Responsibilities of the Federal, State, and Local

¶ … responsibilities of the federal, state, and local public health systems?

On a federal level, the USDA (U.S. Department of Agriculture) and the FDA (Food and Drug Administration) regulate food and drug safety, to ensure that American consumers are protected against tainted or unsafe products. The Surgeon General has often been the spearhead of public health campaigns, such as to encourage Americans to quit smoking or to be aware of the gravity of the AIDS epidemic. The White House has likewise championed many public health service campaigns, such as the current 'Let's Move' campaign of Michelle Obama. The Department of Health and Human Services oversees the majority of health-related initiatives on the part of the federal government, including Medicare, the health insurance program provided for all seniors (HHS, 2011, Official Website).

However, state and local public agencies also have substantial responsibilities in safeguarding public safety. "State health agencies must be able to provide the core functions of public health: assessment, policy development, and assurance across the domains of health protection and health promotion activities" (Beitsch et al. 2006). State health agencies can declare public health emergencies, such as when there was an outbreak of swine flu several years ago. They issue licenses for specific healthcare practitioners, such as nurses. States also engage in bioterrorism preparedness initiatives. States oversee Medicaid, the health insurance program for Americans living below the poverty level.

Local agencies can provide a variety of health functions to the community, and are often less specifically-defined in nature than those at the national and state level. However, city health departments often have a vital role in monitoring food safety, and all local agencies can offer community-based programs to improve the health of community members, such as activities for youth and health screening days for seniors.

Q2. If you were the national decision maker, would you focus on prevention or health care delivery programs?

When confronted with this dilemma, one's gut instinct is to say 'preventative medicine.' The evidence seems to support this decision, given that preventing diabetes with an awareness campaign and blood sugar screening costs far less than treating this chronic condition. From the point-of-view of the patient as well, prevention is superior to actually suffering an illness that may or may not have a cure. Prevention encompasses a wide variety of activities, including but not limited to, vaccinations, screening children's vital signs at a young age in the school environment, screening for heart disease and potential cancers and encouraging people not to smoke and eat and drink to excess. Providing healthy food and healthy places to exercise is also important, and policies that encourage this might include offering subsidies for supermarkets in low-income areas, banning fast food establishments near schools, and creating public places to run and play.