"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.
Since the private health sector is an important, and often dominant, provider of health services in Sub-Saharan Africa, it is the job of governments as the stewards of the health system to engage with it. Increasing the contributions that the existing private health sector is making to public health is an important, but often neglected, element of meeting the daunting health-related challenges facing African nations. This Report presents newly collected data on how and how effectively each country in the Africa region is engaging the respective private health sectors; and how the engagement compares across the region. While the approach taken by governments varies greatly between countries, there is much room for improvement in the Africa region overall to engage more effectively and room for exchange of ideas and good practices on how to do so. Improved solutions on the policy/regulatory side should be supported by effective organization of the private sector itself and by adjustments in donor programs that take the dynamics of the private health sector better into account.
Summarises both the theoretical discussion of appropriate public and private roles in health, and factual information about what is spent on health care, how health systems are organised, and which financing mechanisms are used.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
Bioterrorism, drug-resistant disease, transmission of disease by global travel . . . there's no shortage of challenges facing America's public health officials. Men and women preparing to enter the field require state-of-the-art training to meet these increasing threats to the public health. But are the programs they rely on provide the high caliber professional training they require? Who Will Keep the Public Healthy? provides an overview of the past, present, and future of public health education, assessing its readiness to provide the training and education needed to prepare men and women to face 21st century challenges. Advocating an ecological approach to public health, the Institute of Medicine examines the role of public health schools and degree-granting programs, medical schools, nursing schools, and government agencies, as well as other institutions that foster public health education and leadership. Specific recommendations address the content of public health education, qualifications for faculty, availability of supervised practice, opportunities for cross-disciplinary research and education, cooperation with government agencies, and government funding for education. Eight areas of critical importance to public health education in the 21st century are examined in depth: informatics, genomics, communication, cultural competence, community-based participatory research, global health, policy and law, and public health ethics. The book also includes a discussion of the policy implications of its ecological framework.
How government can forge dynamic public-private partnerships All too often government lacks the skill, the will, and the wallet to meet its missions. Schools fall short of the mark while roads and bridges fall into disrepair. Health care costs too much and delivers too little. Budgets bleed red ink as the cost of services citizens want outstrips the taxes they are willing to pay. Collaborative Governance is the first book to offer solutions by demonstrating how government at every level can engage the private sector to overcome seemingly insurmountable problems and achieve public goals more effectively. John Donahue and Richard Zeckhauser show how the public sector can harness private expertise to bolster productivity, capture information, and augment resources. The authors explain how private engagement in public missions—rightly structured and skillfully managed—is not so much an alternative to government as the way smart government ought to operate. The key is to carefully and strategically grant discretion to private entities, whether for-profit or nonprofit, in ways that simultaneously motivate and empower them to create public value. Drawing on a host of real-world examples-including charter schools, job training, and the resurrection of New York's Central Park—they show how, when, and why collaboration works, and also under what circumstances it doesn't. Collaborative Governance reveals how the collaborative approach can be used to tap the resourcefulness and entrepreneurship of the private sector, and improvise fresh, flexible solutions to today's most pressing public challenges.
How do organizations with different values, interests, and worldviews come together to resolve critical public health issues? How are shared objectives and shared values created within a partnership? How are relationships of trust fostered and sustained in the face of the inevitable conflicts, uncertainties, and risks of partnership?".
New ideas on the role of the state in developing countries have considerable implications for the social sectors, especially health. Certain international organizations have advocated a larger role for private sector health care providers and many developing country governments have adopted this approach. Yet, until now, very little evidence has existed about how shifting the balance between public and private roles might affect equity, and the quality and efficiency of health care. This book presents the results from a coordinated programme of research on the private health care sector including studies carried out by Asian, African and Latin American researchers. The conceptual chapters draw upon both industrialized and developing country literature to describe the intellectual terrain, analyse the key issues and summarize experience to date. This book will help increase understanding of the private sector, as well as illustrating the contentious issues involved in privatization. It will be useful to students and academics involved in international public health courses, and to health policy makers in developing countries.
The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.
