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Assuring the Public’s Health in the 21 st Century: A Research Agenda. Congressional Briefing May 19,2004 Jo Ivey Boufford, MD. The Committee’s Vision Healthy People in Healthy Communities . Causes of Premature Mortality. The Core Function Project: U.S. Public Health Service, 1993.
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Assuring the Public’s Health in the 21st Century: A Research Agenda Congressional Briefing May 19,2004 Jo Ivey Boufford, MD
The Committee’s VisionHealthy People in Healthy Communities
Causes of Premature Mortality The Core Function Project: U.S. Public Health Service, 1993
Public Health Expenditures As a Percentage of Health Expenditures The Core Function Project: U.S. Public Health Service, 1993
Actual Causes of Premature Death in the United States in 1990 Deaths Cause Estimated % of total Deaths Tobacco 400,000 38% Diet/activity patterns 300,000 28% Alcohol 100,000 10% Microbial agents 90,000 8% Toxic agents 60,000 6% Firearms 35,000 4% Sexual behavior 30,000 2% Motor vehicles 25,000 2% Illicit use of drugs 20,000 1% Source: McGinnis & Foege, JAMA 1993
The Essential Public Health Services • Monitor health status to identify community health problems. • Diagnose and investigate health problems and health hazards in the community • Inform, educate and empower people about health issues • Mobilize community partnerships to identify and solve health problems • Develop policies and plans that support individual and community health efforts • Enforce laws and regulations that protect health and ensure safety • Link people to needed personal health services and assure the provision of health care when otherwise unavailable • Assure a competent public health and personal health care workforce • Evaluate effectiveness, accessibility, and quality of personal and population-based health services • Research for new insights and innovative solution to health problems Source: Public Health Function Steering Committee
The Public Health System Community Health care delivery system Assuring the Conditions for Population Health Governmental Public Health Infrastructure Employers & Business Academics The Media INSTITUTE OF MEDICINE
Population-based Prevention Research • Addresses health problems that affect large numbers of people; • Involves a definable population; • Evaluates the application and impact of new discoveries on the actual health of the population; and • Focuses on behavioral or environmental factors associated with primary and secondary prevention of disease in populations; or behavioral, biological, or clinical variations among populations; or integration of behavioral, biological, and environmental factors
Congress and CDC • Recommendation 31 Increase funding to support CDC investigator-initiated prevention research and maintain a strong program of Centers, Institutes, and Offices (CIO) generated research, and • Recommendation 32 Determination of effective funding levels for Prevention Research Centers
NIH • Recommendation 33 NIH should increase the portion of its budget allocated to population- and community- based prevention research and report this annually to the public