Search results

Contrary to the popular view of mandates as rigid and dictatorial mechanisms, this article advances a view of mandates as mechanisms for cooperation and negotiation. The relationship between several state and local actors is investigated in Maryland, particularly within the context of the development of a "loosely" mandated public health program, the Targeted Funding Program (TFP). An analysis of the TFP and the actors involved in the program's development demonstrates how this program is designed to achieve much more than increased fiscal responsibility. The TFP is designed, and continues to be redesigned, to meet the political and professional objectives of various elected and appointed officials at the state and local levels.

From the symposium keynote address, this paper aims to explore how healthcare‐associated infections (HAIs) have been transformed from being only a hospital concern to a much broader public health concern.

The paper is a narrative review.

HAIs have the characteristics that define issues as public health problems. As a result, public health departments can become important partners in the evolving hospital infection control field. However, whether all state health departments can afford to add HAI experts and whether current public health department HAI activities will be effective in preventing HAIs remain important questions.

Public health agencies must be selective about focusing limited resources into areas where they can protect and improve the public's health; whether HAIs are such an area remains to be seen. Although HAIs have historically been the focus of hospitals and hospital‐based services, public health involvement has been mandated through state and federal legislation. In theory, the new mandate is appropriate; in practice, its impact and value need to be comprehensively assessed.

The interdisciplinary team required to evaluate HAI mandatory public reporting comprehensively needs to start from an understanding of the history and concepts underlying public health practice.

This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin.

We show the geographic distribution, funding patterns, and utilization trends for outreach clinics over a 20-year period. Interviews with program planners and outreach clinic staff show how external and internal constraints limited the program’s capacity. We compare clinic operations to the conceptual models guiding program design.

Our findings show that state health officials had to scale back financial support for outreach clinic activities while healthcare providers faced increasing pressure from administrators to reduce investments in charity care. These external and internal constraints led to a decline in the overall number of patients served. We also find that redistribution of clinics to the Milwaukee area increased utilization among Hispanics but not among African-Americans. Our interviews suggest that these patterns may be a function of shortcomings embedded in the planning models.

Planning models have three shortcomings. First, they do not identify the mitigation of health disparities as a specific goal. Second, they fail to acknowledge that partners face escalating profit-seeking mandates that may limit their capacity to provide charity services. Finally, they underemphasize the importance of seeking trusted partners, especially in working with communities that have been historically marginalized.

There has been little discussion about equitably leveraging genetic advances that improve healthcare quality and efficacy. The role of State Health Agencies in mitigating disparities in access to genetic services has been largely ignored in the sociological literature.

In the mid 1980s, amidst a massive restructuring of U.S. capital and a retrenchment of the welfare state, little attention has been paid to the ill‐defined “nonprofit” or “voluntary” service sector in the American economy. The Filer Commission on Private Philanthropy and Public Needs characterised it in 1975 in the following way:

The purpose of this paper is to show how the Turning Point Initiative to improve the health of populations by improving the USA public health system has many lessons on collaboration for governance systems.

The article synthesizes published literature outlining the results of a Robert Wood Johnson Foundation/W.K. Kellogg Foundation grant program to 21 USA states and 43 communities and relationships to administrative practice.

Turning Point's creation of a formalized network of public health partners across the USA has led to innovations in collaboration, increased system capacity, and alternative structures for improving health.

Turning Point's efficacy in community health system improvement can be mirrored in clinical governance. A major potential for improvement in clinical delivery systems is available by re‐thinking key partners, organizational structures, and system administrative capacity.

The purpose of this paper is to inform healthcare providers and healthcare facility leadership about the statutory, administrative, criminal, and tort law implications related to preventable harms from unsafe injection practices.

Review of legal theory and precedents.

The law can address disputes over unsafe injection practices in a variety of ways. Administrative agencies may hold a provider or facility responsible for preventable harms according to specific statutory and regulatory provisions governing licensure. State courts can compensate victims of certain actions or inactions based on tort law, where a breach of a legal duty caused damages. Prosecutors and the public can turn to criminal law to punish defendants and deter future actions that result in disability or death.

The state law findings in this review are limited to legal provisions and court cases that are available on searchable databases. Due to the nature of this topic, many cases are settled out of court, and those records are sealed from the public and not available for review.

Preventable harm continues to occur from unsafe injection practices. These practices pose a significant risk of disease or even death for patients and could result in legal repercussions for healthcare providers and facility leadership.

This article reviews emerging law and potential legal implications for health care and public health related to unsafe medical practices related to needle, syringe, and vial use.

This chapter explores the ethics of a critical vulnerability suffered by migrant health professionals (MHPs): the problem of ‘pathways to nowhere’. This problem arises from dynamic change in the processes, practices and policies governing how migrant professionals achieve accreditation, training and employment in destination countries, whereby established pathways to professional practice are unexpectedly altered or removed. The authors detail the significance of this phenomenon in Australian and Canadian contexts. Drawing on the literature on legitimate expectations and the rule of law, the authors outline the ethical stakes and responsibilities that attach to states creating and then disappointing people’s legitimate expectations, and discuss how these considerations apply to destination countries’ treatment of MHPs.

Raises some questions on moral and legal rights to health care, referring to various claims contained within the report of the UK’s Commission on Social Justice – “Social Justice: Strategies for National Renewal” (1994). Explores the relationship between needs and rights – rights of action and rights of recipience, moral rights and legal rights. Proceeds to delve into the role the state plays in providing services such as health care and whether or not people have a moral right to good health and good health care. Questions if the state should provide health care and, if so, should it be provided as a legal right to citizens? Concludes that the Commission on Social Justice fails to defend the National Health Service on the grounds of justice and moral rights.

Health social movements address several issues: (a) access to, or provision of, health care services; (b) disease, illness experience, disability and contested illness; and/or (c) health inequality and inequity based on race, ethnicity, gender, class and/or sexuality. These movements have challenged a variety of authority structures in society, resulting in massive changes in the health care system. While many other social movements challenge medical authority, a rapidly growing type of health social movement, “embodied health movements” (EHMs), challenge both medical and scientific authority. Embodied health movements do this in three ways: (1) they make the body central to social movements, especially with regard to the embodied experience of people with the disease; (2) they typically include challenges to existing medical/scientific knowledge and practice; and (3) they often involve activists collaborating with scientists and health professionals in pursuing treatment, prevention, research, and expanded funding. We present a conceptual framework for understanding embodied health movements as simultaneously challenging authority structures and allying with them, and offer the environmental breast cancer movement as an exemplar case.

The purpose of this paper is to juxtapose chaos theory with organizational learning theory to examine whether public organizations co-evolve into a new order or rather institutionalize newly gained knowledge in times of a highly complex public health crisis.

The research design utilizes the results from a survey administered to 200 emergency management and public health officials in the Dallas–Fort Worth metroplex.

The findings of this paper suggest that public entities were more likely to represent organizational learning through the coordination of professionals, access to quality information, and participation in daily communication. Leadership was associated with the dissemination of knowledge through the system rather than the development of new standard operating procedures (as suggested by chaos theory and co-evolution).

There are limitations to this study given the purposive sample of emergency management and public health officials employed in the Dallas–Fort Worth metroplex.

The authors find that public organizations that learn how to respond to unprecedented events through reliance on structure, leadership, and culture connect decision makers to credible information resulting in organizational learning.

As a result, public administrators need to focus and rely on their organization’s capacity to receive and retain information in a crisis.

This research contributes to our understanding of organizational learning in public organizations under highly complex public health situations finding decisions makers rely on both organizational structure and culture to support the flow of credible information.