The document discusses the roles and responsibilities of local health departments in providing public health services. It describes how the nearly 3,000 local health departments in the US vary in size and services depending on the community needs. The core services identified by the National Public Health Performance Standards Program include monitoring health status, diagnosing and investigating diseases, informing and educating the public, developing health policies and plans, and enforcing regulations. Employees of local health departments are responsible for assessing community health needs, investigating disease outbreaks, providing health education, and ensuring access to healthcare. The Washington County Health Department in Tennessee was used as an example, outlining its mission and services such as WIC, immunizations, and health promotion programs.

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Public Health and Health Care
Debbie Fernando
HCS/535
June 10, 2013
Dr. Michelle Clemons

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Public Health and Health Care
Public health is defined as “the approach to medicine that is concerned with the health of
the community as a whole” ("Definition of Public Health", 2013). Without public health, health
care would be in vain. A person could be in perfect health one day, come in contact with a
person with a contagious disease, and be dead within twenty-four hours. This may be an extreme
example, but however improbable, it is not impossible. Public health consists of federal, state,
and local levels. This paper will discuss the local health department.
Local health departments
According to "The National Academies Press" (2013), “Local health departments (LHDs)
have a fundamental and complex role as the front line for delivery of basic public health services
to most of the communities in this country” (para. 3). The nearly 3,000 local health departments
in the United States vary greatly in size, depending on the size and nature of the community. The
local health departments also vary in economic circumstances and the governing organizations to
which they answer. The health departments provide a wide variety of services depending on the
needs of the community they serve. Although the services of local health departments vary, the
majority of them provide ten core services. The National Public Health Performance Standards
Program (NPHPSP) has defined the ten core services that should be provided by each local
public health department. They include:
 Monitor
 Diagnose and investigate
 Inform and educate
 Mobilize
 Develop policies and plans

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 Enforce
 Link
 Assure
 Evaluate
 Research
Local health department employees’ responsibilities
Local health department employees have the responsibilities to monitor the health status of
the community to identify and solve community health related problems. This involves assessing
community wide health status, determinants, threats, and needs. Data of populations who are
greater risk than the general population of the community must be monitored. This also involves
using demographics and technology to reach diverse populations. It also involves communication
with other providers and health benefit plans to share data. LHD employees diagnose and
investigate health problems and hazards. Here they perform epidemiological investigations of
disease outbreaks and follow patterns of infectious diseases, the development of chronic disease,
and other environment dangers. They must have a lab capable of conducting rapid screening of a
high volume of patients. They inform, educate, and empower the community regarding health
issues. Here they provide health education and promote activities to better the health of the
population. Community partnerships mobilize and identify and solve health problems. LHD
employees also promote partnerships with providers, school, employers, etc… to help the
population understand the importance of good health and how to obtain good health. LHDs
develop policies and plans that support individual and community health efforts. Here they
develop policies to protect the health of the community. They also see that laws and regulations
that protect health and ensure safety are enforced. They also enforce childhood immunizations,

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seatbelt laws, the maintenance of a clean water supply and restaurant evaluations. They inspect
safety in work places, schools, and make certain health care facilities are up to standards. They
also link people to needed personal health services and assure the provision of health care when
otherwise unavailable. They try to make certain that people who do not have access to health
care can obtain it, whether it is due to lack of money, culture, demographics or whatever is
keeping them from getting health care. They assure competent public and personal health care
workers. They make certain that public health care workers maintain the certifications for their
licenses, continuing education is provided for health care providers, and there is continuous
quality improvement. Then they evaluate the effectiveness, accessibility, and quality of personal
and population-based health services. They evaluate their programs and make adjustments
accordingly. Finally, they research for new insights and innovative solutions to community
health problems. They look for even more improved planning and implementing better policies.
They look to academia for new information on ways to improve what they are presently doing.
("National Public Health Performance Standards Program ", 2010).
Washington County Health Department
Local health departments have brochures and literature if someone has questions but are
too shy to talk to someone. There are brochures on STD’s, pregnancy prevention and counseling,
and more. The local health department in Washington County, Tennessee, has its mission
statement posted on the wall. It is “Protect, Promote, and Improve the health and prosperity of
people in Tennessee”. The Commissioner’s Goals are “to achieve our unique competencies
through community efforts in Primary Prevention, Initiatives and to promote effective and
efficient government through People-Centered, Performance, and Improvement”. The suites

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included are WIC, Immunizations, International Travel, Nutrition, Health Promotion, Dental,
Primary Care, Birth Certificates, Death Certificates, Women’s Health, and CHAD/HUGS/CSS.
Their bulletin board displays “Safe Sleep” with instructions on how to place a newborn in the
crib, nutrition, demonstrating hand portion sizes of the food groups that people should consume,
and more. Some of The brochures found at the Washington County Health Department include
NET-VAC (Northeast Tennessee Vulnerable Adult Coalition), Poison Prevention, Notice of
Privacy Practices, Healthy Foods, and more (Johnson City, TN, Washington County Health
Department, personal communication, June 10, 2013).
Conclusion
Public health and health care go hand in hand. If public health was not a part of our
national health care, individual health care would be useless. Local health departments play a
huge role in keeping the population healthy, whether the population does its part in maintaining
good health. This is provided by environmental checks and rules, surveying contagious diseases
and immunizations. The population along with its local health department has the opportunity for
better health care that continues to improve.

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References
Definition of public health. (2013). Retrieved from
http://www.medterms.com/script/main/art.asp?articlekey=5120
National Public Health performance standards program . (2010). Retrieved from
http://www.cdc.gov/nphpsp/essentialservices.html
The National Academies Press. (2013). Retrieved from
http://www.nap.edu/openbook.php?record_id=10542&page=145

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