Standards for local public health services: where stand the states?
(17/21)
Of the 47 states that participated in a 1983 survey of State Health Departments, 30 were found to have public health standards in place or started. Most states' standards emphasize the range of services to be provided, but substantial variations were found in how standards are formulated, adopted, and used by state and local agencies. (+info)
Current tuberculosis screening practices.
(18/21)
Health department officials in all 50 states and 14 major cities responded to a survey questionnaire designed to obtain information about current tuberculosis screening practices. Persons being screened fell into the groups designated as high risk by the American Thoracic Society (ATS) and the Centers for Disease Control (CDC). The methods used for screening were generally those advocated by ATS, CDC, and the Food and Drug Administration (FDA), although chest radiographs continue to be overused. Screening in about one-half of the groups is mandated by law or regulation. There appears to be some confusion about the circumstances in which "two-step" tuberculin testing should be used. Data on the productivity and costs of screening activities were very limited. We encourage those responsible for tuberculosis screening programs to evaluate them, discontinue those which are unproductive, and intensify those which are productive. (+info)
Health planners and local public finance--the case for revenue sharing.
(19/21)
Little attention has been paid by health planners or researchers to questions of local public finance. However, a review of the literature concerning general revenue sharing (GRS) funds indicated that about $400 million per year from this source is spent on health services and resources. GRS funds, about $6.4 billion per year, are distributed to more than 39,000 State, county, and city governments. The 1976 amendments to the General Revenue Sharing Act eliminated restrictions on the use of the funds, and they can be employed as matching funds for other Federal monies. An exploratory study of the use of GRS funds for health purposes was conducted in several localities, with particular attention to the health systems agencies. Its results confirmed that there are wide variations among localities in the use of revenue-sharing funds to support health services. Also, not only did the health systems agencies' officials have little impact on the allocation of revenue sharing funds, but only in one locale had an HSA official taken a direct role in the budgetary process. Health planners, who were interviewed during the study, described what they considered their agencies' proper role in local budgetary matters. (+info)
Migrant health revisited: a model for statewide health planning and services.
(20/21)
Since the migrant farmworker family is a marginal issue among competing priorities for public health services, the logical strategy ought to be the pooling of limited resources at the state and local level to provide maximum benefit for the dollar and the client. A program planning model in inter-agency migrant health services delivery has been developed in Colorado. The model includes tangible evidence of cooperation by front-line service agencies. A task force approach for joint agency programming was initiated at state and local levels, and a structure for accountability was established which was carried out with performance contracts. (+info)
Asthma. The states' challenge.
(21/21)
At the national level, asthma is increasingly being recognized as an important public health problem. Because of the significant role of environmental exposure in asthma morbidity, public health agencies have a critical role to play in the surveillance and prevention of the disease. In April 1996, the Council of State and Territorial Epidemiologists, with assistance from the Centers for Disease Control and Prevention, surveyed state and territorial public health departments to determine the status of their asthma surveillance and intervention programs. Of the 51 health departments that responded, only eight reported that they had implemented an asthma control program within the previous 10 years. Reasons cited for not having programs included lack of funds, shortage of personnel, and asthma not being a priority. Most states were unable to assess the burden of asthma because they lack data or face barriers to using existing data. Removing barriers to the use of data is a first step toward defining the scope of the asthma problem. (+info)