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Definitions

Community is a group of people who have common characteristics; communities can be defined by location, race, ethnicity, age, occupation, interest in particular problems or outcomes, or other similar common bonds. Ideally, there would be available assets and resources, as well as collective discussion, decision-making and action. (Turnock, BJ. Public Health: What It Is and How It Works. Jones and Bartlett, 2009)

Comunidad es un grupo de personas que tienen características comunes; las comunidades pueden definirse por ubicación, raza, etnia, edad, ocupación, interés en problemas o resultados particulares u otros vínculos comunes similares. Idealmente, habría bienes y recursos disponibles, así como debates, toma de decisiones y acciones colectivas. (Turnock, BJ. Public Health: What It Is and How It Works. Jones and Bartlett, 2009)

Equity is defined as a fair and just opportunity for all to achieve good health and well-being. This requires removing obstacles to health such as poverty and discrimination and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and healthcare. It also requires attention to health inequities, which are differences in population health status and mortality rates that are systemic, patterned, unjust, and actionable, as opposed to random or caused by those who become ill.

Equidad es el que todas las personas tengan una oportunidad justa para gozar de buena salud y bienestar. Esto requiere eliminar obstaculos a la salud, tales como la pobreza y el discrimen y sus consecuencias, incluidas la impotencia y la falta de acceso a buenos empleos con un salario justo, educación y vivienda de calidad, ambientes seguros y atención médica. Además, requiere atención a las inequidades en salud, las cuales son diferencias en el estado de salud y tasas de mortalidad en una población que siguen un patrón y son sistémicas, injustas y remediables, por lo que no son aleatorias o causadas por aquellos que desarrollan una enfermedad.

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The bibliographic citation for this definition is: Preamble to the Constitution of WHO as adopted by the International Health Conference, New York, 19 June - 22 July 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of WHO, no. 2, p. 100) and entered into force on 7 April 1948. The definition has not been amended since 1948.

Salud es un estado de completo bienestar físico, mental y social, y no la mera ausencia de enfermedades o dolencias. La cita bibliográfica de esta definición proviene del Preámbulo de la Constitución de la OMS, según lo aprobado por la Conferencia Internacional de la Salud, Nueva York, del 19 de junio al 22 de julio de 1946, firmada el 22 de julio de 1946 por los representantes de 61 Estados (Registros Oficiales de la OMS, n.° 2, p. 100), y que entró en vigencia el 7 de abril de 1948. La definición no se ha enmendado desde 1948.

Healthcare sector is defined as entities that provide clinical services, mental health services, oral health services, provide or pay for services for individuals, or facilitate the provision of services to individuals. Entities in this sector may include hospitals, health systems, health plans, health centers, behavioral health providers, oral health providers, etc.

Sector de atención médica es definido como las entidades que proveen servicios clínicos, servicios de salud mental, servicios de salud oral, proveen o pagan por servicios para individuos, o facilitan la provisión de servicios a individuos. Entidades en este sector pueden incluir hospitales, sistemas de salud, planes de salud, centros de salud, proveedores de salud del comportamiento, proveedores de salud oral, etc.

Law(s) refer to the aggregate of statutes, ordinances, regulations, rules, judicial decisions, and accepted legal principles that the courts of a particular jurisdiction apply in deciding controversies brought before them. The law consists of all legal rights, duties, and obligations that can be enforced by the government (or one of its agencies) and the means and procedures for enforcing them. (Garner, B.A. editor. Black’s Law Dictionary. 8th ed. West Group; 2004)

Ley(es) se refiere al conjunto de estatutos, ordenanzas, reglamentaciones, reglas, decisiones judiciales y principios legales aceptados que los tribunales de una jurisdicción particular aplican al decidir las controversias que se les presentan. La ley consiste en todos los derechos, los deberes y las obligaciones legales que el Gobierno (o uno de sus organismos) puede aplicar y los medios y los procedimientos para aplicarlos. (Garner, B.A., editor. Black’s Law Dictionary. 8.va ed., West Group, 2004)

Population health is the health outcomes of a group of individuals, including the distribution of such outcomes within the group. The field of population health includes health outcomes, patterns of health determinants, and policies and interventions that link these two. Population health approaches are community or policy non-clinical approaches that aim to improve health and  wellbeing of a group of individuals. This differs from population health management which refers to improving clinical health outcomes of individuals through improved care coordination and patient engagement supported by appropriate financial and care models. (Adapted from Kindig and Stoddart).

Salud de la población son los resultados de salud de un grupo de individuos, incluida la distribución de tales resultados en el grupo. El campo de la salud de la población incluye resultados de salud, patrones en los determinantes de salud, y políticas e intervenciones que unen a ambos. Los enfoques en salud de la población son enfoques no-clínicos comunitarios o de políticas cuyo fin es mejorar la salud y bienestar de un grupo de individuos. Esto difiere del manejo de salud de la población, el cual intenta mejorar los resultados de salud clínicos de individuos a través de mejoras en la coordinación de cuidado y participación del paciente respaldados por modelos financieros y de cuidado apropiados. (Adaptado de Kindig y Stoddart).

Public health is defined as the science of protecting the safety and improving the health of communities through education, policy making and research for disease and injury prevention. (CDC Foundation).

Salud pública es definida como la ciencia dedicada a proteger la seguridad y mejorar la salud de las comunidades a través de la educación, la formulación de políticas y la investigación para la prevención de enfermedades y lesiones. (Fundación CDC).

Research is a systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to generalized knowledge. (United States Department of Health and Human Services. Healthy People 2020. Washington, DC)
-    Community-based Participatory Research (CBPR) is a collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings. CBPR begins with a research topic of importance to the community, has the aim of combining knowledge with action and achieving social change to improve health outcomes and eliminate health disparities. (W. K. Kellogg Foundation, Community Health Scholars Program, 2001 quotes from Minkler M, and Wallerstein N, editors. Community-Based Participatory Research for Health. San Francisco, CA: Jossey-Bass Inc.; 2003)

Investigación es un estudio sistemático, incluidos el desarrollo, comprobación, y evaluación de una investigación, diseñada para desarrollar o contribuir a un conocimiento generalizable. (Departamento de Salud y Servicios Humanos (HHS, por sus siglas en inglés). Healthy People 2020. Washington, DC).
-    Investigación Participativa Basada en la Comunidad (CBPR, por sus siglas en inglés), es un enfoque a la investigación colaborativo que involucra equitativamente a todas las partes en el proceso investigativo y reconoce las fortalezas únicas que cada cual trae. CBPR comienza con un tema de investigación de importancia para la comunidad, tiene como objetivo combinar el conocimiento con acción y lograr el cambio social para mejorar los resultados de salud y eliminar disparidades en la salud. (Fundación W. K. Kellogg, Programa Community Health Scholars, citas de 2001 de Minkler M, y Wallerstein N, editores. Community-Based Participatory Research for Health. San Francisco, CA: Jossey-Bass Inc.; 2003).

From spring 2019 to September 2020, the Public Health National Center for Innovations (PHNCI) partnered with the de Beaumont Foundation to review and revise the 10 Essential Public Health Services (EPHS). The 10 EPHS framework was developed in 1994 by a federal working group. It serves as the description of the activities that public health systems should undertake in all communities. Health departments and community partners around the nation organize their work around the Essential Public Health Services framework, schools and programs of public health teach it, and the framework informs descriptions and definitions of practice.

The framework has provided a roadmap of goals for carrying out the mission of public health in communities around the nation. However, the public health landscape has shifted dramatically since 1994, and in 2019 many public health leaders agreed it was time to revisit whether and how the framework could better reflect current and future practice and how it can be used to create communities where people can achieve their best possible health. The new version includes the most up-to-date framework. To learn about the process, the task force, and more, click here.

Watch the launch event featuring public health leaders:

Celebrating 25 Years and Launching the Revised 10 Essential Public Health Services

The New 10 Essential Services

1) Assess and monitor population health status, factors that influence health, and community needs and assets

This service includes:

  • Maintaining an ongoing understanding of health in the jurisdiction by collecting, monitoring, and analyzing data on health and factors that influence health to identify threats, patterns, and emerging issues, with a particular emphasis on disproportionately affected populations
  • Using data and information to determine the root causes of health disparities and inequities
  • Working with the community to understand health status, needs, assets, key influences, and narrative
  • Collaborating and facilitating data sharing with partners, including multi-sector partners
  • Using innovative technologies, data collection methods, and data sets
  • Utilizing various methods and technology to interpret and communicate data to diverse audiences
  • Analyzing and using disaggregated data (e.g., by race) to track issues and inform equitable action
  • Engaging community members as experts and key partners

This service includes:

  • Anticipating, preventing, and mitigating emerging health threats through epidemiologic identification
  • Monitoring real-time health status and identifying patterns to develop strategies to address chronic diseases and injuries
  • Using real-time data to identify and respond to acute outbreaks, emergencies, and other health hazards
  • Using public health laboratory capabilities and modern technology to conduct rapid screening and high-volume testing
  • Analyzing and utilizing inputs from multiple sectors and sources to consider social, economic, and environmental root causes of health status
  • Identifying, analyzing, and distributing information from new, big, and real-time data sources

This service includes:

  • Developing and disseminating accessible health information and resources, including through collaboration with multi-sector partners
  • Communicating with accuracy and necessary speed
  • Using appropriate communications channels (e.g., social media, peer-to-peer networks, mass media, and other channels) to effectively reach the intended populations
  • Developing and deploying culturally and linguistically appropriate and relevant communications and educational resources, which includes working with stakeholders and influencers in the community to create effective and culturally resonant materials
  • Employing the principles of risk communication, health literacy, and health education to inform the public, when appropriate
  • Actively engaging in two-way communication to build trust with populations served and ensure accuracy and effectiveness of prevention and health promotion strategies
  • Ensuring public health communications and education efforts are asset-based when appropriate and do not reinforce narratives that are damaging to disproportionately affected populations

This service includes:

  • Convening and facilitating multi-sector partnerships and coalitions that include sectors that influence health (e.g., planning, transportation, housing, education, etc.)
  • Fostering and building genuine, strengths-based relationships with a diverse group of partners that reflect the community and the population
  • Authentically engaging with community members and organizations to develop public health solutions
  • Learning from, and supporting, existing community partnerships and contributing public health expertise

This service includes:

  • Developing and championing policies, plans, and laws that guide the practice of public health
  • Examining and improving existing policies, plans, and laws to correct historical injustices
  • Ensuring that policies, plans, and laws provide a fair and just opportunity for all to achieve optimal health
  • Providing input into policies, plans, and laws to ensure that health impact is considered
  • Continuously monitoring and developing policies, plans, and laws that improve public health and preparedness and strengthen community resilience
  • Collaborating with all partners, including multi-sector partners, to develop and support policies, plans, and laws
  • Working across partners and with the community to systematically and continuously develop and implement health improvement strategies and plans, , and evaluate and improve those plans

This service includes:

  • Ensuring that applicable laws are equitably applied to protect the public’s health
  • Conducting enforcement activities that may include, but are not limited to sanitary codes, especially in the food industry; full protection of drinking water supplies; and timely follow-up on hazards, preventable injuries, and exposure-related diseases identified in occupational and community settings
  • Licensing and monitoring the quality of healthcare services (e.g., laboratory, nursing homes, and home healthcare)
  • Reviewing new drug, biologic, and medical device applications
  • Licensing and credentialing the healthcare workforce
  • Including health considerations in laws from other sectors (e.g., zoning)

This service includes:

  • Connecting the population to needed health and social services that support the whole person, including preventive services
  • Ensuring access to high-quality and cost-effective healthcare and social services, including behavioral and mental health services, that are culturally and linguistically appropriate
  • Engaging health delivery systems to assess and address gaps and barriers in accessing needed health services, including behavioral and mental health
  • Addressing and removing barriers to care
  • Building relationships with payers and healthcare providers, including the sharing of data across partners to foster health and well-being
  • Contributing to the development of a competent healthcare workforce

This service includes:

  • Providing education and training that encompasses a spectrum of public health competencies, including technical, strategic, and leadership skills
  • Ensuring that the public health workforce is the appropriate size to meet the public’s needs
  • Building a culturally competent public health workforce and leadership that reflects the community and practices cultural humility
  • Incorporating public health principles in non-public health curricula
  • Cultivating and building active partnerships with academia and other professional training programs and schools to assure community-relevant learning experiences for all learners
  • Promoting a culture of lifelong learning in public health
  • Building a pipeline of future public health practitioners
  • Fostering leadership skills at all levels

This service includes:

  • Building and fostering a culture of quality in public health organizations and activities
  • Linking public health research with public health practice
  • Using research, evidence, practice-based insights, and other forms of information to inform decision-making
  • Contributing to the evidence base of effective public health practice
  • Evaluating services, policies, plans, and laws continuously to ensure they are contributing to health and not creating undue harm
  • Establishing and using engagement and decision-making structures to work with the community in all stages of research
  • Valuing and using qualitative, quantitative, and lived experience as data and information to inform decision-making

This service includes:

  • Developing an understanding of the broader organizational infrastructures and roles that support the entire public health system in a jurisdiction (e.g., government agencies, elected officials, and non-governmental organizations)
  • Ensuring that appropriate, needed resources are allocated equitably for the public’s health
  • Exhibiting effective and ethical leadership, decision-making, and governance
  • Managing financial and human resources effectively
  • Employing communications and strategic planning capacities and skills
  • Having robust information technology services that are current and meet privacy and security standards
  • Being accountable, transparent, and inclusive with all partners and the community in all aspects of practice

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