Editorial on Functions of the Public Health System

Joyce Addo-Atuah^*
*Correspondence: Joyce Addo-Atuah, Professor, Department of Social/Behavioural/Administrative Sciences, Chair, Faculty Council, Touro College of Pharmacy, USA, Email:

Editorial

Public health systems are commonly defined as “all public, private, and voluntary entities that contribute to the delivery of essential public health services within a jurisdiction.” This concept ensures that all entities’ contributions to the health and well-being of the community or state are recognized in assessing the provision of public health services.
The 10 Essential Public Health Services describe the public health activities that all communities should undertake and serve as the framework for the NPHPS instruments. Public health systems should
1. Monitor health status to identify and solve community health problems.
2. Diagnose and investigate health problems and health hazards in the community.
3. Inform, educate, and empower people about health issues.
4. Mobilize community partnerships and action to identify and solve health problems.
5. Develop policies and plans that support individual and community health efforts.
6. Enforce laws and regulations that protect health and ensure safety.
7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
8. Assure competent public and personal health care workforce.
9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
10. Research for new insights and innovative solutions to health problems.
Public health is concerned with promoting and protecting the health of populations.
Public health action occurs at the international, national, state and local level. Most communities are served by health departments whose services include the collection and use of epidemiological data for population surveillance of disease. Health promotion and the protection of population health occurs at the global level, World Health Organization (WHO), and at the national level under the Centres for Disease Control and Prevention, the Food and Drug Administration, the Environmental Protection Agency and the Consumer Protection Agency as public health agencies.
Moral foundations and justifications for public health and the challenges faced due to limited resources are the ethical issues debated that view public health as a social justice, poverty and health disparity concern. Public health policy seeks to balance the greater health outcomes with individual liberties, for example, the immunization debate.
Public health has two primary aims, prevention and health promotion.Prevention is action taken to prevent the occurrence of an event or to minimize its effects after it has occurred. Three levels of prevention are described as
• Primary prevention aimed at reducing risk, such as immunization
• Secondary prevention aimed at detecting and treating disease at early stages, such as screenings (mammograms)
• Tertiary prevention-treatment aimed at modifying risk factors of disease, such as cardiac rehabilitation.
Public health infrastructure provides communities, states, and the Nation the capacity to prevent disease, promote health, and prepare for and respond to both acute (emergency) threats and chronic (ongoing) challenges to health. Infrastructure is the foundation for planning, delivering, evaluating, and improving public health. All public health services depend on the presence of basic infrastructure. Every public health program such as immunizations, infectious disease monitoring, cancer and asthma prevention, drinking water quality, injury prevention requires health professionals who are competent in cross-cutting and technical skills, up-to-date information systems, and public health organizations with the capacity to assess and respond to community health needs. While a strong infrastructure depends on many organizations, public health agencies (health departments) are considered primary players. Federal agencies rely on the presence of solid public health infrastructure at all levels to support the implementation of public health programs and policies and to respond to health threats, including those from other countries.
Public health infrastructure can best be described by what it is and what it does. It includes three key components:
• A capable and qualified workforce
• Up-to-date data and information systems
• Agencies capable of assessing and responding to public health needs
Changes in the health system and other factors are prompting new roles for public health agencies, a growing focus on the integration of public health and primary care, a deeper examination of financing options for foundational or core services, and new strategies to deliver services more efficiently and effectively. One such example is cross-jurisdictional sharing, which can range from supporting informal collaborations to sharing defined services such as laboratory testing, to more formal changes in structure, such as consolidating public health agencies.
Public health data must be accurate, relevant, and timely to inform public health action. National surveys, such as those sent to epidemiologists, laboratories, and health departments, play an important role in understanding the public health infrastructure. National surveillance and reporting systems also play a vital role. Efforts are underway to improve the content of surveys, data collection for major population groups, and timely access to data through public reports and data files. These national surveys and monitoring systems should be sustained, strengthened, and harmonized.
Continuing to strengthen the evidence base for effective community interventions and for the effective organization, administration, and financing of public health services is critical to the future development of public health infrastructure. Public health services and systems research plays an important role in the development of this evidence base; support should be expanded over the decade, with a strong focus on translating research into practice.
Public health in the US works in the public interest. Consider the positive impact in daily life attributed to public health policy and action: Food safety/ restaurant inspections, fluoridated water, seatbelt use, unleaded gasoline, influenza vaccine programs, trans-fats and other nutritional information, public health response to the most recent disaster.