Exam 8: The State Public Health Agencies

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State and local organizational relationships differ throughout the United States, with states adopting a centralized, shared, decentralized, or mixed governance structure. Give a brief explanation of each of these four organizational models.

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Centralized - Local health units are primarily led by state employees and the state retains authority over most decisions related to finances, public health orders, and the selection of local health officials.
Shared - Local health units may be led by state or local government employees. If they are led by state employees, the local government has the authority to make key decisions. In states with a shared governance system where LHDs are led by local employees, the SHA retains the authority to make certain key decisions.
Decentralized - Local health units are primarily led by local government employees, and the local governments retain authority over most key decisions.
Mixed - Some local health units are led by state employees and some are led by local government employees; no one arrangement predominates in the state.

Nearly all activities of public health are now supported by some form of information technology. The advent of public health informatics provides an abundance of data resources. List three ways in which data collection and analysis are critical to SHA operations.

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a. To identify changing needs for health programs
b. To identify emerging threats to the public's health
c. To identify and assess current and future priorities for policies, funding, and program activities

List at least four health areas in which SHAs become involved in providing direct care for community members.

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a. Services for pregnant women and children
b. Family planning
c. Cancer screening
d. Dental health
e. Treatment for TB
f. Treatment for HIV and sexually transmitted diseases
g. Primary medical care, especially for those in rural areas and other areas with clinical workforce shortages

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