About Public Health in the U.S.
Promote population health by directly providing services such as:
- screening for diseases and conditions
- disease prevention through education
- maintaining disease and immunization registries
- state laboratory services
- direct public health interventions
- much more
Collectively referred to as “STLT” pronounced “stilt”
- State & Territorial health departments
- Local health departments (generally county or city)
- Tribal health departments
- executive and administrative leaders of public health
- play a key role in policy development
- must be versed in the relevant/current evidence, and provide expertise about health issues to the legislature and the governor.
- Can be a political appointees
Epidemiologists:
- search for the cause of disease, asking questions like: Who is sick? What are their symptoms? When did they get sick? Where could they have been exposed?
- study answers to those questions using statistical analysis to: identify people who are at risk, determine how to control or stop the spread or prevent it from happening again.
- are like disease detectives. They study data to understand the cause of disease and to determine the best strategy for controlling it or stopping it from spreading. They typically have medical backgrounds as physicians, veterinarians, scientists, and other health professionals.
- Contact tracers notify contacts that they have been exposed to a disease
- They can be epidemiologists, or a separate team
- With COVID, many public health departments have hired separate teams just to do contact tracing in order to keep up with the large volume.
- Local health departments (LHD) are units led by local governments, which make most fiscal decisions. (AKA Home-rule states)
- All local health departments are units of state government, which makes most fiscal decisions.
- Some local health departments are led by state government, and some are led by local government. No one arrangement predominates in the state.
- All local health departments are governed by both state and local authorities.
From NACCHO 2019 National Profile of Local Health Departments | Source
- Public health departments have been underfunded for decades
- Because of this, it hasn’t always made financial sense to invest in automation or technology
- ~50% of state public health funding comes from the federal government
- That funding is often tied to specific programs or diseases
- This has led to new systems being purchased or built to tackle specific diseases, rather than using the funds to expand or improve existing systems.
From ASTHO 2016 National Profile Study | Source
From ASTHO 2016 National Profile Study | Source
- It’s complicated.
- The problems faced by public health departments are long-standing and complex
- There won’t be a one-size-fits-all solution
- We need to work closely with our STLT partners to understand their specific needs
- We also need to keep an eye on the big picture so we can build tools that can help solve common problems that exist across many locations
This is a sub-page of the CDC PRIME ReportStream New Team Member Onboarding Hub.