The Public Health System in the United States

The mission of the public health system in the United States is to promote the mental and physical health of its citizens and to prevent injury, disease, and disability. The United States’ public health system is a multi-faceted system that is very complex. Its role in protecting and enhancing the health of the citizens is tremendously significant (Blendon, 2009).

Public health refers to the art, science, efforts, and approaches employed by all sectors of society to protect, maintain, assure, improve and promote people’s health. Nevertheless, the public health system is not exclusively responsible for guaranteeing decent population health. The entire community, governmental public health infrastructure, the media, the health care delivery system, and academia all play an imperative role. The three major functions of public health are Assessment, Policy Development, and Assurance. Some responsibility of public health function is placed at all government levels i.e. the federal, the state, and the local governments.

Nevertheless, the greatest authority for public health is placed at the state level. The federal government influences public health practice through leadership, funding decisions, and directing attention to public health matters. On the other hand, the state engages in diverse activities to protect public health including licensing healthcare facilities and workers, conducting inspections, enforcing sanitary and safety codes, authorizing quarantine and isolation, and reporting certain illnesses to state authorities. The state often delegates some of these functions to local governments (Adamy, 2009).

Assessment refers to the collection and analysis of information about health problems. This involves the identification of needs, collection, and interpretation of data. Policy development often involves broad-based consultations with all stakeholders to evaluate the information at hand to make informed decisions to ensure that public interest is served by the adopted interventions. This involves priority setting and planning, advocacy and policy leadership, and encouraging the participation of public and private sectors through persuasion and the use of incentives. Assurance refers to protecting and promoting public interests through regulations, campaigns, events, programs, and the use of other strategies to ensure that essential services are provided to meet the set goals.

In 2000, leaders at the Center for Disease Control and Prevention identified ten challenges that continue to face public health in the US and formulated the way forward. These are: instituting a rational health care system; eliminating health disparities among ethnic and racial groups; focusing on children’s intellectual and emotional development; achieving a longer healthspan; integrating physical activity and healthy eating; protecting and cleaning up the environment; preparation in terms of responding to emerging infectious ailments; recognizing and addressing the impact of mental health on the overall well-being; reducing the rate of violence in the society; and the use of technological advances and new scientific knowledge in an ethical, equitable and responsible manner.

There is a mixed opinion among the citizens in terms of health care reform. The majority of American citizens express the desire for reforms in health care since they view the system as too expensive. They are also concerned with the way insurance companies elude meeting health costs through caps, co-payments, and coverage exclusions. In addition, the system does not cover all citizens. Each of these challenges is massive, and given the fragmentation and complexity of the public health system, the political divergence, the need for a cultural shift, and the limited resources allocated to the system, any progress would require a dramatic shift by all stakeholders (Scutchfield, 2009).


Adamy, J. (2009). Support for Health Overhaul Wanes. The Wall Street Journal, Vol.38 (2), 10-15.

Blendon, R. & Benson, M. (2001). Americans’ Views on Health Policy: A Fifty-Year Historical Perspective. Health Affairs Vol.28, 18-29.

Scutchfield F. & Keck, C. (2009). Principles of Public Health Practice. New York: Delmar Cengage Learning.

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