Local the US public health system was in disarray

Local Boards of HealthThe local boards of health started with the purpose of scoping with the epidemics in the United States (Epidemics and Public Health, 2003). The enactment of the 1866 New York Metropolitan Health Act marked a significant turning point in the history of public health not only in New York City but also in the US. The state law created the New York Metropolitan Board of Health as well as giving the new board the power to establish and to enforce the regulations with the purpose of protecting the public’s health (Tobey, 1047). Since its inception, the New York Metropolitan Board of Health had served as the governance model for cities across the country to preserve the well-being of their citizens (Fallon, 2009). In subsequent years, the scope of the local boards of health had evolved beyond controlling the spread of the diseases (Duffy, 1990). ?The Six Public Health Governance FunctionsThroughout the history of the American public health, the works of the local boards of health often go unnoticed until a public health crisis arises (Holsinger, 2013).

The 1988 IOM report revealed that the US public health system was in disarray and described the importance of a government presence in the system to accomplish its mission. The report further defined the role of the public health governmental agencies as assessment, policy development, and assurance (IOM, 1988). Subsequently, this publication led to the contemporary efforts to better describe the public health governmental entities during the 1990s (Holsinger, 2013).In the early 1990s, although researchers had used the three core functions as a basis for various studies on public health activities, they recognized the need for a more specific description of public health (Corso et al., 2000). In 1993, the CDC expanded the three core functions of public health to the ten basic practices, each link to one of the core function (Appendix A). These practices provided a groundwork for measuring public health performance in local jurisdiction (Turnock & Handler, 1994 and Corso et al., 2000).

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An impressive amount of scholarships emerged in support the framework (Miller, 1995). Concurrently, the collaboration of the NACCHO, the Association of State and Territorial Health Officials (ASTHO), and the US Office of Assessment Secretary for Health introduced a similar list, the ten essential elements of a healthy community (Appendix B). The list was developed under the political dynamic at that time when the country headed toward health reform.

The health services delineated public health activities more understandably for external audiences and constituencies with the purpose of communicating a clear role of public health to the elected officials and policymakers (Miller et al., 1994 and Corso et al., 2000). Although these two formulations were compatible, embodying the same concept, they were derived for different applications (Turnock & Handler, 1995). There was a need for the consolidation of one standard list of public health services that not only clearly described these activities to the constituencies but reliable measure these efforts as well (Harrell & Baker, 1994, Turnock & Handler, 1995, Corso, 2000 and Holsinger, 2013). During 1993 – 1994, President Clinton assembled the Public Health Functions Steering Committee that included public health representatives from US service agencies and organizations across the nation. The committee provided a consensus list of ten essential public health services defining the activities that all communities must undertake as in Appendix C (Harrell & Baker, 1994).

 While the public health scholars used the framework of three core functions and ten essentials health services in various research, the practitioners based on the same scheme to develop and implement the standards to measure the performance of the governmental public health agencies at all levels (Bakes-Martin et al., 2005). In 1998, CDC, NACCHO, and their partners established the National Public Health Performance Standard Program (NPHPSP) to generate a national set of performance standards for public health practices (Holsinger, 2013). NACCHO released the first version of local public health governance assessment in 2002 and updated to the second version in 2007. In preparation to upgrade the standards to its version 3 during 2011 – 2013, CDC, NACCHO and NALBOH conducted a review to aid in validating, refining and modernizing the public health governance functions. As a result, NALBOH released the definition of six public health governance functions (Appendix D).

In 2013, NACCHO released the third version of local public health governance assessment. The six public health governance functions served as the foundation for this newest set of standards (Carlson et al., 2015).