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The Future of Public Health (1988) / Chapter Skim
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1. The Disarray of Public Health: A Threat to the Health of the Public
Pages 19-34

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From page 19...
... These and many other problems raise in common the need to protect the nation's health through effective, organized, and sustained efforts led by the public sector. Unfortunately, the explorations of this committee, as documented in this report, confirm that our current capabilities for effective public health actions are inadequate.
From page 20...
... Therefore, the committee intends this report for a broad audience that includes elected public officials at all levels of government, voluntary health organizations, health care providers, educators of all of the health professions, and private citizens with interests in maintaining and improving health in their communities. To help these broad audiences understand why we believe this topic is important to them and their communities, we begin by citing examples of specific threats that can be averted or lessened only through collective actions aimed at the community, in contrast with personal medical services initiated by patients or individual practitioners.
From page 21...
... More than any other event of recent years, the AIDS epidemic has reminded us of the necessity of effective public health actions to protect individuals and society. ACCESS TO HEALTH CARE FOR THE INDIGENT About 43 million Americans, or 18 percent of the population, do not have a physician, clinic, or hospital as a regular source of health care.
From page 22...
... It has also been documented that the gap between rich and poor is widening. Access to health care services in this country has become a crisis both for the population that has difficulty obtaining care and for providers of care, the latter often publicly owned or financed, and the growing reluctance of private health care institutions to provide free care is placing an increasing financial burden on public institutions.
From page 23...
... (The Robert Wood Johnson Foundation, 1985) Studies in several cities indicate that an overwhelming proportion of the medically indigent are admitted or transferred to public hospitals and university hospitals when seeking care.
From page 24...
... (Committee on Trauma Research, Commission on Life Sciences, National Research Council, and Institute of Medicine, 1985) TEEN PREGNANCY About half a million babies are born each year to teenage mothers in the United States.
From page 25...
... Family planning services offered by many public health agencies as well as by private providers can prevent unwanted pregnancies but are underutilized. When pregnancies do occur, efforts in health education and maternal and child health services are needed to improve pregnancy outcomes.
From page 26...
... In 1986, high blood pressure control rates varied among communities from 25 to 60 percent. (Office of Disease Prevention and Health Promotion, Public Health Service, U.S.
From page 27...
... Also, smoking is the major identifiable cause of residential fire deaths and injuries in the country and is associated with higher injury and chemical illness risk in many occupations. About 30 percent of all adults and about 20 percent of high schoolers in the United States regularly smoke cigarettes, but those proportions have decreased from 33 percent of adults and 27 percent of high school teenagers in 1979.
From page 28...
... Intravenous drug use also is a major risk factor for contracting AIDS virus infection from contaminated needles and syringes. The three habits of smoking, alcohol abuse, and drug abuse have consistently been related to poor pregnancy outcomes.
From page 29...
... Toxic SUBSTANCES The problem of hazardous waste generated by industry becomes bigger with each new discovery of environmental contamination from improper disposal of toxic materials. Contamination exists in ground water, air, soil, and food and has serious implications for public health.
From page 30...
... Implementation of federal toxic substances control laws, such as the Toxic Substance Control Act (TSCA) and the Federal Insecticide, Fungicide and Rodenticide Act, has raised numerous questions concerning testing of thousands of chemicals in commercial use, including who should test them, when they should be tested, and for what effects they should be tested.
From page 31...
... The successes of past public health efforts are many. The virtual elimination of many infectious diseases, such as typhoid fever and paralytic polio; great reductions in many of the common childhood communicable diseases (Committee on Public-Private Sector Relations in Vaccine Innovation, Institute of Medicine, 1985~; and initial progress in the control of common chronic diseases, such as heart disease, stroke, and some forms of cancer (Office of Disease Prevention and Health Promotion, Public Health Service, U.S.
From page 32...
... While individual action to improve health is necessary, it is not enough, and, as the above examples illustrate, health status will fall short of the achievable if public health is not strong. To provide a comprehensive and well-founded strategy to overcome the current disarray, the rest of this volume will examine and reaffirm the concepts of public health, develop a desirable framework for public health action, assess the current status of public health as an organized activity in the United States, and finally, recommend specific actions and directions that will provide a vigorous and effective public health enterprise sufficient to the challenges that lie ahead.
From page 33...
... Public Health Reports, supplement to the September-October 1983 Issue. Office of Disease Prevention and Health Promotion, Public Health Service, U.S.
From page 34...
... 34 THE FUTURE OF PUBLIC HEALTH Secretary's Task Force on Alzheimer's Disease, U.S. Department of Health and Human Services.


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