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Public Health: What It Is and How It Works, Fourth Edition

Public Health: What It Is and How It Works, Fourth Edition. Chapter-by-Chapter Power Point Slides Links to Internet-based resources. Chapter 6 The Infrastructure of Public Health. Chapter 6 Will Help You To:.

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Public Health: What It Is and How It Works, Fourth Edition

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  1. Public Health:What It Is and How It Works, Fourth Edition Chapter-by-Chapter Power Point Slides Links to Internet-based resources

  2. Chapter 6The Infrastructure of Public Health

  3. Chapter 6 Will Help You To: • identify the major components of public health’s infrastructure and key dimensions of each component • identify strategies for assessing and enhancing the infrastructure of public health

  4. Assess System Inputs Programs and Services consistent with mandates and community priorities Workforce Information Organization & Relationships Facilities Funding Address Assure Process (Core Functions/Essential Public Health Services) Capacity Outcomes Capacity-Process-Outcome Links Outputs Key Processes Improved organizational performance + Improved program performance Improved Outcomes & Customer Satisfaction Increased Value & Public Support

  5. Infrastructure, Ingredients,and Inputs • Public health infrastructure: the resources and relationships necessary to carry out public health’s core functions and essential services in the community • In Capacity-Process-Outcomes model, inputs are the structural components of the public health infrastructure while processes represent what those inputs do

  6. Human Resources in Public Health • Key element of public health’s infrastructure • Size of the public health workforce unclear because of lack of consensus as to meaning of term “public health worker” • Best guess as to size = 600,000 • Beyond size, distribution, composition, skills/competencies, and impact are key considerations

  7. Full Time Equivalent (FTE) Workers of Governmental Health Agencies, 1995-2005Source: Data from U.S. Bureau of the Census, Public Employment and Payroll Data.

  8. Full Time Equivalent (FTE) Workers for State and Local Health* Agencies per 10,000 Population, Selected Years 1994-2005, U.S.Source: Data from U.S. Bureau of the Census, Public Employment and Payroll Data.

  9. Public Health Work-Doing System

  10. Mean Salary for Full Time Equivalent Workers of State and Local Health* Agencies, Selected Years, 1994-2005, U.S. Source: Data from Bureau of the Census, Public Employment and Payroll Data.

  11. Conventional Wisdom? • Public Health Workforce is shrinking • Average age is high (~47) • Public Health workers soon will be retiring in large numbers • Recruitment and retention are major issues, especially in rural communities • Key disciplines (such as public health nurses and epidemiologists) are increasingly scarce • Few public health workers have received formal training in public health • Public Health Workforce is not prepared for current and future threats

  12. Approaches to Public Health Workforce Development: Pipeline vs. Willy Sutton • Conventional Wisdom approach to workforce development: more schools, increase number of graduates, higher proportion of gradates into primary public health workforce through scholarships and loan repayment programs (Pipeline approach) • Willie Sutton approach to workforce development: focus on the work organizations (that’s where the workers are). • Which approach is likely to be most effective?

  13. Organizational Resources • Largely discussed in Chapter 4; includes governmental and non-governmental organizations • Non-governmental contributions estimated at one-fourth to one-third or more! • Leadership • Coalitions and Consortia • Community Health Partnerships

  14. The MAPP Model

  15. Turning Point’s Performance Management Collaborative Four components of a performance management system Source: Turning Point Performance Management Collaborative, From Silos to Systems: Using Performance Management to Improve the Public’s Health , March 2003.

  16. Information Resources • Assessment data and information • Surveillance systems • Information for planning • Evidence-based policy and decisions

  17. Actual Causes of Death, 2000(Source: Mokdad et al, JAMA 2004)

  18. Fiscal Resources • Total health expenditures = $2.0 trillion • Public health expenditures within total health expenditures = about $60-70 billion • 1/3 from federal sources • 2/3 from state and local sources

  19. Healthy People 2010Infrastructure Objectives • 17 objectives • Data and information systems • Skilled workforce • Effective public heath organizations • Resources • Prevention research • Progress uncertain as of 2006

  20. Discussion • Because of your interest in a public health career you have been asked to provide input into the development of a training package to orient new members of your local Board of Health to their duties. • What themes or messages would you suggest for this video? How would you propose presenting or packaging these messages?

  21. Discussion • Review the progress of the past century related to safer and healthier foods (Safer and Healthier Foods in the Century of Progress in Public Health case study) and a recent report on public perceptions about food safety. • Then follow the chronology of CDC and USDA reports regarding an outbreak of cases of listeriosis in the Mid-Atlantic States. Specifically, review CDC's press releases from mid-September through mid-October 2002,and USDA's press releases from 2001 dated October 2, October 9, October 13, and October 17. • Finally, review the news article dated October 15 titled and "Consumer Groups Accuse US of Negligence in Food Safety.“ • Based on this information and the DHHS-USDA Listeria Action Plan, do you agree or disagree with accusations that USDA and CDC did not protect the public from this risk in a timely manner?

  22. Discussion • What characteristics distinguish a public health professional from a professional working in a public health agency?

  23. Discussion • After reviewing The Past and Future of Public Health Practice, identify the public health practitioner (past or present) that you most admire and the reasons or criteria that led you to this choice.

  24. Additional Resources • Community Strategies for Health. American Public Health Association • Healthy People 2010: Public Health Infrastructure Objectives; Washington DC; USDHHS-PHS; 2000 • Principles of Community Engagement. CDC Public Health Practice Program Office; Atlanta GA; 1997 • Public Health Data Standards Tutorial (modules 4-9). Public Health Data Standards Consortium • Public Health Infrastructure (report to Congress in PDF format) CDC;2001 • Public Health Workforce: An Agenda for the 21st Century (PDF format). USDHHS-PHS; Washington DC; 1997 • Public Health Workforce: Enumeration 2000 (PDF format). USDHHS-HRSA; Rockville MD; 2000

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