ic functions--an index of the extent to which the PHS is meeting its responsibilities and duties--Turnock, Handler, Potsic, Nalluri and Vaughn (1994) examined a random national sample (stratified by jurisdiction and population base) of local health departments. The purpose of the study was to survey these departments in order to determine self-reported compliance with 10 public health practice performance measures that were said to operationalize the three core PHS functions.
Overall compliance with the 10 performance measures was observed to be around 50 percent, based on weighted responses of 208 responding health departments. Compliance was highest for the practices related to the assurance function and least for practices related to the policy development function.
Compliance was also high for departments serving a population of 50,000 or more and those smaller departments organized at the city and city-county levels. Using two different definitions developed by the investigators, 19 and 31 percent of the health departments were judged to be effective in addressing the core functions of public health.
According to the authors, their data suggested that less than 40 percent of the U.S. population was served by a health department effectively addressing the core functions of public health in 1993. It was concluded that considerable capacity building within the public health system is needed. Based on the fact that these core functions are said to be reflective of PHS duties and responsibilities, it can also be concluded that system building is needed before the PHS can be stated to be adequately discharging its duties and responsibilities.
The services provided by the PHS are best illustrated through a review of the major units that comprise the system's core. These units are the: (1) National Institutes of Health (2) Substance Abuse and Mental Health Service Administration;
(3) Agency for Toxic Substances and...