Chapter 2 Organizations That Help Shape Community and Public Health

Agency for Healthcare Research and Quality (AHRQ)

- division of HHS - the nation's lead federal agency for research on health care quality, costs, outcomes, and patient safety

Voluntary Health Agencies

- each of these agencies was created by one or more concerned citizens who thought that a specific health need was not being met by exiting governmental agencies - Ex. Alzheimer's Association, American Cancer Society, American Heart Association, American Lung Association - Exist at national, state, and local levels -Nationally, Most money goes to research. -State-wise, they link national headquarters with local offices to coordinate local efforts and ensure national policies are carried out -Locally, offices are managed by a paid-staff member and they manage volunteers

Nongovernmental Health Agencies

- funded by private donations or, in some cases, by membership dues - arose because there was an unmet need - generally, the agencies operate free from governmental interference as long as they meet Internal Revenue Service guidelines with regard to their specific tax status - Different types: voluntary, professional, philanthropic, service, social, religious, and corporate

Center for Disease Control and Prevention (CDC)

- nation's premiere health promotion prevention and preparedness agency and global leader in PH - serves as the national focus for developing and applying disease prevention and control, environmental health, and health promotion and education activities designed to improve the health of the people of the US - records, analyzes, disease trends, and publishes epidemiological reports on all types of diseases - future initiative: new health protection goals and a new organizational structure

National Institutes of Health (NIH)

- one of the world's foremost medical research centers, and the federal focal point for medical research in the United States

Governmental Health Agencies

- part of the governmental structure - funded primarily by tax dollars and managed by government officials - exist at four levels: international, national, state, and local

Substance Abuse and Mental Health Services Administration (SAMHSA)

- primary federal agency responsible for ensuring that up-to=date information and state-of-the-art practice are effectively used for the prevention and treatment of addictive and mental disorders - mission is to reduce the impact of substance abuse and mental illness on American's communities

National Academy of Sciences (NAS)

- quasi-governmental - acts as an advisor to the government on questions of science and technology

National Science Foundation

- quasi-governmental - funding and promotion of scientific research and the development of individual scientists

Centers for Medicare and Medicaid Services (CMS)

- responsbile for overseeing the Medicare program, the federal portion of Medicaid program, and the related quality assurance activities - In 1997, also became responsible for the State's Children Health Insurance Program (SCHIP)

Local Health Departments

- responsibility of the city or county governments - Inspection of restaurants, public buildings, and public transportation systems, the detection and reporting of certain diseases, and the collection of vital statistics such as births and deaths - most are on a sliding scale - headed by a health officer/administrator/commissioner

Indian Health Services (IHS)

- responsible for providing federal services to American Indians and Alaska Natives - the principal federal health care provider and health advocate for Indian people

Health Resources and Services Administration (HRSA)

- the primary health care service agency of the federal government that provides access to essential health care services for people who are low-income, uninsured, or who live in rural areas or urban neighborhoods where health care is scarce

Administration on Aging (AoA)

- this division of the HHS is the principal agency designated to carry out the provisions of the Older Americans Act of 1965. - Tracks the characteristics, circumstances, and needs of older people; develops policies, plans, and programs to promote their welfare; administers grant programs to benefit older Americans, and administers training research, demonstration programs, and protective services for older Americans - ex. Meals on Wheels

State Health Agencies

-All 50 states have their own state health departments - Promote, protect, and maintain the health and welfare of their citizens - Core functions of public health: assessment, policy development, and assurance - Head of state health departments is usually a medical doctor, who may or may not have extensive experience in community of public health; politically influenced and affiliated - Usually divided into division or bureaus - Serve as conduits for federal funds aimed at local health problems - Offers laboratory services to local health departments and environmental health when the scope is too big for local health departments

World Health Assembly

-Body of delegates of the member nations of the WHO - Meets in general sessions annually and in special sessions when necessary - Primary taks includes approving the WHO program and the budget and deciding major policital questions

Quasi-Governmental Health Organizations

-Organizations that have some official health responsibilities but operate, in part, like voluntary health organizations -Carry out tasks thought to be governmental but also operate independently of government supervision -EX: American Red Cross, National Science Foundation, National Academy of Sciences

History of WHO

-UN charter was adopted at an international meeting in 1945 - In 1946, WHO was created and ratified - Established on April 7, 1948 and the organization officially began its work

Department of Health and Human Services (HHS)

-the United States government's principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves - headed by Secretary of Health and Human Services, who is appointed by the President - Formed in 1980 (during the administration of Jimmy Carter) - largest department in the federal government and most involved with the nation's human concerns

Ford Foundation

contributed greatly to family-planning efforts throughout the world

Commonwealth Fund

contributed to community health in rural communities, improved hospital facilities, and tried to strengthen mental health services

Department of Homestead Security (DHS)

deals with all aspects of terrorism within the United States

W.K. Kellogg Foundation

funded many diverse health programs that address human issues and provide practical solution

Department of Labor

houses the Occupational Safety and Health Administration (concerned with safety and health in the workplace)

Department of Commerce

includes the Bureau of the Census, which collects much of the national data that dire our nation's health programs

Department of Agriculture

inspects meat and diary products and coordinates the Women, Infants, and Children (WIC) food assistance program

Top-down Funding

money that comes from either the federal or state government to the local level

Milbank Memorial Fund

primarily funded preventive-medicine projects

Environmental Protection Agency (EPA)

regulates hazardous wastes

Henry J. Kaiser Family Foundation

supported the development of health maintenance organizations and community health promotion

Sliding scale

the scale used to determine the fee for services based on ability to pay

Robert Wood Johnson Foundation

worked to improve access to medical and dental care throughout the United States and lessen the impact of tobacco on health

National Health Agencies

- Each national government has a department or agency that has the primary responsibility for the protection of the health and welfare of its citizens - These agencies meet their responsibilities through developing health policies, enforcing health regulations, the provision of health services and programs, funding research and supporting state and local health agencies - Ex. Department of Health and Human Services (HHS), Department of Agriculture, the Environmental Protection Agency (EPA), the Department of Labor, the Department of Commerce, and the Department of Homeland Security

Philanthropic Organizations

- Endowed institution that donates money for the good of humankind - Fund health-related programs and research on prevention, control, and treatment of many diseases - Foundations differ from voluntary health organizations because: foundations have money to give way, and therefore no effort is spent on fund-raising. Foundations can afford long-term or innovative research projects, which might be too risky or expensive for voluntary or even government-funded agencies EX: Bill and Melinda Gates Foundation, W.K. Kellogg Foundation, Rockefeller Foundation

American Red Cross

- Founded in 1881 by Clara Barton - "Official" duties includes: (1) providing relief to victims of natural disasters such as floods, tornadoes, hurricanes, and fires and (2) serving as the liaison between members of the active armed services and their families during emergencies - Nongovernmental services: blood drives, safety services (including water safety, first aid, CPR, and HIV/AIDS instruction), nursing and health services, youth services, community volunteer services, and international services

Purpose of WHO

- Has 22 core functions - Primary object is the attainment by all peoples of the highest possible level of health - Financed by its member nations, each of which is assessed according to its ability to pay; the wealthiest countries contribute the greatest portion of the total budget - Successfully eradicated smallpox via global vaccination programs in 1979 - Also in charge of the MDGs. Challenges to meeting the goals include: food security, gender equality, maternal health, rural development, infrastructure and environmental sustainability, and responses to climate change

Barreis to Coordinated School Health Programs

- Insufficient local administrative commitment - Inadequately prepared teachers - Too few school days to teach health in the school year - Inadequate funding - The lack of credibility of health education as an academic subject - Insufficient community/parental support - Concern for the teaching of controversial topics (sex education)

Profesional Health Organizations/Associations

- Made up of health professionals who have completed specialized education and training programs and have met the standards of recognition - Purpose is to have high standards of professional practice for their specific profession, thereby improving the health of society by improving the people in the profession - Services include certification of continuing education programs for professional renewal, the hosting of annual conventions where members share research results and interact with colleagues, and the publication of journals and other reports - EX: Journal of American Medical Association, American Journal of Public Health, american journal of health education

Organization of WHO

- Membership is open to any nation that has ratified the WHO constitution and receives a majority vote to the World Health Assembly - At the beginning of 2010, 193 countries were members - Administered by a staff that includes a director-general, deputy director- general, and nine assistant directors-general

Purpose of Voluntary Health Agencies

- Raise money to fund their programs, with the majority of $ going to research - Provide education both to professionals and to the public - Provide services to individuals and families that are afflicted with the disease or health problem - Advocate for beneficial policies, laws, and regulations that affect the work of the agency (fund-raising is a primary activity of many voluntary agencies)

Agency for Toxic Substances and Disease Registry (ATSDR)

- created by the Superfund legislation - serve the public though responsive public health actions to promote health and safe environments and prevent harmful exposures

Service, Social, and Religious Organizations

- Social interactions amongst people with similar interests while serving others in their community - Religious Organizations are effective in promoting health because: (1) history of volunteerism (2) influence over entire families (3) they have accessible meeting room facilities - Ex: Kiwanis club, fraternal order of police, rotary club, shriners, - Other types of involvement in community health by religious groups include: the donation of space for voluntary health programs such as blood donations, the sponsorship of food banks and shelters for the hungry, poor, and homeless, the sharing of doctrine of good personal health behavior, and allowing community health professionals to deliver their programs through congregations

International Health Agencies

- WHO: most widely recognized and now the largest international health organization - International D'Hygiene Publique: absorbed by WHO -Health Organization of the League Nations: dissolved when WHO was created - United Nations Relief and Rehabilitation Administration -United Nations Children's Fund (UNICEF): formerly known as the United Nations International Children's Emergency Fund - Pan American Health Organization (PAHO)

Food and Drug Administration (FDA)

- charged with protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medicals devices; ensuring the safety of foods, cosmetics, and radiation-emitting products; and relating tobacco products

Coordinated School Health Programs

- commonly referred to as a comprehensive school health program - an organized set of policies, procedures, and activities designed to protect, promote, and improve the health and well-being of students and staff, thus improving a student's ability to learn - three essential components: health education, a healthy school environment, and health services

Administration for Children and Families (ACF)

- composed of smaller agencies - responsible for providing direction and leadership for all federal programs for needy children and families Ex. Head Start