Although the American public health system has made major contributions to life expectancy for residents of this country over the past century, the system now faces more complex health problems that require comprehensive approaches and increased capacity, particularly in local and State public health agencies. To strengthen the public health system, concerted action is needed to meet these five critical needs: First, the knowledge base of public health workers needs to be supplemented through on-the-job training and continuing education programs. To this end, self-study courses will be expanded, and a network of regional training centers will be established throughout the country. Second, communities need dynamic leadership from public health officials and their agencies. To enhance leadership skills and expand the leadership role of public health agencies, focused personal leadership development activities, including a Public Health Leadership Institute, and national conferences will provide a vision of the future role of public health agencies. Third, local and State public health agencies need access to data on the current health status of the people in their communities and guidance from the nation's public health experts. To improve access to information resources, state-of-the-art technologies will be deployed to create integrated information and communication systems linking all components of the public health system. Fourth, local and State agencies need disease prevention and health promotion plans that target problems and develop strategies and the capacity to address them. To provide communities with structured approaches to this process, planning tools have been developed and distributed, and technical assistance will be provided to local and State health agencies to involve each community in planning,priority setting, and constituency building.Finally, public health agencies need adequate resources to fund prevention programs. To improve the use of existing Federal support and enhance the availability of new community resources, grant programs will be modified, and innovative approaches to local resource enhancement will be developed and shared.Activities in these five key areas are designed to improve the infrastructure of the public health system and its capacity to carry out effectively the core functions of public health assessment, policy development, and assurance of the availability of the benefits of public health. If the nation is to achieve the health objectives for the year 2000, the public health system-the individuals and institutions that, when working effectively together, promote and protect the health of the people-must be strengthened.

Computer Communication Networks↗

PubMedDate not supplied

A comprehensive HIV prevention program.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗

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Current approaches to prevention of HIV infections.

The HIV education and prevention strategy of the Centers for Disease Control has three principal components: (a) public information and education, (b) education for school-aged populations, and (c) risk reduction education and individual counseling and testing services for people at increased risk of HIV infection. The most visible components of the public information and education programs are the National Public Information Campaign ("America Responds to AIDS"), the National AIDS Hotline system, and the National AIDS Information Clearinghouse. Components of the youth education program consist of funding for national health and education organizations, funding for State and local education departments, training, surveillance of education efforts, and evaluation. Counseling and testing has entailed performance of approximately 2,500,000 HIV antibody tests with pre- and post-test counseling, notification and counseling of sexual and needle-sharing partners of those infected with HIV, and targeted risk reduction education through community-based organizations. Over time, these activities will continue to evolve and become more effective.

Adolescent↗

PubMedDate not supplied

The prevention of minority youth violence must begin despite risks and imperfect understanding.

Explore the source record for details and available documents.

Adolescent↗

PubMedDate not supplied

Making fair decisions about financing care for persons with AIDS.

An estimated 40 percent of the nation's 55,000 persons with acquired immunodeficiency syndrome (AIDS) have received care under the Medicaid Program, which is administered by the Health Care Financing Administration (HCFA) and funded jointly by the Federal Government and the States. In fiscal year 1988, Medicaid will spend between $700 and $750 million for AIDS care and treatment. Medicaid spending on AIDS is likely to reach $2.4 billion by fiscal year 1992, an estimate that does not include costs of treatment with zidovudine (AZT). Four policy principles are proposed for meeting this new cost burden in a way that is fair, responsive, efficient, and in harmony with our current joint public-private system of health care financing. The four guidelines are to (a) treat AIDS as any other serious disease, without the creation of a disease-specific entitlement program; (b) bring AIDS treatment financing into the mainstream of the health care financing system, making it a shared responsibility and promoting initiatives such as high-risk insurance pools: (c) give States the flexibility to meet local needs, including Medicaid home care and community-based care services waivers; (d) encourage health care professionals to meet their obligation to care for AIDS patients.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Assessing prevention effectiveness using data to drive program decisions.

The measure of the effectiveness of health promotion and disease prevention activities is the impact of prevention policies, programs, and practices on public health and clinical medicine. Assessing prevention effectiveness involves continuing quantitative analysis of health outcomes resulting from prevention practices. Additionally, assessment involves evaluation of disease- and injury-prevention activities, including their medical, legal, ethical, and economic impacts. Although assessing the effectiveness of prevention activities involves measuring efficacy, safety, and cost, the primary criterion is to improve health at a reasonable cost, not merely to contain costs. Policy makers can use the results of assessments to set priorities in public health. The authors use case studies to illustrate various approaches to evaluating prevention programs, including programs for preventing measles, breast cancer, and diabetic retinopathy. Rigorous evaluation of the effectiveness of prevention activities is essential to the wide acceptance of preventive interventions and the willingness to pay for them.

Breast Neoplasms↗

PubMedDate not supplied

Health communication takes on new dimensions at CDC.

Actions by the Centers for Disease Control and Prevention (CDC) to integrate health communication into overall prevention programs as a means of influencing individual behavior to reduce risks to health are described. These actions include a set of 5-year goals for the Agency; a proposal to establish an Office of Health Communication to provide leadership and support for accomplishing the goals; and establishment of a working group to create the proposed Office of Health Communication and to develop a framework for accomplishing the goals. Fundamental to the policy was development of a definition of health communication as the Agency would practice it. Steps taken to reach this definition are outlined as well as the 10 steps adopted as a framework for health communication. The article concludes with a statement describing communication as a part of CDC's overall mission. The hope is that the ultimate accomplishment will be increased awareness among Americans of the importance of good health and their ability to achieve it.

Centers for Disease Control and Prevention, U.S.↗