problem. . . . Its focus is on the interconnection between "causes" and illnesses and the ways they affect each other, as well as the link ages among "causes" and among illnesses. All these ties suggest the plausibility of viewing today'shealth problem as a response to modern environments,and one therefore amenable to improvement throughpublic policy measures (Milio, 1981, p. 9).
Public health policy development is a part of the broader development of social policy. The concepts involving the provision of social services including health care services were expanded and changed significantly in the United States between the early 1920s and the mid 1980s. At one time in the United States, the provision of social services was exclusively the province of private individuals and organizations. During this era, social services, when they were available, were most often provided through religious organizations. As a result of significant shocks to American society between World War I and World War II most significantly the "Great Depression," the concept of a government responsibility for the provision and delivery of social services gained credence. As important as these beginnings were, however, the social service activities of the inter war period were limited in both breadth and depth, in comparison with the postwar period of the 1950s public sector presence in the development, provision, and delivery of social services including health care services.
Between the mid 1940s and the mid 1970s, the pendulum of responsibility for the provision and delivery of social services swung far to the governmental side and away from the private sector side. The swing toward governmental responsibility did not mean an end to private sector participation in the provision and delivery of social services. Many private sector agencies continued to function in a few instances, with little or no change in their operations; in some insta...