Transforming Public Health Practice

Acknowledgments xvii

The Authors xix

The Contributors xxi

Part One Issues and Methods of Public Health Practice

1 The Need for Change in the Practice of Public Health 3

Mission and Services of Public Health 3

Public Health's History and Its Impact on Current Services 10

Gap Between Mission and Current Public Health Practice 13

2 The Success of Public Health Programs: Critical Factors 27

Definition of Public Health 30

Public Health Systems 31

Community Health Workers 34

Population-Based Medicine 36

Problems in Our Health Care System 36

The Need for Improved Accountability of Public Health Professionals 39

Local Health Departments 39

Epidemic of Chronic Diseases 42

Information Management 44

Expansion of Health Education Programs 45

Public Health and the Legacy Concept 46

The Need for Leadership Development in Public Health 48

3 Critical Issues for the Future of Health Care in the United States 53

Why We Are Failing in Our Health Care Reform Efforts 57

Root Causes of the Failures of the Health Care System 60

Other Problem Areas 68

Solution to the Problems in Our Health Care System 70

New Model of Health Care Delivery 72

Public Health as a Potential Solution to the Health Care Crisis in America 75

4 Application of Epidemiological Concepts to Health Care Delivery 81

Descriptive Epidemiology 83

Epidemiology of Communicable Diseases 89

Epidemiology of Emerging Infections 91

Analytical Epidemiology 92

Epidemiology and the Centers for Disease Control and Prevention 95

Data Management 95

Surveillance Systems 97

Managerial Epidemiology 99

Application of Epidemiological Concepts to Health Care 101

5 Shifting the Focus from Communicable to Chronic Diseases 105

Communicable Disease Threat 108

The Challenge of Chronic Diseases 111

The Need for Investment in Preventing Chronic Diseases 114

Health Education 116

The Need for Partnerships to Combat Chronic Diseases 118

Opportunity to Improve the Way Health Care Is Delivered 121

Part Two Issues and Methods of Public Health Leadership

and Management

6 Leadership and Politics in Public Health 129

Development of Power in Health Care Delivery 130

Leadership and Politics in Health Care Delivery 134

Public Health Leadership Styles 137

Transformational Leadership and Public Health 140

Public Health as a Change Agent 142

Public Health Leaders and Power 143

Public Health Leaders and Conflict Management 145

Can Political Appointees Lead Public Health Departments? 146

Communication Skills of the Leader 147

Leadership Development in Public Health 148

Culture of Public Health Workers 150

Public Health Leaders and Innovation 153

7 Empowering Public Health Workers 159

Leadership and Quality Improvement 161

The Public Health Employee 164

Transformational Leadership, Worker Empowerment, and Self-Managed Work Teams in Public Health 165

The Role of Culture 166

Culture and Change 169

Empowerment of Workers in Public Health 173

Disappearance of the Public Health Worker 176

8 Partnerships to Improve the Public's Health 179

Public Health Partners 179

Value of Partnerships for Public Health Organizations 181

Building Community-Wide Partnerships Using an Ecological Model of Health 183

Successful Partnerships 189

Assessing the Role of Partnerships in Improving Community Health 190

9 Leading and Managing Change in Public Health Organizations 193

Public Health and the Urgent Need for Change 193

Challenges Facing Local Public Health Leaders 194

Millennium Development Goals 195

Urgent Need for System Change 196

Visioning the New Public Health 200

Leadership for the New Public Health 201

Changing the Public Health System for the Future 206

Managing Change 207

10 Developing an Outcomes Orientation in Public Health Organizations 213

Quality Nexus of Public Health and Health Care 214

Focusing on Core Functions and Essential Public Health Services 216

Current Quality Improvement Efforts in Public Health Organizations 223

Gaps in the Quality of Public Health Services 226

Federal Leadership of Quality Improvement in Public Health 227

Road Map to Improve Public Health Outcomes 233

11 Opportunities for Improvement in Public Health Practice 239

Disruption and Change in Public Health 242

Public Health Education and Health Promotion Programs 244

The Need for a Chronic Care Model 247

Minimal Political Appreciation of Public Health Activities 248

Use of Technology in Risk Communication 250

Public Health Leadership Required 252

Value of Prevention Programs 254

The Process of Innovation 259

12 Local Solutions to Reduce Inequities in Health and Safety 263
Larry Cohen, Anthony Iton, Rachel Davis, Sharon Murriguez

13 Challenges in the New World of Public Health Practice 299

Determinants of Health 300

Obesity Epidemic 302

Climate Change 305

War and Armed Conflicts 309

Case Studies

Case Study 1 Innovation in Health Education Programs 315

Case Study 2 Disabilities 321
Jill D. Morrow-Gorton

Case Study 3 Formation of Community Partnerships to Prepare for H1N1 327
Marc C. Marchese

Case Study 4 Municipal Health Department Leadership Inside Out 331
Ted Kross

Case Study 5 The Power of Data: Osceola County Secures a Federally Qualified Health Center 337
Julia Joh Elligers

Case Study 6 Using MAPP to Get Up & Go! in St. Clair County 341
Lisa Jacobs

Case Study 7 Partnering for Improved Infant Health in Stanislaus County 345
Lisa Jacobs

Case Study 8 Innovation in Colorectal Cancer Education Programs 349

References 355

Index 375