Sussan Roth
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.” Public health systems can also be described as a network of entities with differing roles, relationships, and interactions as depicted in the picture to the left. All these entities contribute to the public’s health and wellbeing throughout the community. The governmental public health department is a major player in the public health system, but they do not provide the full spectrum of essential public health services alone. The National Public Health Performance Standards Program (NPHPSP) developed by the CDC (which we will use at the 2006 Health Forum) focuses on assessing and improving the overall “public health system.” This assures that the contributions of all entities are recognized in assessing the provision of the 10 Essential Public Health Services. It is important to note that this program is not designed to assess the performance of any one agency within the public health system, but the system’s performance with the goal of quality improvement. Some of the organizations and sectors that are involved in the public health system include: Public health agencies, such as the state or local health department, which serve as the governmental entity for public health and play a major role in creating and ensuring the existence of a strong public health system. Healthcare providers such as hospitals, physicians, community health centers, mental health organizations, laboratories, and nursing homes, which provide preventive, curative, and rehabilitative care. Public safety organizations such as police, fire and emergency medical services. Their work is often focused on preventing and coping with injury and other emergency health-related situations. Human service and charity organizations such as food banks, public assistance agencies, and transportation providers, which assist people to access healthcare and receive other health enhancing services. Educational and youth development organizations such as schools, faith institutions, youth centers, and other groups that assist with informing, educating, and preparing children to make informed decisions and act responsively regarding health and other life choices and to be productive contributors to society. Recreational and arts-related organizations that contribute to the physical and mental well-being of the community and those who live, work, and play in it. Economic and philanthropic organizations such as employers, community development organizations, zoning boards, and community and business foundations that provide resources necessary for individuals and organizations to survive and thrive in the community. Environmental agencies or organizations which contribute to, enforce laws related to, or advocate for a healthy environment. Identifying particular advances in public health is difficult because, in the final analysis, success can be judged only by improvement in the health of a population. Progress is rarely, if ever, a matter of developing a technical intervention and applying it. Population health is determined by a complex mixture of genetic, environmental, and social factors, as well as individual behaviour. Achieving progress not only relies on altering a complex situation but is often something that can be judged only over a period of years (or decades) rather than months. Clearer understanding of the determinants of health and ill health, better control of hazards to health, and earlier detection or improved treatment of established disease are the building blocks of gains in public health. In keeping with the broadening scope of public health practice, the skill base of the workforce is developing beyond medicine, particularly in the applied social sciences.
