1. Public Health Essential Service #2
Diagnose and Investigate Health Problems and Health Hazards in the Community

2. Why do we need to know about the Ten Essential Public Health Services?
Improve quality and performance.
Achieve better outcomes – improved health, less preventable deaths and disease.
Be more efficient with time and money.
Receive national accreditation.

3. Essential Service #2: Part of Assessment Core Function

4. ES #2: Diagnose and Investigate Health Problems and Hazards in the Community
In “plain English”: Identify and respond to health problems or threats.
“Are we ready to respond to health problems or threats? How quickly do we find out about problems? How effective is our response?”
(CDC, 2008)

5. ES#2 – “Diagnose and Investigate” Primary Functions
Timely identification and investigation of health threats.
Availability of diagnostic services, including laboratory capacity.
Response plans to address major health threats.

6. ES #2 – Diagnose and Investigate Detailed Activities
Epidemiological investigations of disease outbreaks/ patterns of:
Infectious disease
Chronic diseases
Injuries
Environmental hazards
Other health threats
Active infectious disease epidemiology programs.
Access to a public health laboratory capable of rapid screening, high volume testing.
Population-based screening, case finding, investigation, and scientific analysis of health problems.
Rapid screening, high volume testing, and active infectious disease epidemiology investigations (CDC, 2008)

7. ES #2: Diagnose and Investigate Examples at ISDH:
Responding to local outbreaks
Syndromic surveillance
BRFSS, YBRS
Universal screening programs
Laboratory testing
Pandemic influenza preparedness
Bio-terrorism exercises
Others?

8. ES #2: Diagnose and Investigate: Who are our partners?
Local health departments, local government
Physicians
Hospitals
Pharmacies
Environmental management personnel
First responders
Schools
Community service providers
Businesses/employers
Citizens of Indiana
Others?

9. ES #2: Diagnose and Investigate How do we analyze performance?
Use the Model Standards:
Planning and Implementation: What type of planning takes place to implement diagnosis and investigation?
State-Local Relationships: Who from the public health system helps us diagnose and investigate?
Performance Management and Quality Improvement: How are we evaluating our diagnostic and investigative efforts and setting goals for improvement?
Public Health Capacity and Resources: How are human, financial, organizational and technical resources used for diagnosis and investigation?

10. Indiana’s Composite Scores: Ten Essential Services

11. ES #2: Diagnose and Investigate by Model Standard
(Add graph)

12. ES #2 Competencies: Analytic/Assessment Skills
Defines a problem.
Determines appropriate uses, limitations data.
Selects, defines variables relevant to defined public health problems.
Identifies relevant and appropriate data sources.
Evaluates data integrity and comparability of data, identifies gaps.
Applies ethics to data collection, maintenance, use, dissemination.
Partners with communities to attach meaning to data.
Makes relevant inferences.
Obtains, interprets information re: community risks, benefits.
Sees how data illuminates ethical, political, scientific, economic issues.

13. ES #2 Competencies: Policy Development/Program Planning Skills
Collects, summarizes, interprets information relevant to an issue.
States policy options; writes clear, concise policy statements.
Articulates the health, fiscal, administrative, legal, social, and political implications of policy options.
States the feasibility, expected outcomes of policy options.
Decides on the appropriate course of action.
Develops mechanisms to monitor and evaluate programs for their effectiveness and quality.

14. ES #2 Competencies: Communication Skills
Communicates effectively in writing, orally, other ways.
Solicits input from individuals and organizations.
Leads, participates in groups to address specific issues.
Uses media, advanced technologies, community networks to communicate information.
Presents accurate demographic, statistical, programmatic, scientific information for professional and lay audiences.
Unbiased listener, respects different points of view, promotes expression of diverse opinions and perspectives (attitude).

15. ES #2 Competencies: Cultural Competency
Interacts sensitively, effectively, and professionally with persons from diverse cultural, socioeconomic, educational, racial, ethnic and professional backgrounds, ages and orientations.
Understands the dynamic forces contributing to cultural diversity (attitude).

16. ES #2 Competencies: Community Dimensions of Practice Skills
Engages effectively with communities.
Identifies community assets and resources.
Develops, implements, and evaluates a community public health assessment.

17. ES #2 Competencies: Basic Public Health Science Skills
Defines, assesses, and understands:
the health status of populations
determinants of health and illness
factors contributing to health promotion/disease prevention
factors influencing use of health services
Identifies, applies basic public health research methods
Applies the basic public health sciences including:
behavioral and social sciences
biostatistics
epidemiology,
environmental public health
prevention of chronic and infectious diseases and injuries

18. ES #2 Competencies: Financial Planning and Management Skills
Develops and presents a budget.
Manages programs within budget constraints.
Applies budget processes.
Develops strategies for determining budget priorities.
Monitors program performance.
Prepares proposals for funding from external sources.
Applies basic human relations skills to:
management of organizations
motivation of personnel
resolution of conflicts
Manages information systems to use data for decision-making.

19. ES #2 Competencies: Leadership and Systems Thinking Skills
Creates a culture of ethical standards in organizations, communities.
Identifies internal, external issues that may impact delivery of essential PH services (i.e., strategic planning).

20. References
CDC National Public Health Performance Standards Program Website:
Indiana Public Health System Quality Improvement Report (2007).
Council on Linkages Training Project Website:

21. ES #2: Diagnose and Investigate Discussion
What does your program do to carry out Essential Service #2?