The Different Types Of Public Health Agencies
It can be quite difficult to clearly understand which public health activity is typically conducted on a state or at the local level or to outline how these responsibilities are distributed between state and local agencies, given the massive amount of agency models that have been adopted and the variations of public health authorities defined by state laws. The following should give you a broader generalization of both state and local public health agencies available out there.
State Public Health Agencies
State agencies will usually handle the role of managing the activities of local health departments and are also directly responsible for implementing certain programs.
Disease Surveillance, Epidemiology, And Data Collection
State health agencies are normally responsible for gathering massive data sets of health-related information, reviewing the information for trends, and investigating anomalous or alarming disease patterns. A good example on health-related data collected, maintained, and analyzed by the state government include important vital statistic records, communicable or infectious disease reports, surveys of behavioral risk factors, cancer registries, childhood immunization registries, hospital discharge databases, and trauma registries.
States are required to surveillance any epidemiology efforts and will typically focus exclusively on infectious disease. Although epidemiological activities related to chronic disease, cancer, environmental threats, and perinatal health have increased substantially in recent years, the majority of states to now keep a close eye on these types of activities. The kind of data routinely gathered by the state can vary, as do the level and sophistication of analytic and epidemiological capacities. State health agencies normally work cooperatively with the Center for Disease Control and Prevention (CDC) in applying surveillance activities to allow for valid aggregation in all states. However, these efforts have not eliminated methodological variation in all states. Local health departments may be actively involved with gathering some type of surveillance data, such as reports on communicable disease. The larger local health departments have surveillance and epidemiology capacity that is comparable to and may even surpass that of a state health department.
Laboratories are vital attachments to many disease surveillance activities. While private clinical laboratories contribute relevant diagnostic test results to surveillance systems, state public health laboratories are mainly responsible for much of the sophisticated testing required for monitoring the population health. Routines typically performed by state labs include screening newborns for rare genetic abnormalities, testing for possible bio-terrorism or emerging infectious agents (such as anthrax or West Nile virus), testing for food-borne illness, typing influenza virus strains, screening children for lead exposure, screening people for exposure to environmental toxins, and testing environmental samples for toxic contaminants.
In some cases, state public health labs may confirm the results of a private laboratory, but usually, state laboratories are responsible for testing that private labs are unable or unwilling to conduct. In some circumstances, laboratory samples are further referred to the CDC for even more testing and confirmation. Some local health departments also provide laboratory-based services. While local laboratories are normally used for clinical purposes, some large local health departments conduct specialized public health laboratory testing.
Preparedness And Response To Public Health Emergencies
State government plays an essential role in planning for public health emergencies. The attention and resources devoted to these activities have increased dramatically since the anthrax attack in 2001. Preparedness and response efforts compass a wide range of responsibilities, these include specialized disease surveillance, laboratory testing, outbreak investigation, mass prophylaxis, quarantine and isolation, and coordination of the emergency medical response. States coordinate these activities with the CDC and the Office of the Assistant Secretary for Preparedness and Response.
Population-based Primary Prevention
Most states will decide to sponsor some kind of population-based health promotion or disease prevention activity. Attempts related to HIV/AIDs, tobacco, injuries, and unintended pregnancy can be considered the most common, but prevention initiatives dealing with obesity, substance abuse, and violence are also frequent. These population-based tasks are diverse, including media campaigns, outreach to high-risk groups, development of educational materials, and policy change initiatives. The strength and scale of these efforts can vary across all states, and the engagement of local agencies are also variable. While a complete inventory of states primary prevention activities have not been performed, an example of promising ideas has been documented. For instance, the National Association of Chronic Disease Directors has compiled a summary of successful efforts reported by state officials.
Health Care Services
State government are not typically directly responsible for delivering health care services to individuals. Although there are notable exceptions of this such as state mental health facilities, services for children with special health needs, treatment services for certain communicable disease ( such as HIV/AIDS) and correctional health. Up to 86% of states provide mental health services through an agency other than the state health agency, but services for children with special health needs and communicable disease services are typically handled by the state health agency. States usually rely on local health departments to provide them with these clinical services.
Often times state health agencies play a main role for monitoring health care services provided by the private-sector delivery system, such as managing trauma systems, sponsoring health planning boards that administer certificate of need programs, and coordinating emergency response. States also handle the role of monitoring the appropriateness of health care resources, assessing underserved areas and populations, and my search for ways to improve access to health care providers through a state-sponsored grant, scholarship, and student loan repayment programs. These access improvement programs are at times aimed at particular populations, such as rural resident or minority groups, or certain services.
Regulation Of Health Care Providers
State governments are also responsible for inspecting and licensing health care professionals and facilities. Although, in most states, these activities are not performed by the state health agency and are instead performed by a sister agency within the state government. An estimated one-third of local health agencies play a role in implementing this kind of regulatory responsibility. States can also handle other work to improve the quality of clinical resources to health care providers and developing and publishing quality report cards that measure the performance of providers or insurance plans.
Other Regulatory Activities
The majority of state health departs will handle the inspection and licensing of food processing facilities, solid waste removal services, and at times jails and prisons.
The state is also responsible for a large range of activities involving the detection and remediation environmental health threats, such as contaminated food and water, radon gas, mosquitoes, and other disease and chemical spills. For plenty of states, an environmental agency is responsible for administering these kinds of activities and the conduct of such work is often delegated to local agencies.
Administration Of Federal Public Health Programs
By integrating these motions, states manage an extensive list of public health funding streams and programs sponsored by the federal government. Some examples include the Preventive Health and Health Services block grant, the Public Health Emergency Preparedness grant, the Hospital Preparedness grant, the Maternal and Child Health block grant, the Women, Infants, and Children (WIC) program, the Vaccines for Children and the Section 317 immunization programs, the AIDS Drug Assistance Program (ADAP), and the Health Resources and Services Administration’s health professional shortage designations.
While local public health agencies may be responsible for handling many of the services connected with to these federal programs, state government usually establishes policies for program operations, allocates funds to all local jurisdiction, coordinates regional activities, and oversees program performance.
Local Public Health Agencies
While the range of public health agencies at the local level is typically dictated by state policy, local policymakers have flexibility in determining what and how activities will be conducted by locally managed departments. For those reasons, the services provided by local public health agencies vary both thin and among states. Local health departments based in metropolitan areas usually have a wide range of functional capacities similar to and, in certain cases, more developed than those of state health agencies. Compared to small local health departments, which are often responsible for a minimal set of public health activities.
Local public health departments usually handle multiple activities that include both personal and population-based services. Here are some of the most commonly provided services:
Usually, a local health department will provide some kind of clinical preventive services. Adult and child immunization and screening for communicable diseases, such as tuberculosis, are the types of clinical preventive services commonly seen available throughout the local health agencies. Ones that are less commonly available are screening for diabetes, cancer, and cardiovascular disease.
Medical Treatment And Other Personal Care Service
Certain types of treatment services are commonly available through local health departments. Relatively few local health departments provide a comprehensive primary health care service, but most do provide treatment for communicable diseases, such as tuberculosis and sexually transmitted disease. Services related to maternal and child health, such as perinatal home visitation, well-child clinics, developmental screening, and WIC nutrition counseling services, are also available by most local agencies. These maternal and child health services are usually restricted by high-risk populations, such as low-income families and mothers and children with special health care needs.
In the case of population-based services most commonly provided by local public health, agencies include influenza pandemic planning, communicable disease surveillance, environmental health surveillance, an inspection of food service establishments, an inspection of schools and day care facilities, and tobacco prevention. Certain local health departments may also decide to engage with primary prevention activities directed at chronic disease, physical activity, and injuries, but these activities are normally conducted in partnership with nongovernmental agencies, other units or local government, or state health agencies.
There are some of the important public agencies most people should be aware of, especially if you are someone who is pursuing a medical field of sorts or have already graduated and are trying to find the best place suited for your needs. While there are many public agencies out there, they all serve their own purpose and are beholden to the state laws implemented by the local government. Keep in mind that just because one place can conduct in one manner doesn’t mean that yours can. Hopefully, this broad range of information has helped gain a better understanding of the massive web that goes into ensuring the public has the best possible public health available to them in today's modern world.