Chapter 3: Powers and Responsibilities of Government

Describe the difference between federal vs state

U.S. Constitution states that a fundamental purpose of the government is “to promote the general welfare”

Reserve clause is interpreted to mean that, since health is not mentioned in the Constitution, responsibility for public health primarily belongs to the states

Interstate commerce provision justifies the activities of the Food and Drug Administration (FDA)

Power to tax and spend is widely used by federal government to control public health policy

• The federal government provides 65% of the fundings for Medicaid

The New Federalism limited Congress’s powers and returned authority to the states

Name the branches of government at the federal, state, and local level

Legislative

Executive

Judicial

Describe legislative

Passes statues

Describe the executive branch

Public health agencies carry out the law. They may issue regulations consistent with statues

Describe judicial

Laws and regulations can be challenged in court

Describe what state health departments do

DPH

Coordinate activities of local health agencies and provide funding

Collect and analyze data provided by the local agencies

Provide laboratory services

Manage Medicaid

License and certify medical personnel, facilities, and services

Handle environment, mental health, social services, and aging issues possibly through separate state agencies

Provide funding to hospitals to reimburse them for treating uninsured patients

Describe local public health agencies

Responsible for:

• Day-day public health tasks

• Core public health functions

• Providing medical care for the poor

Funding resources are variable

• City or county legislatures may not understand the importance of core functions

• Mandates may be funded by state or federal governments

Describe the Richmond County Health Department

Mission:

• To prevent disease, injury, and disability, promote health and well-being, and prepare for and response to disasters

Vision:

• A lean and responsive state government that allows communities, individuals and businesses to prosper

Describe the Centers for Disease Control Prevention

Is at the federal level

main epidemiologic and assessment agency for the nation

publishes morbidity and mortality weekly report (MMWR)

collects date on the US population concerning all aspect of health

addresses infectious diseases, chronic disease, injury prevention, and other issues

Describe the National Institute of Health

Federal level

largest biomedical research complex in the world

exists for cancer, heart, lung, and blood; diabetes; aging; child health and human development; and other topics

National Library of Medicine is an NIH Institute

has laboratories in Bethesda, MD and provides grant funding to researchers at universities and research centers

has a clinical center where medical researchers test experimental therapies

enjoys strong congressional support

Describe the nongovernmental (NGO’s) Public Health Organizations

Organizations that focus on specific diseases include:

• American Cancer Society

• American Heart Association

• American Diabetes Association

• Alzheimer’s Asssociation

Professional membership organizations:

• American Medical Association

• American Nurses Association

• American Public Health Association

Organizations that play a role in defining the future of public health

• National Association of City and County Health Officers

• Association of Schools and Programs of Public Health

• Association of State and Territoral Health Officers

Describe philanthropic foundations

provided funding, resources, and expertise to address a wide array of challenges. Operate independently and focus on specific problems

Examples:

• Bill and Melinda Gates Foundation

• Rockefeller Foudation

• Robert Wood Johnson Foundation

• Pew Charitable Trusts

• Kaiser Family Foundation

• Common Wealth Foundation