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Deals with the position paper presented to the President's Committee on Health Education in Boston, Massachusetts on January 6, 1972 concerning health promotion in the U.S. Basis of the health promotion recommendations of the paper; Importance of having a massive consumer health education effort; Establishment of state health education training centers.

Public health officials promoted COVID-19 vaccines to limit burdens placed on the U.S. healthcare system and end the pandemic. People in some closed religious communities refused to vaccinate and likely acquired temporary immunity through infection. This paper compares the death rates in Amish, Old Order Mennonites, and conservative Mennonite groups to a rate estimated for the U.S. population. Approximately two-thirds of the U.S. population was immunized against COVID-19, while few in the Amish/Mennonite community were. We find divergent patterns. Once vaccines became available, excess deaths declined in the general population and remained elevated among Amish and Mennonites. Vaccination campaigns must consider and value the cultural beliefs of closed religious communities to be effective. [ABSTRACT FROM AUTHOR]

Purpose: As of 2016, an estimated 15.5 million cancer survivors were living in the United States and the number of cancer survivors is expected to increase to 20.3 million by 2026. Numerous clinical studies have shown that comorbidities, such as obesity and diabetes, and unhealthy lifestyle choices, such as physical inactivity and heavy smoking, negatively influence overall quality of life and long-term survival of cancer survivors. Accordingly, survivorship programs seek to focus on overall wellness, including symptom management, monitoring for late effects of treatment, monitoring for recurrence, helping patients adapt healthy behaviors, and quality of life. This paper provides a broad overview of public health efforts to address the needs of cancer survivors.Methods: To describe a range of examples of survivorship initiatives in comprehensive cancer control, we analyzed documents from comprehensive cancer control programs and coalitions and solicited detailed examples from several national partners.Results: Comprehensive cancer control programs, coalitions, and partners are undertaking myriad initiatives to address cancer survivorship and building upon evidence-based interventions to promote healthy behaviors for cancer survivors across the country.Conclusion: A coordinated public health approach to caring for the growing population of cancer survivors can help address the long-term physical, psychosocial, and economic effects of cancer treatment on cancer survivors and their families. [ABSTRACT FROM AUTHOR]

Health information technology research has historically suffered from the persistence of paper-based systems as a barrier to research and refinement of information models. While the field of (non-medical) information science offers a potentially rich source of data, there exist relatively few theoretical links between medical and non-medical information models. This paper argues that the establishment of an integrated translational research pathway is not only useful, but is a critical and necessary step in the realization of a national health information infrastructure in the USA. [ABSTRACT FROM AUTHOR]

The U.S. Department of Health and Human Services implemented the Healthy People initiative to set national health objectives for four different decades since 1979. This national effort has promoted a shared vision for improving the health of all Americans in a very fragmented health care delivery system. The current Healthy People 2020 initiative being implemented by the Department's Office of Disease Prevention and Health Promotion differs from previous efforts in several important ways. This paper explores one of these changes: implementation of a new communication strategy based in modern information technology. This strategy conceptualized a Healthy People 2020 online space that would be a user-focused, 'one-stop shop' for public health and health care professionals, policymakers, and community members to learn about the objectives, plan interventions, and implement strategies to reach the 2020 objectives. The communication strategy incorporated new digital media, including building a following on LinkedIn and Twitter. At present, membership in the Healthy People LinkedIn group is more than 7700 people, and the Healthy People Twitter account (@gohealthypeople) has nearly 50 000 followers. In addition to the growth in number of users, the success of the communication strategy is also confirmed by the consistently high customer satisfaction rankings the site receives from the American Customer Satisfaction Index E-government Satisfaction Index. New developments in digital communication technology have the potential to advance three principal functions originally conceptualized for Healthy People 2020 online: benchmarking, advocacy, and connecting with others. Several exciting digital tools can be used to implement each of these key Healthy People 2020 functions, including mobile Web site optimization, smartphone/tablet apps, social media, and cloud computing. Ultimately, HHS can conduct research with Healthy People target audiences and stakeholders to inform the types of digital tools that will be most helpful to Healthy People 2020 users. [ABSTRACT FROM AUTHOR]

This paper discusses the American Public Health Association's goals with regards to the current health care reform debate. By outlining the organization's historical context with regards to health care reform as well as the parameters of the current medical care and public health crises, the paper explains why APHA's advocacy efforts focused on two major issues: the adoption of a national health program that features universal coverage with a comprehensive set of benefits for all our nation's residents, and the enhancement of the federal, state, and local public health infrastructure. The paper argues that both medical care services and public health programs must be expanded if we are to improve the nation's overall health status. [ABSTRACT FROM AUTHOR]

This paper traces the development of the US federal government's program to provide personal and public health services to American Indians and Alaska Natives since the 1940s. Minimal services had been provided since the mid 19th century through the Bureau of Indian Affairs of the Department of the Interior. As a result of attempts by western congressmen to weaken and destroy the bureau during the 1940s, responsibility for health services was placed with the US Public Health Service. The transfer thus created the only US national health program for civilians. providing virtually the full range of personal and public health services to a defined population at relatively low cost. Policy changes since the 1970s have led to an emphasis on self-determination that did not exist during the 1950s and 1960s. Programs administered by tribal governments tend to be more expensive than those provided by the Indian Health Service, but appropriations have not risen to meet the rising costs, nor are the appropriated funds distributed equitably among Indian Health Service regions. The result is likely to be an unequal deterioration in accessibility and quality of care. [ABSTRACT FROM AUTHOR]

Abstract: One of the 1990 Health Objectives established by the U.S. Department of Health and Human Services is for 60 per ¢ of adults 18-65 years of age to be participating regularly in vigorous physical exercise. Unfortunately, no valid and practical measurement system is available that will allow assessment of leisure lime physical activity participation of large populations. Consequently, not only is it difficult to assess progress toward the 1990 goal, an accurate baseline from which to measure potential progress does not exist. This paper presents a time diary technique for measuring aggregate population physical activity participation and utilizes actual time diaries collected from adults by the Institute for Social Research in 1981 to arrive at a possible baseline. The results indicated that time diaries are a viable method for assessing aggregate physical activity behavior of large populations. American Adults were quite sedentary in 1981. Over a period of one week, 31% undertook no leisure time physical activity. Only 14 per ¢ expended more than 1600 kcals/week in leisure time physical activity, and 10 per ¢ met the DHHS physical activity requirements. (Am J Public Health 1987:77:455-460.) [ABSTRACT FROM AUTHOR]

This paper examines the impact of the growing national health consciousness on the delivery of health care services. The health-involved consumer is first profiled and implications for health care marketing strategy are then identified. Suggestions are also made regarding the tailoring of health services to the health-involved segment. [ABSTRACT FROM AUTHOR]

Background: During the last decade, donor governments and international agencies have increasingly emphasized the importance of building the capacity of indigenous health care organizations as part of strengthening health systems and ensuring sustainability. In 2009, the U.S. Global Health Initiative made country ownership and capacity building keystones of U.S. health development assistance, and yet there is still a lack of consensus on how to define either of these terms, or how to implement "country owned capacity building". Discussion: Concepts around capacity building have been well developed in the for-profit business sector, but remain less well defined in the non-profit and social sectors in low and middle-income countries. Historically, capacity building in developing countries has been externally driven, related to project implementation, and often resulted in disempowerment of local organizations rather than local ownership. Despite the expenditure of millions of dollars, there is no consensus on how to conduct capacity building, nor have there been rigorous evaluations of capacity building efforts. To shift to a new paradigm of country owned capacity building, donor assistance needs to be inclusive in the planning process and create true partnerships to conduct organizational assessments, analyze challenges to organizational success, prioritize addressing challenges, and implement appropriate activities to build new capacity in overcoming challenges. Before further investments are made, a solid evidence base should be established concerning what works and what doesn't work to build capacity. Summary: Country-owned capacity building is a relatively new concept that requires further theoretical exploration. Documents such as The Paris Declaration on Aid Effectiveness detail the principles of country ownership to which partner and donor countries should commit, but do not identify the specific mechanisms to carry out these principles. More evidence as to how country-owned capacity building plays out in practice is needed to guide future interventions. The Global Health Initiative funding that is currently underway is an opportunity to collect evaluative data and establish a centralized and comprehensive evidence base that could be made available to guide future country-owned capacity building efforts. [ABSTRACT FROM AUTHOR]

The article offers information on the challenges faced by the American Public Health Association on the development of the association's Medical Care Section in the U.S. On November 10, 1948, the American Public Health Association's Governing Council voted to approve the petition requesting the establishment of a Medical Care Section. In 1972, the association expanded their health services because of the changes on their needs and demands. In 1920, the association created a committee to study the municipal health departments and determine the extent of variation on the health services and procedures offered in a specific community.

The purpose of this project was to design, implement, and assess a recurring interdisciplinary community health fair in an underserved border town. University of California San Diego (UCSD) medical and pharmacy students, under faculty supervision, worked alongside community partners in Calexico, California to implement a health fair two miles from the U.S.-Mexico border. Demographic and screening data were described from 293 participants from 2014 to 2016. Over 90% (269/293) listed Mexico as their country of birth, 82.9% (243/293) were monolingual Spanish speakers, 75.4% (221/293) had an annual household income of ≤ $20,000, and 58.7% (172/293) described their health as fair or poor. Screening revealed 91.1% (265/291) were overweight or obese, 37.8% (109/288) had hypertension, 9.3% (27/289) had elevated blood sugar, and 11.4% (33/289) had elevated total cholesterol levels. This model could be replicated in other training settings to increase exposure to border health issues and connect patients to local health services. [ABSTRACT FROM AUTHOR]

Objective: To estimate the cost of resources required to implement a set of Foundational Public Health Services (FPHS) as recommended by the Institute of Medicine.Study Design: A stochastic simulation model was used to generate probability distributions of input and output costs across 11 FPHS domains. We used an implementation attainment scale to estimate costs of fully implementing FPHS.Data Collection/extraction Methods: We use data collected from a diverse cohort of 19 public health agencies located in three states that implemented the FPHS cost estimation methodology in their agencies during 2014-2015.Principal Findings: The average agency incurred costs of $48 per capita implementing FPHS at their current attainment levels with a coefficient of variation (CV) of 16 percent. Achieving full FPHS implementation would require $82 per capita (CV=19 percent), indicating an estimated resource gap of $34 per capita.Conclusions: Substantial variation in costs exists across communities in resources currently devoted to implementing FPHS, with even larger variation in resources needed for full attainment. Reducing geographic inequities in FPHS may require novel financing mechanisms and delivery models that allow health agencies to have robust roles within the health system and realize a minimum package of public health services for the nation. [ABSTRACT FROM AUTHOR]

In light of the Patient Protection and Affordable Care Act's goals of better patient care, cost control, and improved population outcomes, prevention has emerged as an important component of health reform. Social work, with its extensive involvement in the health system and deep roots in public health, can benefit from a better understanding of its role in prevention. This study builds on the Social Work Interest in Prevention Study (SWIPS), which evaluated extent, type, and levels of prevention content in nine social work journals from 2000 to 2005. The goal of the expanded study, the SWIPS-Expansion, was to assess whether interest in prevention increased over the years in which health reform was enacted. Of the 3,745 articles reviewed, 9.0 percent (n = 336) met the criteria for "prevention articles." Between 2000 and 2010, prevention articles rose from 4.1 percent to 14.3 percent of all articles. A secondary analysis focused on topics within social work prevention, with violence, aging, and disease as primary focal areas. The findings suggest that although prevention interest appears to be growing, it remains a minority focus in the profession's journals. A national conversation on prevention can help expand the profession's role in health reform at this critical time. [ABSTRACT FROM AUTHOR]

In the last several years, the number of Master of Public Health (MPH) programs has increased rapidly in the US. As such, MPH programs, particularly smaller-sized ones, need to critically examine how their programs are meeting the needs and preferences of local public health practitioners. To assist in this necessity, the University of New Hampshire conducted a comprehensive educational assessment of its effectiveness as a smaller-sized, accredited MPH program. The aim of the assessment was to review the MPH program from the perspective of all stakeholders and then to agree on changes that would contribute to the fulfillment of the program’s mission, as well as improve program quality and reach. The program’s stakeholders examined the following components: policy development and implementation; target audience; marketing strategies; marketplace position; delivery model; curriculum design; and continuing education. Though assessment activities explored a wide array of program attributes, target audience, curriculum design, and delivery strategy presented significant challenges and opportunities for our smaller MPH Program to remain competitive. The effort put forth into conducting an in-depth assessment of the core components of our program also allowed for a comparison to the increasing number of MPH programs developing regionally. Since public health practice is changing and the education of public health practitioners must be adaptable, we propose that a routine assessment of an institution’s MPH program could not only meet this need but also assist with keeping smaller, unbranded MPH programs competitive in a burgeoning marketplace. [ABSTRACT FROM AUTHOR]

Context: Employers have pursued many strategies over the years to control health care costs and improve care. Disappointed by efforts to manage costs through the use of insurance-related techniques (e.g., prior authorization, restricted provider networks), employers have also begun to try to manage health by addressing their employees' key lifestyle risks. Reducing obesity (along with tobacco use and inactivity) is a priority for employers seeking to lower the incidence and severity of chronic illness and the associated demand for health services. Methods: This article describes the employer's perspective on the cost impact of obesity, discusses current practices in employer-sponsored wellness and weight management programs, provides examples from U.S. companies illustrating key points of employers' leverage and opportunities, and suggests policy directions to support the expansion of employers' initiatives, especially for smaller employers. Findings: Researchers and policymakers often overlook the extensive efforts and considerable impact of employer-sponsored wellness and health improvement programs. Greater focus on opportunities in the workplace is merited, however, for the evidence base supporting the economic and health impacts of employer-sponsored health promotion and wellness is growing, although not as quickly as the experience base of large employers. Conclusions: Public and private employers can serve their own economic interests by addressing obesity. Health care organizations, particularly hospitals, as well as public employers can be important role models. Policy development is needed to accelerate change, especially for smaller employers (those with fewer than 500 employees), which represent the majority of U.S. employers and are far less likely to offer health promotion programs. [ABSTRACT FROM AUTHOR]

The application of cost-effectiveness analysis to health care has been the subject of previous reviews. We address the use of economic evaluation methods in public health, including case studies of population-level policies, e.g., environmental regulations, injury prevention, tobacco control, folic acid fortification, and blood product safety, and the public health promotion of clinical preventive services, e.g., newborn screening, cancer screening, and childhood immunizations. We review the methods used in cost-effectiveness analysis, the implications for cost-effectiveness findings, and the extent to which economic studies have influenced policy and program decisions. We discuss reasons for the relatively limited impact to date of economic evaluation in public health. Finally, we address the vexing question of how to decide which interventions are cost effective and worthy of funding. Policy makers have funded certain interventions with rather high cost-effectiveness ratios, notably nucleic acid testing for blood product safety. Cost-effectiveness estimates are a decision aid, not a decision rule. [ABSTRACT FROM AUTHOR]

The article focuses on the status of the preventive healthcare system of the U.S., which is trying to improve its standards. Several steps have been taken to improve preventive health services, including enhancements in health plans, launch of disease management companies, and promoting more awareness about preventive health care. The medical care industry is concerned about the failure of the healthcare system to achieve goals for the prevention and early detection of chronic diseases.

The approach of a millennial passage invites public health to a review of past performance and a preview of future prospects toward assuring a healthy public. Since the 1974 Canadian Lalonde report, the best national plans for health progress have emphasized disease prevention and health promotion. WHO'S multinational Health for All by the Year 2000 promotes basic health services essential to leading a socially and economically productive life. Healthy People 2000, the latest US guide, establishes three goals: increase healthy life span, reduce health disparities, and achieve universal access to preventive services. Its objectives can be used to excite public understanding, equip program development, evaluate progress, and encourage public accountability for health initiatives. Needed is federal leadership in defining requisite action and securing necessary resources. Elsewhere a "new public health" emphasizes community life-style and multisectoral "healthy public policy." In the United States, a national health program is needed to achieve equity in access to personal health care. Even more essential is equitable sharing in basic health determinants in society—nutritious food, basic education, safe water, decent housing, secure employment, adequate income, and peace. Vital to such a future is able and active leadership now from governments and public health professionals. [ABSTRACT FROM AUTHOR]

Four local health departments in California tested a process of state/local negotiations for the purpose of implementing model standards in community preventive health services. The standards. which covered five program areas, had been developed by a collaborative work group of representatives from the United States Conference of City Health Officers, the National Association of County Health Officials, the Association of State and Territorial Health Officials, the American Public Health Association. and the US Department of Health, Education. and Welfare. Evaluation of the project indicates that the success of the negotiation transactions and results varied, both among local health departments and program areas. A number of factors have been identified as influencing the negotiations, including the availability of baseline data the extent to which individual programs are currently affected by required standards of performance, and health department attitude toward the project. The future utility of this model is considered within the broader context of changes now occurring in the financing and organization of public health within the United Stales. Project findings suggest that the Model Standards negotiations Could provide stale and local levels of government with a valuable management tool for determining health care priorities and generating objective programmatic data for budget justification. (Am J Public Heath 1982: 72:1230-1237.) [ABSTRACT FROM AUTHOR]

A set propositions is offered to provide a frame of reference for proposed strategies to improve healthful behavior by placing personal choice-making in the context of societal option-setting. The health status of populations at a given point in time is seen as a result of customary personal choice-making. These choices in turn are limited by both the perceived and actual options available to individuals, depending on their personal and their community's resources, from which to make choices, Most people, most of the time will make the easiest choices, i.e., will do the things, develop the patterns or life-styles, which seem to cost them less and/or from which they will gain more of what they value in tangible and/or intangible terms. The range of options available to them, and the ease with which they may choose certain ones over others, is typically set by organizations, public and private, formal and informal. The more powerful the organization, i.e., the more effective it is in carrying out its policies, the more it affects the populations, whether or not these effects are immediately perceived by individuals in their day-by-day choicemaking. Implications for health education strategies are noted. [ABSTRACT FROM AUTHOR]

The article discusses several myths and misconceptions underlying nutritional and health care programs in the U.S. Medical myths have led to the development of health care programs as well as the abolishment of some programs believed to have negative physiological effects. Many health programs developed by the federal government and medical organizations are believed to prevent diseases and responsible for the marked drop in mortality rates and the population boost. However, these myths and misconceptions have greatly affected the design and execution of health programs which has real medical relevance.

The article discusses the potential and role of podiatry in community health programs in the U.S. The author emphasized on the education of the podiatrist, his activities in various health programs and related matters. Podiatry is the smallest of the medical profession categories. However, podiatric education has reacted sharply to societal needs, bringing new emphasis to present health problems. The health system is faced with the necessity for providing both quality and quantity care at a time when trained medical manpower is in short supply.

A mail survey dealing with abortion coverage in the United States under Title 19 was conducted with State Commissioners of Health and Welfare of the 55 states and Territories. The results are reported and discussed. [ABSTRACT FROM AUTHOR]

Poor health and low living standards prevail in Chinese-American communities. This report discusses some social and cultural origins of health needs among Chinese-Americans and describes the role of community participation in health programming for one Chinese community, the Chinatown of Boston. [ABSTRACT FROM AUTHOR]

The National Legal Program on Health Problems of the Poor is discussed in terms of its organization, responsibilities and activities. During its short existence of only a few years it has developed and utilized a number of legal tools and become involved in a wide range of health problems. [ABSTRACT FROM AUTHOR]

Three referral patterns in a comprehensive health care delivery program are described and analyzed. Findings are discussed and interpreted. [ABSTRACT FROM AUTHOR]

Abstract: Community-oriented primary care (COPC) represents a specific variation on the general primary care model. Seven case studies from vastly different health care settings were examined and this report describes the diversity of expression of the principles of COPC observed. The results suggest that COPC is not limited to publicly funded programs, but can find expression in the private sector as well. The organization of financing and the lack of feasible quantitative tools hinder the full development of the model. (Am J Public Health 1986; 76:279-281.) INSET: Expanded Nurse Training Program Includes Home Health Care. [ABSTRACT FROM AUTHOR]

International trends and recently proposed changes risk confining the duties of epidemiologists to support of health services delivery or to serving as functionaries within exclusively clinical departments pose a threat to the future role and training of epidemiologists. It is argued that these attempts would weaken the academic focus for epidemiologists and compromise the system of recognition and rewards available through the hierarchy of the discipline. [ABSTRACT FROM AUTHOR]

The article discusses the cooperative efforts of the state and federal animal health officials to combat bovine tuberculosis in the U.S. The government made changes in program in order to prevent the eradication effort from degenerating into a static control program. National program statistics and studies of current outbreaks have shown the need for better surveillance and condemnation of all exposed cattle in herds with spreading infection. It was also mentioned that detailed epidemiological investigations are essential to finding and eliminating the remaining foci of disease.

Background: The gap between the highest and lowest life expectancies for race-county combinations in the United States is over 35 y. We divided the race-county combinations of the US population into eight distinct groups, referred to as the "eight Americas," to explore the causes of the disparities that can inform specific public health intervention policies and programs.Methods and Findings: The eight Americas were defined based on race, location of the county of residence, population density, race-specific county-level per capita income, and cumulative homicide rate. Data sources for population and mortality figures were the Bureau of the Census and the National Center for Health Statistics. We estimated life expectancy, the risk of mortality from specific diseases, health insurance, and health-care utilization for the eight Americas. The life expectancy gap between the 3.4 million high-risk urban black males and the 5.6 million Asian females was 20.7 y in 2001. Within the sexes, the life expectancy gap between the best-off and the worst-off groups was 15.4 y for males (Asians versus high-risk urban blacks) and 12.8 y for females (Asians versus low-income southern rural blacks). Mortality disparities among the eight Americas were largest for young (15-44 y) and middle-aged (45-59 y) adults, especially for men. The disparities were caused primarily by a number of chronic diseases and injuries with well-established risk factors. Between 1982 and 2001, the ordering of life expectancy among the eight Americas and the absolute difference between the advantaged and disadvantaged groups remained largely unchanged. Self-reported health plan coverage was lowest for western Native Americans and low-income southern rural blacks. Crude self-reported health-care utilization, however, was slightly higher for the more disadvantaged populations.Conclusions: Disparities in mortality across the eight Americas, each consisting of millions or tens of millions of Americans, are enormous by all international standards. The observed disparities in life expectancy cannot be explained by race, income, or basic health-care access and utilization alone. Because policies aimed at reducing fundamental socioeconomic inequalities are currently practically absent in the US, health disparities will have to be at least partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries. [ABSTRACT FROM AUTHOR]