PH 381 - Comprehension Check #2

system mapping

identify how health department is embedded in the community, see what orgs are connected, measure the quality of these connections, strategize on how to fill gaps

• untangle web of relationships

• understand and change poor structures → we can expand the choices available to us to create more satisfying long term solutions to chronic problems

describe the healthcare delivery system parts

1. acute care

2. ambulatory care

3. long term care

4. community health

public health problem

the gap btwn desirable health status and the current health status

how to identify a problem in PH

1. getting to root cause

2. consider the affected

3. thinking about future possibilities

public health problem statement

clear, concise description of a PH issue, that includes info about its magnitude, impact, and who’s affected

describe the branches of the federal gov

1. legislative

   1. create laws

2. executive

   1. enact laws

3. judicial

   1. interpret laws

Describe the legislative branch

congress

• senate (100 chairs)

• house of reps (435 chairs)

describe the house of reps powers

• rules/precedent, voting

• initiate revenue bills

• impeachment of federal officiers

• elect president if electoral college is tied

describe the powers of the senate

• rules/precedent, voting, fillibusters

• impeachment and investigation

• nominations of judges/justices, ambassadors, etc

• declarations of war

describe the legislative process

legislation must pass with majority in house and senate before president sigs into law

• if legislation is vetoed by the pres, congress needs 2/3 majority in each body to override the veto

describe the executive branch

1. president

2. vice president

3. executive office (advisors, chief of staff)

4. the cabinet (15 department leaders)

   • appointed by president and confirmed by senate

   • agency advisors

describe the presidential powers and executive office

• responsible for implementing and enforcing laws written by congress

  • signing and vetoing legislation

executive office of the president includes:

1. chief of staff

2. director of the office of management and budget

3. white house communications office and press secretary

4. national security council

describe the vp powers

• break tie in senate

• can assume presidency if president unable

describe the judicial branch

1. supreme court (9 judges)

2. court of appeals (94 judges, 12 courts)

3. district court

what are the limits of the federal government and states

• US constitution divides power btwn states and federal gov

  • general welfare clause

• interstate commerce and regulation

  • taxes (revenue and spending)

  • regulations (safety, environ, etc)

what are the 4 types of law

1. constitutional

2. judicial

3. legislative

4. administrative

describe administative law (federal)

• rules and regs from within the exec branch

• earliest laws were for PH

• governs legal relationships btwn private subjects and the state or agency

• must align with US constitution

• cannot violate statuatory law

ex.) reg of food/air/chemicals *chevron deference

describe statuatory law (federal)

acts and statutes enacted by congress (must align w US constitution)

ex.) HIPAA, ACA

• statutory = strictly constructed by the courts

describe judicial law (federal)

• common laws that provide guidance when there are no regulatory standards

• can supersede or strike down any statutory of administrative laws based on the interpretation of the constitution

• constitution is THE guiding document

describe federal agencies (???)

• exec = health/human services, interior, commerce

• department of health and human services

chevron deference

• 1984: chevron vs natural resources defense council

  → if federal legislation is unclear, courts should defer to reasonable interp of relevant agency

• 2024: loper bright vs. department of commerce

  • determined regulatory agencies expanded their powers beyond what congress intended

  • SCOTUS overturns chevron deference → reduces power of agency

Describe the budget process

1. president submits budget to congress

2. house and senate mark up and pass budget

3. house and senate conference the budget resolution

4. spending bills passed by appropriations committee

5. reconciliation/authorization

6. new fiscal year begins (oct 1)

describe the office of management and budget

• budget development and execution

• management: oversight of agency performance, procurement, financial management, info tech

• review federal regs from exec agencies

• 3 of 5 functions (idrk what this means)

describe the congressional budget office (CBO)

works alongside congress to provide important, non-partisan information on budget and economic policy

describe the role of states in public health

• state scan create laws and regulations

• police powers

• 10th amendment - power to the states

describe the 10th ammendment

power to the states

• the powers not delegated to the US by the constitution, nor prohibited by it to the states, are reserved to the states respectively, or to the people

  • states can create laws and regulations

  • people can vote

3 branches of state gov

1. legislative

2. executive

3. judicial

• same as federal gov

describe “police powers”

states have the authority to enact laws and promote regulations (ex. privacy, autonomy, economic interest)

• can promote general welfare and protect/preserve/restrict private interests within limits set by the state and federal constitutions

• definition of “police powers” = the product of legislative determinations addressed to the purposes of the gov → incapable of complete definition for police powers

Describe the use of preemption

when 2 authorities disagree, the higher authority of law will supersede (or “preempt”) the law of the lower authority

• ex.) riverside CA vs health department: voters passed legislation to enhance patients access to medical marijuana

What are the 3 essential PH services?

1. assessment

2. policy development

3. assurance

Describe community orgs

1. non-gov: not a function or under the authority of the gov

2. non-profit: multiple types, legal and tax status, social or public benefits

3. charitable/philanthropic

What are the types of community orgs? describe them.

1. CBO: community based organization

   • rooted to a place, local relationships/ties, group/issue specific

2. CSO: community serving organization

   • services a community but may not be from or in the community

3. CPBO: community power building organization

   • works to change laws/policies that impact a specific group (may be related to an issue or geo)

how do community orgs center communities in PH?

ID challenges, tailored interventions, relationship and resource building, long term solution, recognizes community power

What are the core values of CBO relationship building?

1. seek to understand, acknowledge, shift, and share power

2. commit to centering community

3. practice accountability and transparency → trust

4. recognize harms, build, heal

5. promote mutual benefit and natural strengths

Describe CPBOs

• building the ability of communities most impacted by structural oppression to set the agenda toward changing systems to create and sustain healthy communities and the ability to achieve that agenda

  • focus on structural and long term change

  • growth of PH related initiatives

  • data driven and strategic

• building community capacity

  • moving beyond CBOs

describe successful PH interventions

informed and developed by and for communities

explain the “general welfare” clause in the constitution

• allows that the governing body empowered by the document to enact laws to promote the general welfare to the people

• PH applications (???)

→ sep of powers: gives congress the power to legislate on any national problem