ABSTRACT
From a national perspective, local public health practice continues to face many of the challenges identified in the 1988 Institute of Medicine study. Unless they are addressed broadly, current trends may exacerbate further the capacity of local public health agencies. Efforts to strengthen local practice should focus on workforce development, scale of operations, and resources. New and innovative models of collaboration between academia and local practice are proposed.
Subject(s)
Faculty, Medical/organization & administration , Interinstitutional Relations , Public Health Practice/standards , Schools, Public Health/organization & administration , Cooperative Behavior , Forecasting , Humans , Models, Organizational , Total Quality Management/organization & administration , United StatesABSTRACT
This paper reviews the recent experience in Washington State which resulted in creation of a separate state Department of Health. Until the 1989 legislation was passed, Washington was one of 19 states in which public health was organizationally housed in a superagency. The Institute of Medicine, in its 1988 report on The Future of Public Health, recommended that states organize core functions under a separate department of health. The effort in Washington State was led by local public health officials. Success followed four years of hard work during which mistakes were made, coalitions were built, and legislative process was learned.
