national average rate of homicide deaths. ’Violence and injury’, she said, ’must be considered as a problem of public health’. Margaret Conley, President of WFPHA, told us that the Federation, founded in 1967, now had 44 member countries. Dr Keck took as the title of his Presidential Address ’Creating a Healthy Public’. He started by saying that there is something wrong when some can get all the health care they want whilst others cannot get the health care they need. He referred to the time in which we live, with the collapse of the USSR as being ’interesting’, whether we consider them ’cursed’ or ’blessed’ is questionable, but they are certainly ’momentous’. He mentioned a number of inconsistencies in Government action and said that health decisions were often based on political, rather than medical science. There was an inability to set a limit on the ’hightech’ arms race, but great difficulty in setting community health targets, He referred a number of times to the contrast selling clinical high-tech medicines to the
comparative few and providing
a community health nation. A substantial change programme healthy is needed to make health care available to all. In her lecture, Dr Sadik of the United Nations Population Fund discussed the challenge of controlling populationgrowth, particularly in third world countries. Though rates of increase of populations may be falling, the absolute increases in population were alarming. The population of Sub-Saharal Africa is expected to rise from the present 500 million to 1.3 billion in 30 years and that of Mexico City from the present 18 million to 24 million by the end of the century. She spoke of a lack of sustained political commitment to effective control. The final ’Keynote Address’ was given by Dr Hiroshi Nakajima who took as his subject ’WHO and Cooperation in International Health: The Role of Non-Governmental Organisations and Voluntary Associations’.
to create a
J W T
Dickerson
w een
Public Health in the United States Steven R Moore, FRSH United States
Chief of Staff, im-Chair, Service, Office Branch, Public General, of Surgeon Assistant
Health the Health Resources and Services Admininistration, Rockville, MD 2085 7, USA
Public Health in the Federal Government: Traditional public health activities within the United States federal government are located in the Department of Health and Human Services. The Department is headed by a Secretary, equivalent to a Cabinet Minister, who serves along with the Secretaries of each of the 16 Departments in the President’s Cabinet. Unlike many countries, there is no national health plan or centralized health authority in the United States. Health care to individuals is provided through a mixture of private providers, public providers and a variety of payment
mechanisms. Private insurers provide health care payment for many employed persons, the federal government provides support for the poorest citizens, but a large segment of the population (estimated at about 37 million persons) have no insurance coverage for health care. This large segment of the ’at risk’ population, without insurance coverage or the ability to pay for care, continues to provide a major health care problem in the United States. Under the Secretary, the Assistant Secretary for Health is delegated federal authority for health matters. The Assistant Secretary for Health serves as the head of the
Downloaded from rsh.sagepub.com at OAKLAND UNIV on June 9, 2015
51
Public Health Service. The Public Health Service was founded in 1798, with the prime responsibility to maintain the health of its seaman, and to protect the population from diseases and plagues arriving from seagoing vessels. Indeed, the yellow PHS flag has its origins in the yellow flag that was flown from quarantined vessels. Today, the Public Health Service provides a wide array of health care services, policy coordination, provider payment, research, and regulation, with its stated mission ...’improving the health of our Nation’s people’. The Public Health Service is composed of 8 agencies, each legislated by Congress to provide certain health or health-related services to specified segments of the population. Certain areas encompassing the entire Service (such as the Office of International Health) are maintained in the Office of the Assistant Secretary of Health, rather than being placed in an agency. The 8
Agencies
and
a
brief outline of their mandated
responsibilities:
Agency for Health Care Policy and
Research
(AGCPR)
AHCPR’s mission is to enhance the quality, appropriateness and effectiveness of health care services and to improve access to these services. To accomplish this, AHCPR funds research and evaluations, facilitates health care guideline development, promotes improvements in the provision of health care services, and supports the dissemination of research information (AHCPR, 2101 E Jefferson St, Room
programmes in epidemiology, field and laboratory analysis, environmental surveillance, occupational and worksite health, immunization, health statistics, and health promotion are provided to individual states, as well as multiple international locations (CDC, Building 1, Room 2000, 1600 Clifton Road NE, Atlanta, GA 30333).
Food and
Drug Administration (FDA)
FDA’s mission is ensuring the safety and effectiveness of all food and drug products. FDA’s regulatory oversight includes all prescription medicines, food manufacturing, cosmetics safety, biologic products, radiologic and medical devices, veterinary drugs, and related toxicologic surveillance (FDA, 14-71 Parklawn Building, 5600 Fishers Lane, Rockville, MD 20857).
Health Resources and Services Administration
populan
Indian Health Service
300, Rockville, MD 20852).
Agency for Toxic Substances and Disease Registry (ATSDR) ATSDR’s mission is to implement health-related sections of federal laws that protect the public from hazardous wastes or environmental spills of hazardous substances. ATSDR also provides emergency response capability to states and other government agencies where toxic or environmental disasters threaten humans (ATSDR, Building I, Room 2000, 1600 Clifton Rd NE, Atlanta, GA 30333).
(HRSA)
HRSA’s mission is the provision of general health services to underserved populations, as well as improving ac equity, quality and costs of medical care for these HRSA funds service delivery to over 600 community health centres, rural health centres, migrant health centres and multiple sites lacking physicians or other primary care providers. Special population needs particularly targeted include: maternal and child health, AIDS infected, homeless, Hansen’s Disease infected, individuals needing organ transplants, and the ageing (HRSA, 14-03 Parklawn Building, 5600 Fishers Lane, Rockville, MD 20857).
(IHA)
IHS’s mission is comprehensive health service delivery to over 1 million American Indians and Alaska Natives. IHS services include not only hospital and ambulatory care (including dental, and eye services), but also preventive and rehabilitation services, as well and community sanitation and environmental control. IHS encourages tribal involvement and assists Indian tribes in developing
(it,
unique approaches to meeting health care needs 6-03 Parklawn Building, 5600 Fishers Lane, Rockville,
own
MD 20857).
Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) ADAMHA’s mission is to provide research, training, related to substance abuse and mental illness. The mission is undertaken through its three institutes, National Institute on Drug Abuse (NIDA), National Institute of Mental Health (NIMH), and National Institute on Alcohol Abuse and Alcoholism (NIAAA) (ADAMHA, 12-105 Parklawn Building, 5600 Fishers
prevention and
treatment
Lane, Rockville, MD 20857).
Centres for Disease Control
(CDC)
National Institutes of Health
CDC’s mission is the prevention, surveillance and control of unnecessary disease, disability and premature death. Its
52
(NIH)
NIH’s mission is the improvement of the health of the Nation through biomedical research. NIH provides funds for non-Federal researchers through its 13 disease or condition-specific. institutes, funds intramural NIH researchers and maintains a 540 bed research hospital, and supports the National Library of Medicine (the world’s largest repository of medical literature). Additionally international research linkages are developed and enhanced through the Fogarty International Centre (NIH, Building 1, Room 125, 9000 Rockville Pike, Bethesda, MD 20892).
Downloaded from rsh.sagepub.com at OAKLAND UNIV on June 9, 2015
comparative few and providing
a community health nation. A substantial change programme healthy is needed to make health care available to all. In her lecture, Dr Sadik of the United Nations Population Fund discussed the challenge of controlling populationgrowth, particularly in third world countries. Though rates of increase of populations may be falling, the absolute increases in population were alarming. The population of Sub-Saharal Africa is expected to rise from the present 500 million to 1.3 billion in 30 years and that of Mexico City from the present 18 million to 24 million by the end of the century. She spoke of a lack of sustained political commitment to effective control. The final ’Keynote Address’ was given by Dr Hiroshi Nakajima who took as his subject ’WHO and Cooperation in International Health: The Role of Non-Governmental Organisations and Voluntary Associations’.
to create a
J W T
Dickerson
w een
Public Health in the United States Steven R Moore, FRSH United States
Chief of Staff, im-Chair, Service, Office Branch, Public General, of Surgeon Assistant
Health the Health Resources and Services Admininistration, Rockville, MD 2085 7, USA
Public Health in the Federal Government: Traditional public health activities within the United States federal government are located in the Department of Health and Human Services. The Department is headed by a Secretary, equivalent to a Cabinet Minister, who serves along with the Secretaries of each of the 16 Departments in the President’s Cabinet. Unlike many countries, there is no national health plan or centralized health authority in the United States. Health care to individuals is provided through a mixture of private providers, public providers and a variety of payment
mechanisms. Private insurers provide health care payment for many employed persons, the federal government provides support for the poorest citizens, but a large segment of the population (estimated at about 37 million persons) have no insurance coverage for health care. This large segment of the ’at risk’ population, without insurance coverage or the ability to pay for care, continues to provide a major health care problem in the United States. Under the Secretary, the Assistant Secretary for Health is delegated federal authority for health matters. The Assistant Secretary for Health serves as the head of the
Downloaded from rsh.sagepub.com at OAKLAND UNIV on June 9, 2015
51
Public Health Service. The Public Health Service was founded in 1798, with the prime responsibility to maintain the health of its seaman, and to protect the population from diseases and plagues arriving from seagoing vessels. Indeed, the yellow PHS flag has its origins in the yellow flag that was flown from quarantined vessels. Today, the Public Health Service provides a wide array of health care services, policy coordination, provider payment, research, and regulation, with its stated mission ...’improving the health of our Nation’s people’. The Public Health Service is composed of 8 agencies, each legislated by Congress to provide certain health or health-related services to specified segments of the population. Certain areas encompassing the entire Service (such as the Office of International Health) are maintained in the Office of the Assistant Secretary of Health, rather than being placed in an agency. The 8
Agencies
and
a
brief outline of their mandated
responsibilities:
Agency for Health Care Policy and
Research
(AGCPR)
AHCPR’s mission is to enhance the quality, appropriateness and effectiveness of health care services and to improve access to these services. To accomplish this, AHCPR funds research and evaluations, facilitates health care guideline development, promotes improvements in the provision of health care services, and supports the dissemination of research information (AHCPR, 2101 E Jefferson St, Room
programmes in epidemiology, field and laboratory analysis, environmental surveillance, occupational and worksite health, immunization, health statistics, and health promotion are provided to individual states, as well as multiple international locations (CDC, Building 1, Room 2000, 1600 Clifton Road NE, Atlanta, GA 30333).
Food and
Drug Administration (FDA)
FDA’s mission is ensuring the safety and effectiveness of all food and drug products. FDA’s regulatory oversight includes all prescription medicines, food manufacturing, cosmetics safety, biologic products, radiologic and medical devices, veterinary drugs, and related toxicologic surveillance (FDA, 14-71 Parklawn Building, 5600 Fishers Lane, Rockville, MD 20857).
Health Resources and Services Administration
populan
Indian Health Service
300, Rockville, MD 20852).
Agency for Toxic Substances and Disease Registry (ATSDR) ATSDR’s mission is to implement health-related sections of federal laws that protect the public from hazardous wastes or environmental spills of hazardous substances. ATSDR also provides emergency response capability to states and other government agencies where toxic or environmental disasters threaten humans (ATSDR, Building I, Room 2000, 1600 Clifton Rd NE, Atlanta, GA 30333).
(HRSA)
HRSA’s mission is the provision of general health services to underserved populations, as well as improving ac equity, quality and costs of medical care for these HRSA funds service delivery to over 600 community health centres, rural health centres, migrant health centres and multiple sites lacking physicians or other primary care providers. Special population needs particularly targeted include: maternal and child health, AIDS infected, homeless, Hansen’s Disease infected, individuals needing organ transplants, and the ageing (HRSA, 14-03 Parklawn Building, 5600 Fishers Lane, Rockville, MD 20857).
(IHA)
IHS’s mission is comprehensive health service delivery to over 1 million American Indians and Alaska Natives. IHS services include not only hospital and ambulatory care (including dental, and eye services), but also preventive and rehabilitation services, as well and community sanitation and environmental control. IHS encourages tribal involvement and assists Indian tribes in developing
(it,
unique approaches to meeting health care needs 6-03 Parklawn Building, 5600 Fishers Lane, Rockville,
own
MD 20857).
Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) ADAMHA’s mission is to provide research, training, related to substance abuse and mental illness. The mission is undertaken through its three institutes, National Institute on Drug Abuse (NIDA), National Institute of Mental Health (NIMH), and National Institute on Alcohol Abuse and Alcoholism (NIAAA) (ADAMHA, 12-105 Parklawn Building, 5600 Fishers
prevention and
treatment
Lane, Rockville, MD 20857).
Centres for Disease Control
(CDC)
National Institutes of Health
CDC’s mission is the prevention, surveillance and control of unnecessary disease, disability and premature death. Its
52
(NIH)
NIH’s mission is the improvement of the health of the Nation through biomedical research. NIH provides funds for non-Federal researchers through its 13 disease or condition-specific. institutes, funds intramural NIH researchers and maintains a 540 bed research hospital, and supports the National Library of Medicine (the world’s largest repository of medical literature). Additionally international research linkages are developed and enhanced through the Fogarty International Centre (NIH, Building 1, Room 125, 9000 Rockville Pike, Bethesda, MD 20892).
Downloaded from rsh.sagepub.com at OAKLAND UNIV on June 9, 2015
