Delivery Mechanisms

HealthWith the need to define public health, and its core functions and essential services, a challenge exists to provide efficient and effective delivery mechanisms for public health services. While public health agencies and programs exist at all three levels of government, public health officials agree that local health departments lead the way in providing programs and services (Turnock, 2001). Local public health departments are charged with protecting, promoting, and maintaining the health of the population within their jurisdiction (Rawding & Wasserman, 1997).

Unfortunately, whereas local public health departments must provide essential public health services, these services are often underused or not used at all. Providing health services sometimes proves prohibitively expensive, so some local health departments face the task of moving services traditionally delivered locally to the private sector. Emergence of public health service delivery by managed-care organizations, hospitals, and other healthcare organizations, cause some to question the need for providing services at the local level (Rawding & Wasserman, 1997).

However, others argue that only selected local health department responsibilities can or should be delegated (Rawding & Wasserman, 1997). Questions about mechanisms for service delivery, coupled with growing numbers of underinsured or uninsured adults and children suggest a need for profound changes in the health care system. The nation should examine not only roles and characteristics of public health services, but service delivery as well.