According to the World Health Organization -- “Public health refers to all organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole” (WHO N.pag). Due to the scare of pandemic diseases such as Avian Influenza, SARS and Ebola virus have compelled the government of the United States to emphasize on public health. Recent surveys reveal that despite the world-class surveillance and diagnostic capabilities, the United States government should always remain prepared for health outbreaks. After the horrendous attack of 9/11, the American government started to marshal both their legal authority and financial assets for combating any potential threats to the public health.
The threat of pandemic diseases are usually considered and addressed in terms of national security. The American system of federalism and their fragmented infrastructure of public health results in the expenses of control plans and measures falling on the local and state governments, with greatly disproportionate impact and uneven effectiveness in a few communities (Price 921-929).
Current Status of Public Health
On 23 March 2010, President Barak Obama signed the PPACA (Patient Protection and Affordable Care Act), commonly known as ACA into the law. There are few important mandates about public health in this legislation for health reform. The reform of public health involves the development of several new programs for prevention and increased the development and monitoring of the workforce managing public health. The new healthcare reform includes four main features related to public health, these are;
Patient Protection and Affordable Care Act (PPACA)
The ACA was designed for encouraging and realigning collaboration between the healthcare system and the public health. The legislation focuses on health system and insurance reform, the PPACA includes many provisions that carry important public health implications. The PPACA explicitly calls for initiatives for promoting public health and prevention strategy: The National Prevention Strategy and The Prevention and Public Health Fund. Also, the reform has several opportunities for improving public health. The Internal Revenue Service (IRS) in the new reform requires all non-profit hospitals complete a CHNA (community health needs assessment) in every three years and annually report the level by which they address the identified needs. Although CHNA has been conducted by the local health departments for several years, the ACA requirement presents an opportunity for health departments and hospitals to work together on improvement and assessment of the public health (Jordan & Duckett N.pag).
HHS Prevention and Public Health Fund
The ACA (Affordable Care Act) also established the PPH (Prevention and Public Health) Fund for providing sustained and expanded national investments in public health and prevention, for improving the health outcomes and enhancing the quality of health care. Till now, this fund has been investing in the a range of activities based on evidence including initiatives on clinical prevention; public health infrastructure, research, surveillance and tracking, tobacco prevention, immunizations and screenings and public health training and workforce. In the 2012 Consolidated Appropriations Act, initially the Congress directed the HHS to build a website that reports on the use of funds presented through the funds of Prevention and Public Health (Health and Human Services N.pag).
NPHII (National Public Health Improvement Initiative)
This NPHII initiative has been built to provide support for health departments and their bona fide representatives for accelerating the accreditation of public health and readiness activities.
Also, implementation of performance and improvement management systems and practices is also part of the initiative. The initiative also includes implementing and sharing the practice-based evidence. In the year 2013, Centre of Disease Control released additional $32.5 million, for funding 73 territorial, states, local and tribal health departments, supported by the PPACA (CDC N.pag).
National Prevention Strategy
On 16 July 2011, the National Prevention Strategy was released, which would guide the United States of America in the most achievable and effective means for improving national well-being and health. This strategy prioritizes the prevention of public health outbreaks by integrating actions and recommendations across several settings to better health and protect lives.
This strategy predicts a prevention-oriented society in which all sectors recognizes the importance of health for society, families, and individuals and work with each other for achieving better health for all Americans (HHS N.pag).
Actions to Prevent Outbreaks
The American government has a well-developed and strong (although largely untested) regulations that enable the health providers and professionals to respond swiftly to any potential epidemic outbreak. Quarantine and isolation are the practices of public health used for limiting and stopping the spreading the disease. Legal tools protecting the public limit the exposure of infection to the infected and the people that might get infected. Apart from serving the medical functions, the state holds the right to isolate and quarantine people for the benefit of the American public. The government is willing to practice their right and ensure there are no outbreaks of epidemics in the country (Price 6).
When the American Government learns about an epidemic, agencies start consulting with each other for deciding the response and the management plan. The government agencies having relevant expertise are CDC, NIH, FDA, USAID or DoD. Among them, CDC is a prime organization who prepares for preventing any possible pandemic. CDC is at the core of the American public health system, and the organization exists for protecting the people and communities and saving people lives through disease control and managing outbreaks like Ebola and H1N1. The EOC (Emergency Operations Center) of CDC works at the centre of command that help to monitor and coordinate the emergency responses to any threat to the public health.
EOC is staffed with a 24X7 service and it serves as the main point of contact to report health threats like natural disasters, pandemic flu and terrorist activities (CDC Foundation N.pag).
In case a pandemic outbreak happens such as the Ebola or H1N1 virus, the CDC conducts an investigation to provide assistance to cities, communities, states and international partners facing the outbreak. The technical assistance includes consultation, patient management, lab testing, lab work analysis, patient care and management infection control and tracking the contacts. The primary goal of the CDC is to determine the reason of the pandemic and the source of the toxin/virus/infection, learning about the transmission, method of spreading, breaking the transmission cycle and prevent further spread and treatment of present cases. Scientists in the CDC labs would work for the development of vaccines, preparing the vaccines, distribution and administration of the vaccines to the public (CDC Foundation N.pag).
The current method in place for public health system is working efficiently as seen in the case of CDC managing the inflow of Ebola in the United States through quarantine and pandemic management. Despite all the advances in technology and medicine, Americans remain at a larger risk than before from infectious diseases, potential bioterrorism organisms and drug resistant infections (Sun N.pag). In case of bridging healthcare delivery and public health, the United States carries an opportunity for learning from innovations linking the social services, public health and the health care system. In the year 2013, the U.S. spent around $2.9 trillion on health care. This means almost $10,000/person, greater than any other country in the world. Despite the 2010 launch of ACA and the slowdown of spending, the United States is still outspending other countries, whose citizens are leading healthier lives.
The United States remains one of the richest countries in the world and still Americans are still dying younger from heart disease, chronic illness, lung disease, diabetes, AIDS/HIV and obesity that peer countries. For strengthening the integration of public health systems and service, it is important the right building blocks are used for helping the communities respond to any emergency, provide access to high quality of care and develop support ensuring healthy choice becomes the easy choice. Food, safety and shelter become priorities for several people before they start focusing on getting medical care. The government can make it easier on the people by coordinating health care and support sectors to provide quality service to most people (Ahmad N.pag).
The public health system in the United States works for to preventing disease, prolonging life and promoting health. The public health system was reformed in the year 2010 with the signing of the Affordable Care Act. This act is built to help the American public health system better and prevent disease, prolong life and promote health. CDC is an organization under the new system that carries the responsibility of managing the health of American public and preventing spread of epidemics. The government has been using isolation and quarantine as techniques for managing the pandemics in the country. There are still actions that can be taken for improving the public system by aligning all healthcare services and support organizations to deliver the highest quality of care.
Ahmad., N. Three Things the United States Can Learn About Public Health From Around the World. Culture of Health. rwjf.org. 23 June 2015. Web. 23 July 2015.
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CDC Foundation. How CDC saves lives by controlling REAL global disease outbreaks. CDC. cdcfoundation.org. 2015. Web. 2015.
Jordan., N & Duckett., P. The Affordable Care Act and Public Health. Public Health Review 2.1 (2014) N.pag. Print
Price, P. J. "Sovereignty, Citizenship and Public Health in the United States." New York University Journal of Legislation and Public Policy 17 (2014): 919-988 . Print.
Price, P. J. "Ebola and the Law in the United States: A Short Guide to Public Health Authority And Practical Limits." Emory Legal Studies Research 14.299 (2014): 1-26. SSRN. Web. 23 July 2015. <http://dx.doi.org/10.2139/ssrn.2538187>.
Sun., L.H. U.S. launches new global initiative to prevent infectious-disease threats. The Washington Post. washingtonpost.com. 13 February 2014. Web. 23 July 2015.
WHO. Public Health. World Health Organization. who.int. 2015. Web. 2015.
U.S. department of H.H.S. Prevention and Public Health Fund. HHS. hhs.gov. n.d. Web. 2015
U.S. department of H.H.S. National Prevention Strategy. HHS. surgeongeneral.gov. 24 July 2015. Web. 24 July 2015.