Agenda - 03-09-1999 - III-B - Laserfiche WebLink

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12 HEALTHY COMMUNITIES The committee's analysis, presented in this report, reaffirmed the understanding of public health professionals and health scientists that the public's health depends on the interaction of many factors; thus, the health of a community is a shared responsibility of many entities, organizations, and Interests in the community, Including health service delivery organizations, public health agencies, other public and private entities, and the people of a community. Within this context of shared responsibility, specific entities should identify, and be held accountable for, the actions they can take to contribute toward the community's health. As a result of this understanding, the committee focused its report on how governmental public health agencies, especially at the state and local levels, can develop partnerships with managed care organizations to deliver personal and population -based health services and with public and private community organizations to deal with broader concerns to advance the health of the community. Developing these partnerships, the committee believes, will be critical for advancing the health of the public and of communities in the future. • Public Health and Managed Care In the past decade, there has been substantial growth in organized health care delivery systems in most parts of the United States. Managed care organizations, the most common form of these systems, can be defined as "any system that is under the management of a single entity that (1) insures members -- either by itself or through an intermediary, (2) furnishes covered benefits through a defined network of participating providers, and (3) manages the health cart practices of participating providers" (Rosenbaum and Richards, 1996). Public health practice is sometimes thought of as separate from, or complementary to, the delivery of personal health services. A more helpful distinction is between personal health services and community interventions. Personal health services involve a one- to-one interaction between a provider and a Patient (IOM, 1993). Personal health services are delivered primarily by private- ssector organizations, but in many communities, governmental health dePartin ents provide many of these services, especially for disadvantaged populations. } Community interventions aim to alter the social or physical environment to change one or more health- related behaviors or to directly reduce the risk of causing a health problem. Community-based services are usually carried out by public health agencies, other government agencies, or comm carried voluntary organizations. The provision of personal health services per se, even if they are delivered in the community rather than in health care settings, is not a community intervention. Outreach or community-based activities intended to improve access to personal health services or their utilization, however, are { included. Public health .agencies are often challenged to provide both types of services, but community organizations frequently help the public hea agency 13 ro 4%