Examples of the 10 Essential Services in Action Now lets look at concrete examples of each of the 10 Essential Services of Public Health Examples of the 10 Essential Services in Action

Monitor health status to identify community health problems Examples of monitoring health status to identify community health problems include the many surveillance systems in place thorough the nation. When used correctly death certificates, birth certificates and immunization registries all tell us about the health of our communities and allow us to take action based upon solid information. Monitor health status to identify community health problems Examples: Death Certificates, Birth Certificates, Immunizations Registries, Surveillance

When problems are identified either by surveillance systems, alert citizens or other means, they need to be investigated. Examples of the essential services “Diagnose and investigate health problems and health hazards in the community” are outbreak investigations done when foodborne illness is reported and child death review boards which examine why children die in a community and how future child deaths can be prevented. Diagnose and investigate health problems and health hazards in the community Examples: Outbreak Investigations, Child Death Review Boards

Inform, educate, and empower people about health issues Governments must inform, educate and empower people about health issues for two reasons. First many health issues require behavioral change by informed citizens. For others non-profit organizations and business can influence health. Finally for some health issues, laws are needed to protect citizens and money is needed to fund programs. Citizens and elected officials need to be informed of the options so they can make good decisions about government services and about their own behavior. Inform, educate, and empower people about health issues Example: Lead Paint displays in hardware stores, News Releases on Rabies and West Nile Virus

Mobilize community partnerships to identify and solve health problems Government can’t work alone. Many of the problems such as poor diets, inadequate wages and lack of physical exercise require community partnership. Hence one of the Essential Services is to mobilize community partnerships to identify and solve health problems. One example is the Allegheny County Health Department's Tobacco Stakeholders group which met to come up with the best ways to limit sales of tobacco to minors. Mobilize community partnerships to identify and solve health problems Example: ACHD Tobacco Stakeholders Group, Advisory Boards, Collaborative Activities

As mentioned previously Government agencies must also develop policies and plans that support individual and community health efforts. Something as simple as sidewalks and crime can have a large impact upon whether people can exercise. Government policies can influence both. Other examples include smoke free restaurants and helmet laws. Develop policies and plans that support individual and community health efforts Example: Smoking Bans, Helmet Laws, Restaurant Inspection Laws

Enforce laws and regulations that protect health and ensure safety Writing good laws and policies is not enough. Governments must enforce laws and regulations that protect health and ensure safety. Citizens in communities with good restaurant inspection programs can eat out with confidence knowing that refrigeration has been tested and food handling has been observed to make sure good practices are in place. Enforce laws and regulations that protect health and ensure safety Example: Food Inspection Certificates, Enforcement of Smoking Regulations

Most of the public is familiar with this Essential Services -” Link people to needed personal health services and assure the provision of health care when otherwise unavailable” because of Medicaid , Medicare and the Children’s Health Insurance Programs. However may people are not covered by either employer or government insurance programs. The direct provision of services by government clinics or federally qualified centers is another way that government helps to assure the provision of services when unavailable from the private sector. Link people to needed personal health services and assure the provision of health care when otherwise unavailable Example: Children’s Health Insurance Programs, Federally Qualified Centers.

Assure a competent public health and personal health care workforce. The Essential Services of Public Health are not much good if the the public health workforce is not capable of carrying out them. Educating the public health workforce is just one example of the essential service” Assure a competent public health and personal health care workforce”. Assure a competent public health and personal health care workforce. Example: Conferences, Training programs, journals, School of Public Health, Satellite Programs, Certifications

Quality improvement is part of the American Way and public health takes this responsibility very seriously. Economic analysis, and outcome evaluations are just two of the ways that public health evaluates effectiveness, accessibility, and quality of personal and population-based health services. Evaluate effectiveness, accessibility, and quality of personal and population-based health services Example: Outcome evaluation and Economic Analyses

Research for new insights and innovative solutions to health problems Finally, public health is faced with new problems every day. Research for new insights and innovative solutions to health problems are therefore essential for maintaining the health of the community. Innovative ideas such as needle exchange programs need to be tested before being used population wide. Research for new insights and innovative solutions to health problems Example: Needle Exchange Programs

Example: Heart Disease At the end of this lecture you will be asked to think about ways the 10 Essential Services of Public Health can be used to solve a problem in your community. As an example let’s look at heart disease. For the first essential service- Monitor health status to identify community health problems. -Typically death certificate files are used to monitor deaths from heart disease For the second service - Diagnose and investigate health problems and health hazards in the community Investigations are need to determine which factors (smoking , lack of exercise, weight, blood pressure problems, racial and ethnic disparities) are contributing most to heart disease deaths in a community. 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 For the third essential service, Inform educate, and empower people about health issues - The local public health agency can work with news agencies to provide information to its citizens about ways to improve cardiovascular health such as walking. An example of the 4th essential service, mobilize community partnerships to identify and solve health problems would be working with a local block watch groups to make it safer for residents to walk at night or providing instruction in CPR and other rescue techniques. Inform, educate, and empower people about health issues Mobilize community partnerships to identify and solve health problems

Assure a competent public health and personal health care workforce Policies and plans that support individual and community health efforts include laws which require that food be labeled as to its fat and calorie content and schools that include physical activity in the curriculum. Instruction of local health care professionals about ways to help people stop smoking can help assure a competent public health and personal health care workforce. Develop policies and plans that support individual and community health efforts Assure a competent public health and personal health care workforce

Enforce laws and regulations that protect health and ensure safety Laws and regulations that improve cardiovascular health include bans on smoking at work sites. Public Health can link people to needed health services by providing blood pressure screening and cholesterol testing. 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

Research for new insights and innovative solutions to health problems An example of the essential service to evaluate effectiveness, accessibility and quality of personal and population-based health services is to monitor and publish cardiovascular surgery outcomes by hospital. Research for new insights and innovative solutions to health problems includes trying to find better ways to help individuals alter their behaviors. Evaluate effectiveness, accessibility, and quality of personal and population-based health services Research for new insights and innovative solutions to health problems

Now think about a current public health problem faced by you or your institution. Take that public health problem or issue and think about how you can provide the 10 essential services. It is my hope that by doing this you will think of approaches you might not have other wise considered. I also hope that you now have an appreciation of the many facets of public health and your role in them. Thank you. Exercise: Think about a current public health problem faced by you or your institution. Take that public health problem or issue and think about how the 10 essential services of public health can solve that problem.