The 10 Essential Public Health Services (EPHS) describe the public health activities that all communities should undertake. For the past 25 years, the EPHS have served as a well-recognized framework for carrying out the mission of public health. The EPHS framework was originally released in 1994 and more recently updated in 2020. The revised version is intended to bring the framework in line with current and future public health practice.
The revised EPHS framework was released on September 9, 2020, as a result of a collaborative effort by the Public Health National Center for Innovations (PHNCI) and the de Beaumont Foundation, who convened a task force of public health experts, leaders, and practitioners and engaged the public health community in activities to inform the changes. The task force also included experts from federal agencies, including CDC, which were instrumental in establishing and supporting the original EPHS framework. Details about the process to update the EPHS can be found on the PHNCI website, along with accompanying materials.
The 10 Essential Public Health Services provide a framework for public health to protect and promote the health of all people in all communities. To achieve equity, the Essential Public Health Services actively promote policies, systems, and overall community conditions that enable optimal health for all and seek to remove systemic and structural barriers that have resulted in health inequities. Such barriers include poverty, racism, gender discrimination, ableism, and other forms of oppression. Everyone should have a fair and just opportunity to achieve optimal health and well-being.
The National Public Health Performance Standards program supports efforts to ensure that the Essential Services are provided across the public health system. The program provides tools for state and local public health systems and public health governing bodies to assess capacity and performance.
This fourth edition marks the biggest change to the book in 20 years. For the first time it sets each key subject area in a global health context, whilst retaining its traditional strength in covering population health for the United Kingdom. New and revised chapters for this edition include:
The content is wide-ranging and written in an accessible and engaging style. It covers topics as diverse as: the story of the 2014 Ebola virus outbreak in West Africa; the elements of tobacco control policy; the health impact of climate change; the global health organisational architecture; the concept of health; the new paradigm of public mental health; the biological pathways that link to the health effects of social deprivation; the ideal of universal health coverage; the essentials of immunisation; the basis of healthy ageing; the historical events that led to the germ theory of disease and the Victorian sanitary revolution.
This new edition is essential reading for all undergraduate and postgraduate students of public health, medicine, nursing, health policy, social science, and public sector management. Those embarking on a career in public health will find it of great value throughout their professional life. The book is also an extremely useful resource for established practitioners in primary care, doctors, senior nurses, health system managers, healthcare policy makers, civil servants in ministries of health, and members of boards of health organisations.
Public Health Emergencies provides a current overview of public health emergency preparedness and response principles with case studies highlighting lessons learned from recent natural and man-made disasters and emergencies. Designed for graduate and advanced undergraduate public health students, this book utilizes the 10 essential services of public health as performance standards and foundational competencies from the Council on Education for Public Health to assess public health systems. It emphasizes the roles and responsibilities of public health careers in state and local health departments as well as other institutions and clarifies their importance during health-related emergencies in the community. Written by prominent experts, including health professionals and leaders on the frontlines, this textbook provides the framework and lessons for understanding the public health implications of disasters, emergencies, and other catastrophic events, stressing applied understanding for students interested in pursuing public health preparedness roles.
Practical in its approach, Part One begins with an introduction to the fundamentals of public health emergency preparedness with chapters on community readiness, all-hazards preparedness design, disaster risk assessments, and emergency operation plans. Part Two covers a range of public health emergency events, including hurricanes, tornadoes, earthquakes, disease outbreaks and pandemics, accidents and chemical contamination, nuclear and radiological hazards, extreme heat events, and water supply hazards. The final part addresses special considerations, such as how the law serves as a foundation to public health actions; preparedness considerations for persons with disabilities, access, and functional needs; children and disasters; and a chapter evaluating emerging and evolving threats. Throughout, chapters convey the roles of front-line, supervisory, and leadership personnel of the many stakeholders involved in preparedness, response, and recovery efforts to demonstrate decision-making in action.
During the past 150 years, two factors have shaped the modern public health system: first, the growth of scientific knowledge about sources and means of controlling disease; second, the growth of public acceptance of disease control as both a possibility and a public responsibility. In earlier centuries, when little was known about the causes of disease, society tended to regard illness with a degree of resignation, and few public actions were taken. As understanding of sources of contagion and means of controlling disease became more refined, more effective interventions against health threats were developed. Public organizations and agencies were formed to employ newly discovered interventions against health threats. As scientific knowledge grew, public authorities expanded to take on new tasks, including sanitation, immunization, regulation, health education, and personal health care. (Chave, 1984; Fee, 1987)
The link between science, the development of interventions, and organization of public authorities to employ interventions was increased public understanding of and social commitment to enhancing health. The growth of a public system for protecting health depended both on scientific discovery and social action. Understanding of disease made public measures to alleviate pain and suffering possible, and social values about the worthiness of this goal made public measures feasible. The history of the public health system is a history of bringing knowledge and values together in the public arena to shape an approach to health problems.
Sanitation also changed the way society thought about public responsibility for citizen's health. Protecting health became a social responsibility. Disease control continued to focus on epidemics, but the manner of controlling turned from quarantine and isolation of the individual to cleaning up and improving the common environment. And disease control shifted from reacting to intermittent outbreaks to continuing measures for prevention. With sanitation, public health became a societal goal and protecting health became a public activity.
At the same time, public responsibility for the health of the population became more acceptable and fiscally possible. In earlier centuries, disease was more readily identified as only the plight of the impoverished and immoral. The plague had been regarded as a disease of the poor; the wealthy could retreat to country estates and, in essence, quarantine themselves. In the urbanized nineteenth century, it became obvious that the wealthy could not escape contact with the poor. \"Increasingly, it dawned upon the rich that they could not ignore the plight of the poor; the proximity of gold coast and slum was too close.\" (Goudsblom, 1986) And the spread of contagious disease in these cities was not selective. Almost all families lost children to diphtheria, smallpox, or other infectious diseases. Because of the the deplorable social and environmental conditions and the constant threat of disease spread, diseases came to be considered an indicator of a societal problem as well as a personal problem. \"Poverty and disease could no longer be treated simply as individual failings.\" (Fee, 1987) This view included not only contagious disease, but mental illness as well. Insanity came to be viewed at least in part as a societal failing, caused by physical, moral, and social tensions.
Chadwick's report was quite controversial, but eventually many of his suggestions were adopted in the Public Health Act of 1848. The report, which influenced later developments in public health in England and the United States, documented the extent of disease and suffering in the population, promoted sanitation and engineering as means of controlling disease, and laid the foundation for public infrastructure for combating and preventing contagious disease.
Shattuck's report was widely circulated after publication, but because of political upheaval at the time of release nothing was done. The report \"fell flat from the printer's hand.\" In the years following the Civil War, however, the creation of special agencies became a more common method of handling societal problems. Massachusetts set up a state board of health in 1869. The creation of this board reflected more a trend of strengthened government than new knowledge about the causes and control of disease. Nevertheless, the type of data collected by Shattuck was used to justify the board. And the board relied o