In an era of diminished resources, public health agencies are being asked to do more with less. Evidence suggests that while revenues at the state and local levels have been flat or increased slightly since 2010, a large number of governmental public health agencies in the United States have been forced to cut programs and/or staff to compensate for the relative paucity of funds at their disposal.
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Frontiers in Public Health Services and Systems Research is an open-access, rapid-response, peer-reviewed online journal offering brief, preliminary PHSSR findings from ongoing or recently completed empirical studies or quality improvement projects. Journal articles answer questions of importance regarding the organization, financing, and delivery of public health services; the structure, operation, and management of public health delivery systems; the application of quality improvement methods in public health settings; and/or the impact of these endeavors on population health. Findings must have the potential to guide future public health practice, health policy, and research. Frontiers is intended to provide quick access to actionable public health infrastructure research to improve public health practice at the state and local levels. It is of use to practitioners, policy makers and researchers.
Public health system partnerships and the scope of maternal and child services: a longitudinal study
Local health departments (LHDs) struggle to serve their communities in the face of ongoing fiscal constraints. Fiscal constraints have led to the elimination and reduction of maternal and child health services (MCH). LHDs have used various strategies to minimize the negative impact fiscal constraints of elimination or reduction of services provided to their communities. Many LHDs have used strategies such as developing partnerships.
Health care reform has resulted in changes throughout the health system, including the Affordable Care Act (ACA) requirement that hospitals conduct community health needs assessments, taking into greater consideration the public health of their respective communities. This has led to growing strategies to develop partnerships between hospitals and public health (PH) as a way to meet these needs1. Meantime, there is a need for data on Hospital-PH partnerships, due to the growing emphasis that these types of partnerships get implemented in practice.
Cross-jurisdiction resource sharing is considered a possible means to improve efficiency and effectiveness of public health service delivery. A merger of the Tuberculosis (TB) clinics of a rural and a metropolitan jurisdiction in East Tennessee provided an opportunity to study service provision changes in real time. A mixed methods approach was used, including quantitative data on latent TB treatment outcomes and qualitative data from staff interviews, as well as documentation of changes in staffing time in TB services.
Effective communication is one of the core competencies for public health professionals and is required for local health department (LHD) accreditation. Public health communication specialists play a critical role as conduits of health information, particularly with regard to managing relationships with media and the message that is ultimately represented by news outlets. However, capacity for engagement with traditional media in community health improvement at the local level has not been well-described.
The paper presented by these researchers, is, as would be expected, well thought out and supported by their careful research. It correctly concludes that the topic of hospitals’ role in addressing social determinants of health deserves more attention. However, in the future, examination of the IRS Form 990 Schedule H Part II, Community Building, will not be the best way to do it.
In 2008, the Internal Revenue Service (IRS) revised and standardized the reporting policy for community benefit expenses for non-profit hospitals. These expenses are required for tax-exemption. At that time, the IRS designated some categories of activities as non-eligible as a community benefit, but still mandated their reporting on hospitals’ Form 990- the annual tax filing for non-profit organizations.
Recently, Dr. Jenine Harris and her colleagues examined the use of journals by state chronic disease prevention staff to stay up-to-date on public health evidence. We, at Frontiers in PHSSR, are pleased to be included among the journals listed in the survey. Online open-access journals are shifting the paradigm of scientific publication, allowing free and rapid exchange of information.
Local health departments (LHDs) can more effectively develop and strengthen community health partnerships when leaders focus on building partnership collaborative capacity (PCC), including a multisector infrastructure for population health improvement. Using the 2008 National Association of County and City Health Officials (NACCHO) Profile survey, we constructed an overall measure of LHD PCC comprised of the five dimensions: outcomes-based advocacy, vision-focus balance, systems orientation, infrastructure development, and community linkages.
A major goal for the health services research community is to provide evidence policymakers can use to improve the public’s health. However, it can be difficult to know what evidence policymakers want and how they decide what research to fund.
In order to understand where policymakers turn for evidence and how they make funding decisions amid fiscal and political constraints, AcademyHealth conducted a 3-part Fireside Chat series in the spring of 2014. This editorial summarizes the evidence gaps identified, and provides strategies for communicating with decision makers.