Performance Improvement 1998. Office of Public Health and Science

02/01/1998

Contents

Measuring Expenditures for Essential Public Health Services

Evaluation of the HBCU Capacity Building Program

Environmental Health Data Needs: An Action Plan for Federal Public Health Agencies (Workshop Results, March 3-5, 1997-- Linthicum Heights, Maryland)

Stakeholders Revisit Healthy People 2000 to Maximize the Impact for 2010

Health of Washington Women

TITLE: Measuring Expenditures for Essential Public Health Services

ABSTRACT: In 1995, the Public Health Foundation, under contract to the U.S. Public Health Service (PHS), worked with State and local public health, mental health, substance abuse, and environmental agencies in nine States-Arizona, Illinois, Iowa, Louisiana, New York, Oregon, Rhode Island, Texas, and Washington-and with Federal PHS agencies to develop and test a methodology for estimating investments in ten essential public health services. These services include both personal health services (care provided to individuals) and population-based health services (interventions that prevent disease and promote health among entire populations). The report finds that public health expenditures can indeed be defined, measured, and monitored according to the essential services framework. The report also produced State-level estimates of essential public health services spending. It finds that (1) more than 2 of every 3 dollars spent by the 9 States on essential public health services ($6.1 billion of $8.8 billion) was for personal health services; (2) population-based health services spending ($2.7 billion or $36 per capita) was only 1 percent of total health care expenditures in the participating States; (3) of the population-based expenditures, 26 percent was for enforcing laws and regulations protecting the health and safety of the public; (4) States were the largest funders of population-based health services, providing 50 percent of the total funding for these activities (Federal funding accounted for 32 percent, while local and other sources accounted for the remaining 18 percent); and (5) of the $7.1 billion PHS expenditures on essential public health services, $2.4 billion (34 percent) supported prevention-related research and $2 billion (29 percent) supported personal health services. The report makes recommendations to improve the methodology for future data collection. (Final report: 36 pages, plus appendices.)

AGENCY SPONSOR: Office of Disease Prevention and Health Promotion

FEDERAL CONTACT: Deborah R. Maiese

PHONE NUMBER: (202) 401-5809

PIC ID: 6194

PERFORMER ORGANIZATION: Public Health Foundation, Washington, DC

TITLE: Evaluation of the HBCU Capacity Building Program

ABSTRACT: In 1992, the Public Health Service (PHS) initiated the Historically Black Colleges and Universities (HBCUs) Capacity Building Program to increase HBCUs' involvement in health and social service programs funded by PHS and other Federal agencies. The hypothesis was that HBCUs could compete more effectively for grant monies if they had comprehensive and fully functional sponsored program offices (SPOs). This evaluation, conducted by the Office of Minority Health (OMH), addresses a series of questions regarding the appropriateness of program processes and the observable impacts of the program at four participating HBCUs. The OMH designed evaluation methods around a logic model that documents the links between program assumptions, activities, and final outcomes. The OMH collected data through questionnaires, site visits, and telephone interviews. The evaluation includes quantitative and categorical indicators of program implementation and outcomes, as well as comparisons of qualitative case histories. The report finds that the grant funds and technical assistance achieved many of the program's aims. An SPO was established at all four participating HBCUs, resulting in more structured and uniform procedures for obtaining and managing externally sponsored programs. Program impact data show that some desired outcomes, such as increased proposal submissions and awards, were partially achieved. The study concludes by highlighting major findings and recommendations related to program effectiveness, including the need for investments in programmatic, as well as administrative, infrastructure. (Final report variously paginated.)

AGENCY SPONSOR: Office of Minority Health

FEDERAL CONTACT: Joan Jacobs

PHONE NUMBER: (301) 443-9923

PIC ID: 6246

PERFORMER ORGANIZATION: Expand Associates, Silver Spring, MD

TITLE: Environmental Health Data Needs: An Action Plan for Federal Public Health Agencies (Workshop Results, March 3-5, 1997-Linthicum Heights, Maryland)

ABSTRACT: State and local public health agencies have had a long-standing role in monitoring the human health hazards of environmental factors. Public health agencies must be able to collect the necessary information to assess the impact of environmental hazards on community health. The Federal government can help State and local public health agencies in environmental surveillance by identifying the types of information and data necessary to successfully protect community health. This report presents the findings of a conference held in March 1997 to assess the environmental health information needs of State and local governments. The report finds that (1) resources should be used to improve existing data collection systems and to increase data accessibility and usability, rather than to create new data collection systems; (2) the integration of activities and electronic data among public health, environmental health, and environmental protection agencies is vital; (3) the usefulness of environmental health information systems can be enhanced through common data architecture, delineation of core baseline and sentinel data, and a comprehensive, central environmental health data repository; (4) these information systems must be evaluated based on their usefulness to State and local agencies in responding to community demands for timely, accurate, and reliable information, and in achieving their research, surveillance, intervention, and health education goals; and (5) full funding of these systems is necessary so that they may be built into a national network that meets the needs of a national environmental health research agenda. The workshop also developed seven key roles the Federal government could play in helping States and localities improve their environmental health surveillance. Finally, the workshop considered potential short-term strategies to help the Federal government fulfill these roles. (Final report: 12 pages, plus appendices.)

AGENCY SPONSOR: Office of Disease Prevention and Health Promotion

FEDERAL CONTACT: Dalton Paxman

PHONE NUMBER: (202) 205-5829

PIC ID: 6322

PERFORMER ORGANIZATION: Public Health Foundation, Washington, DC

TITLE: Stakeholders Revisit Healthy People 2000 to Maximize the Impact for 2010

ABSTRACT: The objectives articulated in Healthy People 2000 aim to improve the health of Americans through effective prevention strategies. They form a model framework for results-oriented performance measurement that can be made relevant to both population-based and individual health care initiatives. They also serve as a benchmark against which health improvement efforts across the Nation can be measured over time. The development of Healthy People 2010 provides an opportunity to consider the successes and failures of Healthy People 2000 in achieving these important goals. Based on experience with Healthy People 2000 and major changes since 1990 in the Nation's health and health care, this report explores new approaches for the development of Healthy People 2010. The perspectives of the Healthy People Steering Committee and the Healthy People Consortium, made up of 350 member organizations were sought. Through interviews with key Steering Committee members, a retreat for the entire Steering Committee, and seven focus groups of Consortium members, clear themes and suggestions emerged. The report finds that both Steering Committee and Consortium members valued Healthy People 2000 as a framework and a voice for public health concerns and issues. However, both groups had several suggestions for the next version. For example, (1) most members of the Steering Committee thought that the document should be reduced in size, (2) Steering Committee members were more interested than Consortium members in making major changes to the document, (3) Consortium members recommended that current information technology be used in order that the document reach the widest audience possible, and (4) health care purchasers and managed care plans thought that there should be fewer priorities and objectives in order to focus on a limited number of problems. The final stakeholders' report is available on the Internet at http://web.health.gov/healthypeople.

AGENCY SPONSOR: Office of Disease Prevention and Health Promotion

FEDERAL CONTACT: Deborah R. Maiese

PHONE NUMBER: (202) 401-5809

PIC ID: 6491

PERFORMER ORGANIZATION: Academy for State and Local Government, Washington, DC

TITLE: Health of Washington Women

ABSTRACT: This report examines the health and well-being of women in Washington State. A broad coalition of Washington's health care providers, researchers, and activists organized to implement this evaluation. To add to the quantitative data collected and analyzed, the report also includes qualitative information from focus groups of women from diverse geographical areas and economic and social strata. The focus groups were conducted to gather women's perceptions and satisfaction with the health care services they received throughout the State. The data show that the nearly 2.8 million women who live in Washington State are living longer lives, are making many positive decisions about their health, and experience, on average, a better standard of living than women in United States in general. The report finds that the overwhelming majority of women in the State are white and live in urban areas, but about 11.3 percent live below the poverty line. The report also finds that women reported more days of poor mental and physical health than did men, but that they are less likely than men to have a sedentary lifestyle, are less likely to smoke, and are more likely to eat healthy fruits and vegetables. Access to health care for Washington's women is relatively good, but about 10 percent did not participate in a health insurance plan in 1994 and 12 percent reported that they were unable to see a doctor because of the cost. Furthermore, elderly women, those with less than a high school education, and poor women were less likely to use mammography and have regular Pap smears. The report also examines rates of domestic violence and sexually-transmitted diseases, as well as mortality patterns and birth-related indicators. The report provides several policy recommendations to address problem areas for Washington women's health. (Final report: 68 pages, plus appendix.)

AGENCY SPONSOR: Regional Health Administrator-Region X

FEDERAL CONTACT: Karen Matsuda

PHONE NUMBER: (206) 615-2501

PIC ID: 6684

PERFORMER ORGANIZATION: Washington Women's Education Foundation, Seattle, WA

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