Six questions hospitals should consider to help rebuild America’s public health system
Picture this: A U.S. health system that responds to public health threats in a timely manner. A system that regularly performs community-based health status assessments to determine the community’s health needs. A system in which public and private providers, payers and practitioners have an adequate workforce; information, data and communications systems; and organizational and systems capacity to reduce the overall burden of preventable illness. That ideal picture bears little resemblance to today’s public health system, which is underfunded, undermanned and inadequate to meet the challenges of protecting and promoting all Americans’ health in the 21st century. Chronic disease has increased disproportionately, creating overwhelming reimbursement shortfalls for hospitals.
The National Steering Committee on Hospitals and the Public’s Health is calling on hospitals to fulfill a critical role as collaborators and leaders in recreating the U.S. public health infrastructure and capacity. In a new report, the committee of hospital leaders, public health directors and academics calls for a new paradigm and makes seven recommendations in areas where hospital leadership and involvement are urgently needed. Support for recreating the public health infrastructure and expanding capacity is one recommendation. The report was made possible through a cooperative agreement between the Centers for Disease Control and Prevention and the Health Research & Educational Trust.
Strengthening the public health system won’t happen all at once, but rather one part at a time. The report provides questions for assessing a hospital’s performance in improving public health:
1. What is your hospital’s relationship with local public health partners? How can a collaborative relationship be initiated and strengthened?
2. If there is no local public health authority in your community, who is responsible for public health and for environmental protection? How are you working with responsible officials?
3. Does your board of directors include local public health representatives and community members?
4. In what priority health areas do hospitals and public health in your community share or exchange expertise, staff, space and resources for mutual benefit?
5. In what ways is your hospital supporting the public health infrastructure beyond the hospital’s walls?
6. Are you doing all you can to support your community’s health? Take an inventory of what you are doing.
Public health interventions need to be substantiated. At Parkland, we are participating in outcomes and process research in the community to “prove up” our contributions or modify our next attempt at improving the community’s health.
By considering these questions, hospital leaders can collaborate with their public health counterparts, start or maintain active dialogue with local agencies, and advocate for adequate financial support to rebuild and maintain the U.S. public health system. Then a strong and cohesive system to attend to the public’s health will come into focus.
Ron Anderson, M.D., is president and CEO of Parkland Health & Hospital System, Dallas.
Access the “Report of the National Steering Committee on Hospitals and the Public’s Health” at www.hret.org.
This article first appeared in the March 2007 issue of H&HN magazine.