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Ep3-Who Knew? What Health Departments Do
A health department in Kentucky pays half your rent. Another in Oregon runs the county jail's medical system. A third in Iowa partners with businesses to raise wages for childcare workers.
How did we end up with a public health system where one department operates comprehensive medical clinics while another struggles to conduct timely septic inspections?
Let’s investigate the 4 categories of work that state and local health departments choose from when planning their activities: foundational services (disease response and restaurant inspections), clinical care for low-income residents, social determinants of health (housing and nutrition), and health strategy (coordinating all the pieces of a community's health infrastructure).
Most local public health departments don't do all four. Some can barely manage one. The variation is staggering.
Regardless, all public health agencies are better off when they find community-based partners to collaborate with and engage regularly with their residents… Even better when they can prove their efficacy, quantify the return on investment, and explain why they take actions that might well be unpopular.
Chapter Markers
00:00 What Do Health Departments Actually Do?
01:51 Local Health Department Variation
03:33 Four Buckets of Foundational Services
05:17 Clinical Care and the Safety Net
07:05 Social Determinants of Health
09:20 Chief Health Strategist Role
10:53 Five Paths to Build Trust
About Michael Sparer
Michael S. Sparer, J.D., Ph.D. is Chair of the Department of Health Policy and Management at Columbia University's Mailman School of Public Health, where he has taught for over 30 years. He also directs the Center for Public Health Systems, which examines how America's fragmented public health infrastructure functions and how it can better serve communities.
Professor Sparer’s research examines how policy shapes politics both in health insurance systems and in local health departments. He is particularly expert in Medicaid policy and in the inter-governmental dynamics that have shaped the evolution of that program. His work on public health has also focused on federalism and on the ways in which local health departments respond to changing political and fiscal environments. Before his academic career, he spent seven years as a litigator for the New York City Law Department. He is a three-time recipient of Columbia teaching excellence awards and former editor of the Journal of Health Politics, Policy and Law.
About the Mailman School of Public Health, Center for Public Health Systems
The Center for Public Health Systems at Columbia's Mailman School of Public Health conducts needed research, facilitates public discussions, develops policy proposals, and provides educational programs, all with the goal of encouraging a better, more efficient, and more equitable public health system. This work builds on the recognition that the nation’s public health system is currently under-resourced, under-paid, and under-valued and that a stabilized and strengthened system would benefit all of us.
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By Center for Public Health SystemsA health department in Kentucky pays half your rent. Another in Oregon runs the county jail's medical system. A third in Iowa partners with businesses to raise wages for childcare workers.
How did we end up with a public health system where one department operates comprehensive medical clinics while another struggles to conduct timely septic inspections?
Let’s investigate the 4 categories of work that state and local health departments choose from when planning their activities: foundational services (disease response and restaurant inspections), clinical care for low-income residents, social determinants of health (housing and nutrition), and health strategy (coordinating all the pieces of a community's health infrastructure).
Most local public health departments don't do all four. Some can barely manage one. The variation is staggering.
Regardless, all public health agencies are better off when they find community-based partners to collaborate with and engage regularly with their residents… Even better when they can prove their efficacy, quantify the return on investment, and explain why they take actions that might well be unpopular.
Chapter Markers
00:00 What Do Health Departments Actually Do?
01:51 Local Health Department Variation
03:33 Four Buckets of Foundational Services
05:17 Clinical Care and the Safety Net
07:05 Social Determinants of Health
09:20 Chief Health Strategist Role
10:53 Five Paths to Build Trust
About Michael Sparer
Michael S. Sparer, J.D., Ph.D. is Chair of the Department of Health Policy and Management at Columbia University's Mailman School of Public Health, where he has taught for over 30 years. He also directs the Center for Public Health Systems, which examines how America's fragmented public health infrastructure functions and how it can better serve communities.
Professor Sparer’s research examines how policy shapes politics both in health insurance systems and in local health departments. He is particularly expert in Medicaid policy and in the inter-governmental dynamics that have shaped the evolution of that program. His work on public health has also focused on federalism and on the ways in which local health departments respond to changing political and fiscal environments. Before his academic career, he spent seven years as a litigator for the New York City Law Department. He is a three-time recipient of Columbia teaching excellence awards and former editor of the Journal of Health Politics, Policy and Law.
About the Mailman School of Public Health, Center for Public Health Systems
The Center for Public Health Systems at Columbia's Mailman School of Public Health conducts needed research, facilitates public discussions, develops policy proposals, and provides educational programs, all with the goal of encouraging a better, more efficient, and more equitable public health system. This work builds on the recognition that the nation’s public health system is currently under-resourced, under-paid, and under-valued and that a stabilized and strengthened system would benefit all of us.