Chapter 2: Organizations that help Shape Community and Public Health

Administration for Community Living (ACL)

- created in 2012 - Integrates the efforts of: the Administration on Aging, Administration on Disabilities, National Institute on Disability, Independent Living and Rehabilitation Research, Center for Integrated Programs, Center for Management and Budget, Center for Policy and Evaluation - responsible for increasing access to community supports, while focusing attention and resources on the needs of older American and people with disabilities across the lifespan

Substance Abuse and Mental Health Services Administration (SAMHSA)

- developed in 1993 - federal agency that is 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: to reduce the impact of substance abuse and mental illness on American's communities - There are 4 centers in this: the Center for Substance Abuse Treatment (CSAT), Center for Substance Abuse Prevention (CSAP), Center for Mental Health Services (CMHS), Center for Behavioral Health Stats and Quality (CBHSQ) aka Office of Applied Studies = contributes to the overall mission of SAMHSA

Organizations of Local Health Departments

- each LHD headed by health officer/administrator/commissioner (usually they are a physicians, if not they will be appointed a health officer who is a physical to consult the basis to advise as needed) - health officer is appointed by a board of health or elected by the general public - the health officer and administrative assistant may reckoned which programs will be offered by the LHDs - local health officers have powers. Health officers are hired part time. Activites of the LHD are carried out by an administrator trained in pubic health.

roles of state health departments

- establish and spread health regulations that have the force and effect of law throughout the state - provides a link between federal and local public health agencies (city and county) - serve as channels for federal funds aimed at local health problems. Funds are distributed to local health departments by their state health departments - link local needs with federal expertise ex. epidemiologists from CDC are sometimes available to investigate local disease outbreaks at the request of state health departments - they can provide resources and expertise to local health departments (like providing lab services because equipments are expensive)

LHD revenues

- from local resources, state funds and federal pass through funds - services are usually limited on fee for service basis - LHDs use a sliding scale

F. Nongovernmental Health Agencies

- funded by private donations or membership dues - they arose because there was an unmet need and the agencies operate free from governmental interference as long as they meet the guidelines of the IRS - types: voluntary, professional, philanthropic, service, social, religious, and corporate

state health departments

- head is usually a medical doctor (may carry the title of the director, commissioner, or secretary; they may sometimes have no extensive experience in community or public health - it is the commissioner, assistant commissioner, and division chides who set policy and provide direction for the state health department - middle or lower level employee hired through merit system and ma or may not be able to influence health department policy > usually they are trained health specialists

Food and Drug Administration (FDA)

- in charge with protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices; ensuring the safety of foods, cosmetics, and radiation-emitting products, and regulating tobacco products - Help speed innovations that make med and foods safer and more effective, providing the public with accurate science-based information they need to use med and foods to improve their health, regulating manufacture/marketing/distribution of tobacco products, addressing the nation's counterterrorism capability and ensuring the security of the supply of foods and medical products - Revolves around regulatory activities and the setting of health and safety standards as in the Federal Food, Drug, and Cosmetic Act. - With limited resources, FDA regulations are left to other federal agencies and to state and local agencies. Ex. Dept of Agriculture

Today and Red Cross

- international movement of the Red Cross comprises of the Geneva based IRC, International Federation of Red Cross and Red Cross Societies and over 190 National Red Cross and RC Societies - Emblem is a red frame in shape of square on the edge of white background

communities today

- less autonomous and more dependent on federal and state funding - to large and complex to respond effectively to health emergencies or to make improvements in community and public health - need better community organizing and careful long term planning

D. Local Health Departments

- local-level governmental health organizations or (LHDs) - LHDs are the responsibility of the city or county governments - In large metro areas > community health needs are served by city health departments. In rural areas with population up to 50,000 people > under the jurisdiction of a county health department. - If population is concentrated in a single city, a LHD may have jurisdiction over both the city and county residents. In populated rural areas, there could be more than one county served by a single health department. - LHDs provides health services to the people of the community. Services are mandated by state laws (set standards for health and safety). Ex of local health services can be inspections in restaurants. - Local health jurisdiction enact ordinances that are stricter than those of the state.

Center for Disease Control and Prevention (CDC)

- located in Atlanta, Georgia - nation's leading health agency dedicated to saving lives and protecting the health of Americans - 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 in the US - its works to control communicable diseases and maintains records, analyzes disease trends, and publishes epidemiological reports on all types of disease (from lifestyle, occupational, and environmental causes) - supports state and local health departments and cooperates with other national health agencies from WHO member nations - Achievements: The outbreaks that do not happen, the communicable diseases that are stopped before spreading, and the lives saved from preventable chronic diseases and injuries. The Ebola outbreak in 2014 and the Zika outbreak in 2015-16.

Voluntary Health Agencies

- nonprofit organizations created by concerned citizens to deal with a health need not met by governmental health agencies - They arise by themselves and they are an American creation ex. Alzheimer's Association and the First Candle (SIDS Alliance)

E. Quasi-Governmental Health Organizations

- organizations that have some responsibilities assigned by the government but operate more like voluntary agencies - get their funding and legitimacy from governments and carry out government work but they operate independently of government supervision - receive some financial support from private sources ex. American Red Cross, National Science Foundation, and the National Academy of Sciences

organization of state health departments

- organized into divisions or bureaus that provide certain standard services - divisions can include: environmental health, administration, communicable diseases, dental health, health education or promotion , health services, public health preparedness (bioterrorism) etc.

Health Resources and Service Administration (HRSA)

- 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 r urban neighborhoods where health care is scarce - improves access to health care services for people who are underinsured, isolated, or medical vulnerable - mission: maintains the National Health Service Corps and helps build the health care workforce through training and education programs - administers a variety of programs to improve the health of mothers and children and serves the people living with HIV/AIDS through Ryan White CARE act - oversees the nation's organ transplantation system

disagreements with voluntary health agencies

- problem with the budget: some people believe that less should be spent on research and more on treating those people with a disease - problem about funds raised at the local level should be sent to the national headquarters instead should be saved for local use - those outside the agency say that when an agency achieves its goal they should dissolve (ex. March of Dimes then moved on to deal with birth defects and TB)

Indian Health Service (IHS)

- responsible for providing health care services to American Indians and Alaska Natives - provides comprehensive health service delivery system for 1.9 million American Indians and Alaskan Natives who belong to 567 federally recognized tribes in 35 states - relationship between the federal government and Indian tribes > established in 1787 - principle health care provider and health advocate for Indian people - Mission is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level. Goal is to assure that comprehensive and culturally accepted personal and public health services are available and accessible to AI and AN people. - 1989 IHS was developed to an agency level

History of the Red Cross Idea

- started in 1863 by Swiss Men who were concerned with the treatment provided to the wounded during times of war; groups was called International Committee for the Relief to the Wounded - This committee was lead by Henry Dunant. They brought together delegates from 16 nations in 1864 to the Geneva Convention for the Amelioration of the Condition of the Wounded in Armies in the field (first Geneva Convention) to sign the Geneva treaty. - Lead to the establishment of the International Committee of the Red Cross: work during times of disaster and international conflict, visits prisoners of war to ensure the are being treated humanly

CDC 24/7

- statements for its current role: Detecting and responding to new and emerging health threats, tackling the biggest health problems causing death and disability for Americans, putting science and technology into action to prevent disease, promoting healthy behaviors/communities/environment, developing leaders and training the public workforce/ disease detectives, and taking the health pulse of our nation

strategies for achieving MDGs

- strong government leadership and policies and strategies that meet the needs of the poor - sufficient funding and technical support from the international community

A. International Health Agencies World Health Organization

- the most widely recognized international governmental health organization - located in Geneva, Switzerland and has 6 regional offices - Africa- Brazzaville, Congo (AFRO) - Americas - Washington DC, US (PAHO) - E. Med - Cairo, Egypt (EMRO) - Europe - Copenhagen, Denmark (EURO) - SE Asia - New Delhi, India (SEARO) - Western Pacific - Manila, Philippines (WRPO)

activity of voluntary agencies

- they do mostly fundraising - "a-thon" - become United Way agencies and receive funds that derived from the annual United Way campaign (conducts fundraising efforts at worksites) ex. American Cancer Society, American Heart Association, and American Lung Association - Many agencies are formed to help meet special health needs. Major concern is the amount of money that the voluntary agency spent on the cause and how much money they spend on fundraising and overhead.

roles of ATSDR

1) evaluates info on hazardous substances released into the environment to assess the impact on public health 2) conducts and sponsors studies and other research related to hazardous substances and adverse human health effects 3) establishes and maintains registries of human exposure (long term follow up) and complete listings of areas closed to the public or restricted in use due to contamination 4) summarizes and makes data available on the effects of these substances 5) provides consultations and training to ensure adequate repose to public health emergencies federal health agencies work taken on new meaning after 9/11

contributions of religious groups to community and public health

1) they have had a history of volunteerism and preexisting reinforcement contingencies for volunteerism 2) they can influence entire families 3) they have accessible setting missions for the less fortunate ex. religious organizations: Protestants One Great Hour of Sharing, the Catholics Relief Fund, Untied Jewish Appeal They also include the donation of space for voluntary health programs (like AA), the sponsorship of food banks and shelters for the hunger, poor, and homeless, the sharing of the doctrine of good personal health behavior, and allowing the community and public health professionals to deliver their programs through congregations But they can also hinder our health like protesting about sex education

10 essential public health services

1. Monitor health status to identify community health problems. 2. Diagnose and investigate health problems and health hazards in the community. 3. Inform, educate, and empower people about health issues. 4. Mobilize community partnerships and action to identify and solve health problems. 5. Develop policies and plans that support individual and community health efforts. 6. Enforce laws and regulations that protect health and ensure safety. 7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable. 8. Assure competent public and personal health care workforce. 9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services. 10. Research for new insights and innovative solutions to health problems.

6 core functions of WHO

1. Providing leadership on matters critical to health and engaging in partnership where joint action is needed 2. Shaping research agenda and stimulating the generation, translation, and dissemination of valuable knowledge 3. Setting norms and standards, and promoting and monitoring their implementation 4. Articulating ethical and evidence based policy options 5. Providing technical support, catalyzing change, and building sustainable institutional capacity 6. Monitoring the health situation and assessing health trends

ability of today's communities to respond to their own problems is hindered by:

1. developed and centralized resources in national institutions and organizations 2. concentration of wealth and population in largest metropolitan areas 3. rapid movement of information, resources, and people made possible by advanced communication and transportation technologies that eliminate the need for local offices where resources were once housed 4. globalization of health 5. limited horizontal relationship between organizations 6. system of top-down funding for most community programs

the difference between philanthropic foundation and voluntary health agencies

1. foundations have money to give away and therefore no effort is spent on fundraising 2. Foundations can afford to fund long term and innovative research projects (like the Rockefeller with yellow fever vaccine)

Obama health care reform law

1. implementation of new revision to help families and small business owners in getting information to Mae the best choices for insurance coverage in a competitive insurance market 2. working with states and additional partners to strengthen public programs 3. coordinating efforts with departments to design and implement a prevention and health promotion strategy to promote prevention, wellness, and public health 4. taking action to support primary care workforce 5. taking on authority to establish a health care system to oversee that every dollar os spent in a wise and transparent manner 6. implementing provisions to reduce the cost of medications 7. Authority to making Community Living Assistance Services and Support Act (CLASS act) 8. implementing Indian Health Care Improvement Act

American Recovery and Reinvestment Act (ARRA)

22 billions for health information tech, subsidies for those who are recently unemployed to maintain health insurance, 1 billion for continued effectiveness research in health.

Public Health Service (PHS)

AHRQ, ATSDR, CDC, FDA, HRSA, IHS, NIH, SAMSHA, OGA, OPHS, ASPR make up the public health service CMS, ACF, and ACL make up the human services operating divisions

recent changes in the HHS

Addition of the Center for Faith Based and Community Initiatives and Assistant Secretary for Public Health Emergency Preparedness

Result of Obama health care reform law

Commitment lead to advanced access, quality, ad affordability in the nation's health care system. Provided 90% of Americans health care coverage.

Ebola and WHO

Good progress has been made to make systems and tools that allow for rapid and effective response. 6 rapid diagnostic tools that can detect Ebola virus in matter of hours, 24 worldwide testing labs, an Ebola vaccine, registered foreign medical teams and thousands of responders who can rapidly deploy to outbreaks.

Organizational Chart for the US Department of HHS

HHS is organized into 11 operation agencies. And has 10 regional offices. These offices serve as representatives of the secretary of HHS in dealings with the state and local governmental organizations.

Indian Health Care Improvement Act

Improved health services to Alaska Natives and African Indians.

international health organizations older than WHO

International D'Hygiene Publique - 1907 Health Organization of the League of Nations - 1919 United Nations Relief and Rehabilitation Admin 1943 United Nations Children's fund (UNICEF) 1946 Pan American Health Organization (PAHO) 1902

small pox and WHO

It was eradicated by a collaborative global vaccination program led by WHO. In 1978, a lab in England had an accident and resulted in one death and a limited outbreak of the disease. 1979 the World Health Assembly declared the global eradication of this disease.

Road Map

Made goals and targets to be reached in 2015 in each of the 7 areas.

Millennium Development Goals (MDGs)

Resulting eight goals in the area of development and poverty eradication. Aimed at reaching poverty and hunger, tackling ill health, gender inequality, lack of education, lack of access to improved drinking water, and environmental degradation. Saved million of lives and improved conditions from having target interventions, sound strategies, and adequate resources. Aimed at interactive processes between health and economic development (better health is a major contributor to economic growth and social cohesion)

Community Living Assistance Services and Support Act (CLASS act)

Voluntary, self-funded long term care insurance option

top-down funding

a method of funding in which funds are transmitted from federal or state government to the local level

how are community organizations classified?

according to their sources of funding, responsibilities, and organizational structure

core function of public health

assessment, policy development, assurance - assessment of info on the health of the community, public health policy development, and assurance that public health services are provided to the community

medicare and Medicaid

created in 1965 to ensure that special groups were covered by programs would not be deprived of health care because of cost

MDGs proven to be effective in monitoring development through

data to track interventions, performance, and accountability

Sustainable Development Goals (SDGs)

goals created by the WHO to build on the work accomplished via the Millennium Development Goals (MDGs) 17 goals. Made to be interconnected and concentrated towards eradicating poverty, addressing climate change, and increasing economic growth. Developed in 2015 to build on MDGs and improve lives through global and unified effort. Want to improve availability, quality, and timeliness of data, national level analyses, and global level outcome

I. Governmental Health Agencies

health agencies that are part of the government and funded by taxes - funded by tax dollars and managed by government officials - designated as having authority over some geographic area - exists at four governmental levels -- international, national, state, and local

general program of work

provides a vision and is used to guide the work of the organization during a pre-determined period of time

sliding scale

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

Purpose of Voluntary Health Agencies

(1) raise money to fund their programs with the majority of the money going to fund research (2) provide education to both professionals and to public (3) provide service to those individuals and families that are afflicted with the disease or health problems (4) Advocate for beneficial policies, laws, and regulations that affect the work of the agency and in turn the people they are trying to help

examples of philanthropic foundations

- Bill and Melinda Gates Foundation: made commitments to community health - Commonwealth fund: contributed to community health in rural communities, improved hospital facilities, and tried to strengthen mental health services - Ford Foundation: contributed to family planning and youth sexuality efforts - Robert Wood Johnson Foundation: improve the culture of health and policies dealing with health related systems - Henry Kaiser Foundation: supported health care reform and community health promotion - Kellogg Foundation: address human issues and provides a practical solution - Millbank Memorial Fund: funded projects dealing with the integration of people with disabilities

Superfund legislations

- Comprehensive Environmental response Compensation, and Liability Act - legislation enacted to deal with the cleanup of hazardous substances in the environment

Corporate Involvement in Community and Public Health

- Corporations find that their single largest annual expenditure behind salaries and wages if for employee health care benefits. - In effort to keep a healthy workforce and reduce the amount paid for health care benefits, they support health related programs both at and away from the worksites. Worksite programs are used to trim down the medical bills. - Worksite safety awareness programs and first aid services and implementing health promotion policies and enforcing state and local laws that prohibit smoking on company grounds.

B. National Heath Agencies

- Each has a department or agency that has a responsibility for the protection of the health and welfare of its citizens - Responsibilities: develop health policies, enforce health regulations, provisions of health services and programs, fund research, and support state and local agencies - Primary national health agency is Department of HHS. ex. Department of Agriculture - inspects meats and dairy products and coordinates the Nutrition Program for WIC, Environmental Protection lion Agency - regulates wastes, Dept of Labor - safety and health in workplace, Commerce and Bureau - national data for health programs, DHS - terrorism

Centers for Medicare and Medicaid Services (CMS)

- Established as the Health Care Financing Administration (HCFA) 1977 - Oversees the Medicare program, the federal portion of the Medicaid program, and the related quality assurance activities. - Children Health Insurance Program (CHIP) became a responsibility of the CMS.

Service, Social, and Religious Organizations

- Ex. Jaycees, Kiwanis Club, Fraternal Order Police, Rotary Club, Elks, Lions, Moose, Shriners, American Legion, and Veterans of Foreign Wars - enjoy social interactions with people of similar interests and service to others in their communities - health is not their main reason but they make contributions in that direction by raining money or funding health related programs

Centers, Institutes, and Offices (CIOs)

- For the CDC to carry out its work they are organized into CIOs. - Allow the agency to be more responsive and effective when dealing with public health concerns. Implements the CDC's response and provides intra-agency support and resource sharing for issues an specific health threats.

The American Red Cross

- Founded in 1881 by Clara Barton - has quasi-governmental status - they have certain responsibilities placed on it by the federal government by it is funded by voluntary contributions: (1) provide relied to victims of natural disasters (floods, tornadoes, hurricanes, and fires- Disaster Services) (2) serving as liaisons between members of the active armed forces and their families during emergencies (3)they engage in many nongovernmental services (blood drives safety services) - granted charter in 1900; President is the chairman of ARC and Attorney General and Treasury are the counselor and treasurer

Organization of the WHO

- IT is a specialized agency concentrating exclusively on health by providing technical cooperation, carrying out programs to control and eradicate disease and striving to improve the quality of human life - Membership open to any nation that has ratified WHO constitution and receives a majority vote from the World Health Assembly - 196 countries were members - meets annually or in special sessions to talk about approving the WHO program and the budget for the following biennium and deciding policy questions - administered by a staff that includes an appointed director (general and deputy director) and 7 assistant directors (vernal and 6 regional directors)

Ebola outbreak and the CDC

- It was in West Africa. CDC activated the Emergency Operation Center to provide assistance and control activities. Deployed teams.

Professional Health Organizations/Associations

- Made up of health professionals who have completed specialized education and training programs and have met the standards required for their respective fields. - Mission: promote high standards of professional practice for their specific profession (improving the health of society by improving the people in the profession) - funded through membership ex. American Medical Association, the American Dental Association, the American Nursing Association, the American Public Health Association, and the Society for Public Health Education - they publish journals, certify continuing education programs for professional renewal, host conventions to share research, publish. - Advocate on issues that are important to their membership. Provide the opportunity for benefits *group insurance and discount travel rates

Organization of Voluntary Health Agencies

- Most exist at national, state, and local levels - National Level: policies that guide the agency are made - Portion of money is raised locally is forwarded to the national office and it is allocated to the agency's budget. Money is put into research to discover the cause and cure for a particular disease or health problem. (ex. March of Dimes helped eliminate polio as a disease problem through immunization research) - State level offices of voluntary agencies are the same compared to the state department of health because they are linked to the national headquarters with local offices. They want to coordinate local efforts and to ensure that policies developed at the national headquarters are carried out. They can also provide training services and can serve as consultants and problem solvers. - Local level office of each voluntary agency are managed by paid staff worker who has been hired either by the state level office or local board of directors. - Local board of directors serve on a voluntary basis. - Working under the manager are the local volunteers (backbone). The local level is where most of the money is raised, most of the education takes place, and most service is rendered. Two types of volunteers: professional (have had training in medical profession) and lay (no medical training)

Zika virus and the CDC

- Much closer to South America and could spread to the US. CDC and PAN work with other public health experts in Brazil to see the link between Zika and group B streptococcus, microcephaly, and other pregnancy outcomes. Wanted to see the birth outcomes and developmental concerns among infants and children born to women with Zika virus during pregnancy.

Agency for Health Care Research and Quality (AHRQ)

- Named was changed as part of the Health Care Research and Quality Act of 1999 - the Nations lead federal agency for research on health care quality, costs, outcomes, and patient safety - sponsors and conducts research the provides evidence-based information on health care outcomes (quality, cost, use, and access) - information helps health care decision makers (patients and clinicians, health system leaders, and policy makers) make more informed decisions and improve quality of health care services

Other Quasi-Governmental Organizations

- National Science Foundation and the National Academy of Sciences - NSF: funding and promotion of scientific research and the development of individual scientists; they receive and disperse federal funds but operates independently of governmental supervision. Charted by Congress in 1863 - NAS: acts as advisor to the government on the question of science and technology - both of them fund projects, publish reports, and take public stands on health related issues

Purpose and Work of WHO

- Primary objective: attainment by all peoples of the highest possible level of health. - Financed by its member states with assessed and voluntary contributions. Each member assessed according to its ability to pay. Voluntary contributions from members and makes up more than 3/4 of financing - Noteworthy work of WHO was the eradication of small pox. And the efforts to contain outbreaks of Ebola. - Work of WHO is outlined in "general programme of work". And recent work in the United Nationals Millennium Declaration

Twelfth General Programmee of Work

- covers the 6 years from 2014-2019 - categories covered include: communicable diseases, non, health throughout the life cycle, health systems, preparedness, surveillance, and response, and corporate services and enabling functions

Agency for Toxic Substance and Disease Registry (ATSDR)

- created by Superfund legislation in 1980 - enacted to deal with the cleanup of hazardous substances in the environment - mission is to serve the public through responsive public health actions to promote healthy and safe environments and prevent harmful exposures

Whole School, Whole Community, Whole Child Model (WSCC)

- Schools are governmental agencies because they are funded through tax dollars and under the supervision of an elected school board. And their mission is to improve the heath of those in the school community. School is the best agency ti help young people. - created by the CDC and ASCD - focus is an ecological approach that is directed at the whole school, with the school intern drawing its resources and influences from the whole community and serving to address the needs of the whole child - it expands on the 8 elements of CSH (coordinated school health): health education, nutritional environment and services, employee wellness, health services, counseling, psychological, and social services, physical education, healthy and safe school environment, and family/community involvement - the WSCC expands mostly on: social and emotional climate, physical environment, community involvement and family engagement. Wants to meet the needs for greater emphasis on psychosocial and physical environment and the growing roles that community agencies and families must play. - addresses the need to engage students as active participants in their learning and health

HHS and fiscal years information

- There is a reserve fund of more than 630 billion to fund health care system reform. Funded half by new revenue and half by savings proposals - Looking towards fundamental health care reform.

United Nations Millennium Declaration

- adopted at Millennium Summit 2003 - set out principles in 7 areas: peace, security, and disarmament; development and poverty eradication, protecting common environment, human rights, democracy, and good governance, protecting vulnerable, meeting special needs of Africa, and strengthening the UN

Department of Health and Human Services

- agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves - lead by Secretary of HHS, appointed by president and is a member of their cabinet - 1980, created when the Department of Health, Education, and Welfare (HEW) was divided into the HHS and Dept of Education. - most involved with the nation's human concern and touches the lives of more Americans compared to other agencies - it is the dept of serving people. Budget is 1.150 trillion 25% of total budget. Largest department in federal government.

C. State Health Agencies

- all 50 states have their own state health department - Purpose: to promote, protect, and maintain the health and welfare of their citizens - purpose are represented in the core function of public health

Philanthropic Foundations

- an endowed institution that donates money for the good of humankind - Support community health by funding programs and research on the prevention, control, and treatment of many disease. - Foundation directors can determine the types of programs that will be funded - domestic foundation can be national, state, or local

National Institutes of Health (NIH)

- began as Laboratory of Hygiene in 1887 - one of the world's foremost medical research centers and the federal focal point medical research in the US - Seeks fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce the burdens of illness and disability. - most of the research are conducted by scientists at public and private universities and other research institutions - receive NIH funding for their research proposals through peer-review grant applications process - NIH seeks to ensure that federal research monies are spent on the best conceived research projects - List of Units within the National Institutes of Health on page 50

History of WHO

- began when.a charter of the UN was adopted at an international meeting in 1945 - charter was an article calling for the establishment of a health agency with wide powers - 1846 at the International Health Conference representatives from all of the countries in the UN created and ratified a constitution for WHO - April 7, 1948 constitution went into force and organization started (world health day)

Administration for Children and Families (ACF)

- composed of smaller agencies and responsible for providing directions and leadership for all federal programs to ensure children and families are resilient and economically secure - ACF > lead to the start of Head Start (serves one million preschoolers). Aimed at family assistance, refugee resettlement, and child support enforcement. Service in school readiness of young children from low income families.