HISTORY
The nation has seen an awakening to the important role the public health system plays in improving the nation’s health status and in assuring that the public is protected from potential health problems. The release of two Institute of Medicine reports on the future of public health prompted a major examination of and investment in the nation’s public health system infrastructure. Efforts to improve and develop the nation’s public health system spurred many organizations and agencies to undertake new and significant initiatives designed to impact community health status through twin goals: community health improvement and protection.
As outlined in the goals of the National Public Health Performance Standards Program, it is crucial that public health practitioners encourage further development of the evidence base of Public Health and Public Health Services and Systems Research (PHSSR). The National Coordinating Center for PHSSR is designed to facilitate the efforts of the PHSSR community. The Center is working to establish a knowledge base that will allow researchers to optimize scarce resources to support the development, evaluation, and improvement of the public health system’s organization, financing, and delivery of services in the nation’s communities.
TIMELINE
1914:
American Medical Association commissions the development of methods for the comparative assessment of state public health agencies and their services, with the goal of making empirically-supported recommendations for improving public health services.
1925:
The American Public Health Association forms the Committee on Administrative Practice, which develops an appraisal form methodology for assessing and comparing local public health services, and conducts a series of comparative measurement and assessment activities through the 1950s.
1960's:
Professional associations including APHA and ASTHO commission studies that examine the role of public health agencies in medical care provision, including a focus on their changing roles and responsibilities after implementation of Medicare, Medicaid, and the federal Neighborhood Health Centers program (later called Community Health Centers).
1974:
Arden Miller, Gordon DeFriese, Ned Brooks and colleagues at UNC-Chapel Hill conduct the first national survey of local health departments in more than a decade, characterizing the organization, financing, staffing, and service delivery patterns of these agencies. This work leads to a series of studies led by Miller and supported by the Robert Wood Johnson Foundation and the Bureau of Community Health Services within the U.S. Department of Health and Human Services during the 1970s and 1980s.
1981:
Gordon DeFriese and colleagues publish the first typology of organizational arrangements between state and local public health agencies in the American Journal of Public Health.
1988:
The Institute of Medicine issues its landmark report, The Future of Public Health, which identified many weaknesses in how public health activities are organized, financed, and delivered, and articulated a set of three core public health functions that should be performed in every state and community.
1989:
The National Association of County and City Health Officials conducts its first census survey of local health departments, the National Profile of Local Health Departments. Subsequent surveys are conducted in 1992-93, 1997, 1999, 2005, 2008 and 2010 with principal support from CDC and RWJF.
1990's:
Guided by the IOM report, the U.S. Centers for Disease Control and Prevention commission a series of studies to develop methods for measuring the extent to which core public health functions are performed by local health departments. Arden Miller at UNC-Chapel Hill and Bernard Turnock at the University of Illinois-Chicago lead seminal studies in this area throughout the decade.
1998:
The CDC's National Public Health Performance Standards Program begins to develop performance measures for state and local public health systems, under the leadership of Paul Halverson and colleagues.
1999:
A pioneering group of researchers meets with CDC officials to discuss approaches for applying health services research concepts and methods more broadly to the public health system.
2000:
AcademyHealth, the nation's professional association for health services and systems research, launches a special interest group meeting devoted to public health services and systems research, with start-up funding provided by CDC. The interest group meets annually, later with funding from the Robert Wood Johnson Foundation.
2003:
A definition of the emerging field of public health services and systems research is proposed by Glen Mays, Douglas Scutchfield and Paul Halverson in a special issue of the Journal of Public Health Management and Practice devoted to progress in the field.
2005:
The Robert Wood Johnson Foundation notices what’s being done in the field, and a relationship with RWJF begins with the funding of a project for the Center for Public Health Systems and Services Research to work with the National Library of Medicine to identify databases pertinent to PHSSR. The PHSSR subset now boasts more than 160 datasets, instruments and indices in the database. In the process of identifying databases, the Center identifies key bibliographic resources for the PHSSR community.
RWJF funds a series of studies on public health organization and financing through a special solicitation in its Changes in Health Care Financing and Organization (HCFO) program administered by AcademyHealth. Projects and grants continue to increase, propelling the burgeoning field of PHSSR.
2007:
The Center for Public Health Systems and Services Research is established at the University of Kentucky and funded through a grant from RWJF.
Since 2007, the Center’s role has included:
- Creating a work group to ensure that existing public health data is easier to analyze. Once completed, the three organizational survey results will be integrated into a comprehensive repository for use in public health services and systems research. That database will be integrated with others to put new, richer information at the fingertips of researchers.
- Coordinating and uniting the activities of our partners: Public Health Law Network, Public Health Law Research, Practice Based Research Networks, Public Health Finance, AcademyHealth’s PHSSR interest group, National Network of Public Health Institutes.
- Nurturing the growth of tomorrow’s researchers by awarding mini-grants to 29 junior faculty or doctoral dissertation candidates from across the nation.
- Launching the online community devoted to PHSSR. Membership has grown to more than 500 members who receive regular electronic updates via the InsideTrack e-newsletter and alerts.
- Hosting the Keeneland Conference, a gathering place for more than 300 public health researchers, practitioners and policymakers to come together to learn about new developments in the field of PHSSR, share information and network.
- Connecting the PHSSR community through social media:
- Linking professionals from around the world for collaboration and training through technology.
- Sharing news about various PHSSR topics, funding opportunities and information about events through newsletters from the National Association of County and City Health Officials, the Association of Schools of Public Health, and Academy Health.
- Spreading the word about our work through social media, cross promotion with various groups and exhibits, and trade shows where we reach out to the public health community.
2010:
RWJF selects the University of Kentucky as the home of the new National Coordinating Center for Public Health Services and Systems Research, charged with focusing on five pillars:
- Education of researchers
- Education of practitioners to use research
- Increase number of funding sources for research
- Increase number of grants available to PHSSR researchers
- Provide technical assistance, communication, dissemination, utilization and visibility of PHSSR