York, NY: Springer. Weissert, W. G., & Weissert, C. S. (2012). Governing Health: The Politics of Health Policy. Baltimore, MD: Johns Hopkins University Press. Read More