For the Public's Health:
Revitalizing Law and Policy to Meet New Challenges
Committee on Public Health Strategies to Improve Health; National Research Council
Available online at: http://bit.ly/j168fs
“…..Laws transform the underpinnings of the health system and also act at various points in and on the complex environments that generate the conditions for health. Those environments include the widely varied policy context of multiple government agencies, such as education, energy, and transportation agencies, as well as many statutes, regulations, and court cases intended to reshape the factors that improve or impede health.
The measures range from national tobacco policy to local smoking bans and from national agricultural subsidies and school nutrition standards to local school-board decisions about the types of foods and beverages to be sold in school vending machines.
Funding that supports the activities of public health agencies is provided primarily by federal, state, and local governments. However, government budgets must balance a variety of needs, programs, and policies, and the budgets draw on different sources (including different types of taxes and fees), depending on jurisdiction. Therefore, the funds allocated to public health depend heavily on how the executive and legislative branches set priorities.
Other funding sources support public health activities in the community, including “conversion” foundations formed when nonprofit hospitals and health insurers became privatized (such as The California Wellness Foundation). Additionally, funds for population health and medical care activities may be provided by community-based organizations with substantial resources, not-for-profit clinical care providers, and stakeholders in other sectors.
The subjects addressed in the three reports are not independent of each other and, indeed, should be viewed together. For example, measurement of health outcomes and of progress in meeting objectives can provide evidence to guide the development and implementation of public health laws and the allocation of resources for public health activities.
Laws and policies often require the collection of data and can circumscribe the uses to which the data are put, for example, prohibiting access to personally identifiable health information. Similarly, statutes can affect funding for public health through such mechanisms as program-specific taxes or fees. And laws shape the structure of public health agencies, grant them their authority, and influence policy.
In the three reports, the committee will make a case for increased accountability of all sectors that affect health—including the clinical care delivery system, the business sector, academe, nongovernment organizations, communities, and various government agencies— wherever possible, with coordination by the government public health agency leading or coordinating activities and sectors…..”
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