The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation’s public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report.

The Future of the Public’s Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation’s health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public’s health.

Focusing on diverse partnerships as the framework for public health, the book discusses:

• The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement.
• The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system.
• The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation.

Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON ASSURING THE HEALTH OF THE PUBLIC IN THE 21ST CENTURY
• LIAISONS FROM THE BOARD ON HEALTH PROMOTION AND DISEASE PREVENTION
• LIAISON PANEL ON ASSURING THE HEALTH OF THE PUBLIC IN THE 21ST CENTURY
• Preface
• Acknowledgments
• Executive Summary
• 1. Assuring America's Health
  • ACHIEVEMENT AND DISAPPOINTMENT
  • HEALTH AS A SOCIAL AND POLITICAL UNDERTAKING
  • ISSUES THAT MAY SHAPE THE NATION'S HEALTH STATUS
  • THE PUBLIC HEALTH SYSTEM AND ITS KEY ACTORS
  • PRESENT AND FUTURE CHANGES NEEDED FOR A HEALTHY NATION
  • BROAD TRENDS INFLUENCING THE NATION'S HEALTH
  • CONCLUDING OBSERVATIONS
  • REFERENCES
• 2. Understanding Population Health and Its Determinants
  • A POPULATION PERSPECTIVE
  • THE PHYSICAL ENVIRONMENT AS A DETERMINANT OF HEALTH
  • THE SOCIAL DETERMINANTS OF HEALTH
  • POPULATION-LEVEL PREVENTIVE INTERVENTIONS
  • THE PUBLIC HEALTH SYSTEM IN ACTION: A SCENARIO
  • CONCLUDING OBSERVATIONS
  • REFERENCES
• 3. The Governmental Public Health Infrastructure
  • PRIOR ASSESSMENTS OF THE PUBLIC HEALTH INFRASTRUCTURE
  • THE ROLE OF GOVERNMENTS IN PUBLIC HEALTH: AN OVERVIEW AND LEGAL FRAMEWORK
  • THE FEDERAL PUBLIC HEALTH INFRASTRUCTURE
  • CRITICAL COMPONENTS OF THE PUBLIC HEALTH INFRASTRUCTURE
  • FINANCING THE PUBLIC HEALTH INFRASTRUCTURE
  • CONCLUDING OBSERVATIONS
  • REFERENCES
• 4. The Community
  • DEFINING THE COMMUNITY
  • COMMUNITY-BASED COLLABORATION
  • FRAMEWORK FOR COLLABORATIVE COMMUNITY ACTION ON HEALTH
  • EVALUATING AND RESEARCHING COMMUNITY HEALTH IMPROVEMENT
  • SUSTAINING COMMUNITY ACTION ON HEALTH
  • CONCLUDING OBSERVATIONS
  • REFERENCES
• 5. The Health Care Delivery System
  • ACCESS TO HEALTH CARE
  • NEGLECTED CARE
  • PROBLEMS IN QUALITY OF CARE
  • CAPACITY OF THE HEALTH CARE SYSTEM TO SERVE THE POPULATION
  • COLLABORATION WITH GOVERNMENTAL PUBLIC HEALTH AGENCIES
  • COLLABORATION WITH OTHER PUBLIC HEALTH SYSTEM ACTORS
  • IMPLICATIONS OF GROWING HEALTH CARE COSTS
  • CONCLUDING OBSERVATIONS
  • REFERENCES
• 6. Employers and Business
  • EMPLOYERS' ROLE IN HEALTH INSURANCE COVERAGE
  • EMPLOYERS' ROLE IN ASSURING HEALTH CARE QUALITY
  • EMPLOYER INTEREST IN PROMOTING THE HEALTH OF EMPLOYEES: A RATIONALE FOR CORPORATE INVESTMENT IN HEALTH
  • ROLE OF BUSINESSES AND INDUSTRIES IN PROMOTING A HEALTHY ENVIRONMENT
  • A CASE FOR IMPROVING THE HEALTH AND WELL-BEING OF COMMUNITIES
  • CONCLUDING OBSERVATIONS
  • REFERENCES
• 7. Media
  • NEWS MEDIA AND THE NATIONAL PUBLIC AGENDA
  • NEWS MEDIA AS A CATALYST TO PROMOTE HEALTH AT THE COMMUNITY LEVEL
  • NEWS MEDIA COVERAGE AND HEALTH INFORMATION
  • MEDIA AND HEALTH COMMUNICATION
  • HEALTH COMMUNICATION CAMPAIGNS: THEORY, EVALUATION, AND RESEARCH NEEDS
  • CONCLUDING OBSERVATIONS
  • REFERENCES
• 8. Academia
  • EDUCATION AND TRAINING
  • RESEARCH
  • SERVICE
  • CONCLUDING OBSERVATIONS
  • REFERENCES
• APPENDIXES
  • A Models of Health Determinants
  • B Models for Collaborative Planning in Communities
  • C Recommendations from The Future of Public Health
  • D Healthy People 2010 Objectives for the Public Health Infrastructure
  • E Competencies for Public Health Workers: A Collection of Competency Sets for Public Health-Related Occupations and Professions
  • F Data-Gathering Activities
  • G Agendas for Public Committee Meetings
  • H Committee Biographies

Support for this project was provided by the Centers for Disease Control and Prevention; the National Institutes of Health; the Health Resources and Services Administration; the Substance Abuse and Mental Health Services Administration; the Department of Health and Human Services, Office of the Secretary, Assistant Secretary for Planning and Evaluation; and the Department of Health and Human Services, Office of Disease Prevention and Health Promotion, Contract No. 200-2000-00629. The views presented in this report are those of the Institute of Medicine Committee on Assuring the Health of the Public in the 21st Century.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.