PERFORMANCE STANDARDS FOR STATE AND LOCAL HEALTH DEPARTMENTS

Public health departments are organizations established by state and local governments to protect and promote the health and safety of the people living in or visiting the area served by a state or local government. Public health departments protect and promote health and safety by assuring delivery of the ten Essential Public Health Services which are described as:

• Monitoring community health to understand patterns of disease, injury, and environmental threats to the public's health.
• Diagnosing and investigating occurrences of disease, injury, and environmental hazards in order to control and prevent people from suffering ill health effects.
• Informing, educating, and empowering people to understand health risks and use of preventive measures to protect and promote health and safety.
• Mobilizing people in communities to take collective actions and form partnerships to solve community health problems.
• Developing policies and plans that support individual and community health improvement efforts.
• Enforcing laws and regulations that protect health and ensure safety.
• Linking people to needed personal health services and assuring the provision of health care when otherwise unavailable.
• Assuring that a competent public and personal healthcare workforce is available to people.
• Evaluating effectiveness, access, and quality of personal and population-based health services.
• Conducting research to gain new insights and develop innovative solutions to control or prevent health and safety problems.

Public health departments are not the only organizations that contribute to protecting and promoting the health and safety of state and local populations. A variety of other organizations provide services that protect and promote population health and safety. Public health departments have a leadership responsibility to work with these public health partners to assure all people are served by programs that effectively protect and promote health and safety.

The capability of state and local health departments to perform these roles varies across the United States. This difference in capability leaves some people at greater risk of experiencing a preventable health problem. Such differences in the capacity and performance of public health systems are unacceptable to public health leaders. To assure state and local public health departments provide effective leadership in the public health system, model standards have been developed to assess the capacity and performance of public health systems and to guide improvement activities. These model standards have been established by the U.S. Centers for Disease Control and Prevention (CDC) in partnership with the Association of State and Territorial Health Officials, the National Association of County and City Health Officials, the National Association of Local Boards of Health, the American Public Health Association, and the Public Health Foundation. Similar standards have been adopted in other countries.

The model standards established by these public health organizations describe an optimal capacity and performance level necessary to effectively deliver the essential services described above. By measuring how well public health systems achieve these model standards, public health departments and their partners can identify improvement needs and take steps to enhance the quality and performance of essential public health services delivery. Improvement in performance of essential services will facilitate effective protection and promotion of everyone's health and safety.

Paul K. Halverson

Michael T. Hatcher

(see also: Association of State and Territorial Health Officials; Boards of Health; Community Health; Community Health Report Cards; Essential Public Health Services; Practice of Public Health; Practice Standards; State and Local Health Departments )

Bibliography

Corso, L. C.; Wiesner, P. J.; Halverson, P. K.; and Brown, C. K. (2000). "Using the Essential Services as a Foundation for Performance Measurement and Assessment of Local Public Health Systems." Journal of Public Health Management and Practice 6(5):1–18.

Halverson, P. K. (2000). "Performance Measurement and Performance Standards: Old Wine in New Bottles." Journal of Public Health Management and Practice 6(5):vi–x.

Harrell, J. A.; Baker, E. L. et al. (1994). Public Health in America. Washington, DC: U.S. Public Health Service, Public Health Functions Steering Committee.

Mays, G. P. et al. (1998). "Assessing the Performance of Local Public Systems: A Survey of State Health Agency Efforts." Journal of Public Health Management and Practice 4(4):63–77.

Turnock, B. J. (2000). "Can Public Health Performance Standards Improve the Quality of Public Health?" Journal of Public Health Management and Practice 6(5):19–25.