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The Essential Public Health Services

The diagram to the right depicts the ten essential public health

services that have been defined, and the specific actions that are

necessary to maintain and improve the community’s public health.

The outer perimeter of the circle indicates the core functions of

these services. These specific functions in the public health system,

when followed, provide assurance to the public, that they will live healthy and happy lives,

through disease prevention, and protection programs within the community.

The three core functions of public health noted in the outer ring of the diagram are: assessment,

policy development and assurance. The first core function is assessment. Two of the essential

public health services are included in this core function. The first is to monitor the community

environment and the health status of the public. It requires identification of any health threats or

problems, and identification of specific groups that may be at high risk. The community health

service must also solve community health problems.

The second essential public health service also falls under the core function of assessment. The

requirement of this service is to diagnose and investigate health problems and health hazards

which exist within the community. This includes ensuring water standards are maintained, the

identification of possible hazardous wastes, and to focus on poor housing conditions to prevent

any hazards that could affect public health.

The third essential public health service falls under the core function of policy development. It

includes the need to inform, educate and empower the community about existing health issues.

This service includes population-targeted provision of health information within the community,

and the collaboration with other health care providers. It also includes the dissemination of

health education within worksites, schools and churches.

The fourth essential public health service is included in the core function of assessment,

addresses the need for community public health collaboration and partnerships. It states that the

community needs to mobilize community partnerships to solve existing community health

problems. These program partnerships could include housing authorities, law enforcement,

schools and other community organizations. Included in this service is the need for preventive

screening and support programs.

The fifth essential public health service is included in the policy development core function. It

addresses the need for development of plans and policies that could include safe, affordable

housing which, could help the homeless, and other programs such as full-day kindergarten.

Policies to be created would include the planning for community health improvement by the

community local government.

The sixth essential public health service falls under the core function of assurance. It requires the

enforcement of the laws and regulations which enforce and protect the community public health

and safety. This would include safety in the food industry, and provision of clean water supplies

and the enforcement of clean air policies.

The seventh essential public health service also falls under the assurance core function. It defines

the need to link people to the needed personal healthcare services, and assures the provision of

healthcare when it is not available to the public. This service is listed as a community outreach

and an “enabling” service.

The eighth essential health service also is part of the assurance core function. The community

must assure the availability of a competent public and personal healthcare workforce. This

service can include the education and training of healthcare workers to meet the community


The ninth essential health service is also part of the assurance core function. This service requires

continuous evaluation of existing health programs for effectiveness, quality of the personnel and

accessibility to healthcare services.

The tenth and final essential health service falls under the assurance core function. It stipulates

the need for new research, which could provide new original solutions to health problems. The

research specified addresses the need for community-based participatory research designs.

At my community-concentration site, (Rutgers Cooperative Extension, Department of Family

and Community Health Sciences), a great deal of their work falls under the scope of the third

essential public health issue, which states the need to inform, educate and empower people about

health problems. The members of the organization work to specifically educate the population of

Hunterdon County, New Jersey on health issues, and how to prevent them. With my preceptor, I

have presented numerous nutrition and health education classes within the county. Together,

with the person in charge of cancer prevention at Hunterdon Medical Center, we presented

information on colorectal cancer, and the dietary recommendations for preventing this disease.

The health professional from the Medical Center presented information on the need to be

screened for colorectal cancer. We presented the dietary methods of prevention, which are

recommended by the American Institute of Cancer Research. The program developed into a long
presentation, as it became very interactive with attending participants. It was obvious that the

attendees wanted to learn the information which we provided. The facility receives requests for

these types of programs from various community healthcare professionals, on a regular basis.

Additionally, the facility participates in a “Grow Healthy” program, which involves the

elementary schools within the county. The Family and Community Health Sciences department

of Rutgers Cooperative extension, works to educate the young students in the county on healthy

eating and lifestyles, by educating them on ways to eat more fruits and vegetables, making smart

food choices and becoming more physically active. The schools are also able to participate in

creating school gardens, with the help of the Master Gardeners from the Rutgers Cooperative


Through my Wellness project we designed and implemented a Worksite Wellness Program for

Hunterdon County Employees. This program is actually an example of primary prevention

strategies. The group meets once monthly, and we provide education on the prevention of

chronic disease, through healthy eating, improved physical activity and stress management. I

have had the opportunity to participate in many of these programs which involve educating and

empowering the various populations in Hunterdon County, New Jersey.

Additionally, my community concentration site works to mobilize community partnerships and

actions that they can collaboratively work to resolve health problems. This is required under the

seventh essential public health service. My preceptor is a member of the Hunterdon County

Partnership for Health. I have attended one of their monthly meetings. Some of the members

included in this program are health practitioners from Hunterdon Medical Center, Hunterdon

Behavioral Health, the Cancer Coalition of Hunterdon and Mercer Counties, board members of
local schools, United Way of Hunterdon County, New Jersey Department of Health, and

Hunterdon Drug Awareness Programs. These are only a few of the members. The list is quite

extensive. Collaboratively, they work to develop health programs for the community which offer

preventive information, and information on health improvement. Recently, the program members

scheduled a county-wide 3-mile walk to be held on a Wednesday, at 3 different locations, and

three different times. Participation was great, even though the weather was not. The group

intends to promote additional walks over the course of this spring and summer, with an effort to

promote the importance of regular physical activity.

Another program which I was lucky enough to participate in was the planning of a Summer

Feeding Program for children of Flemington, New Jersey. The gentleman who initiated this

program runs the Salvation Army in Flemington. Together with my preceptor and this gentleman

who initiated the program, we planned the entire menu for the summer, the food that would be

required, and assisted with the documentation which needed to be sent to the USDA for

approval. The Partnership for Health, collaboratively again, is working to locate volunteers to

facilitate implementation of this program.

These are only a few the health programs that my facility is involved in. They also work with the

SNAP-Ed programs. One large program which they offer annually, is the 4-H Fair, where they,

among other events, conduct health screenings. Again, this event is one that is planned

collaboratively with other members of the Hunterdon County Partnership for Health.

My preceptor is a member of the Diabetes Coalition, in which she works cooperatively with

other Registered Dietitians from the Diabetes Center of Hunterdon Medical Center. Once

diabetes patients have completed their initial diabetes education at the center, they are referred to
one of my preceptor’s diabetes support groups. If my preceptor finds that new members to the

diabetes support group require additional individual counselling, she will either refer them back

to the Diabetes center, or to an Endocrinologist within the Hunterdon Healthcare System. This is

an example of Essential Public Health Service number seven, which requires people who work in

the public healthcare system to link people to needed personal health services.

At the meetings, I have had the opportunity to meet other Registered Dietitians, who are

members of the Hunterdon Partnership for Health. One RD who I recently met, had just initiated

a weight management program for older children, at one of the local Wellness Centers. I have

observed many wonderful collaborations within the community at these program meetings. Some

of the RD’s that I have met work in a clinical setting, but they attend the meetings to offer their

knowledge and support, and often to volunteer at one of the many functions the Partnership for

Health offers. I have been lucky enough to observe how many Registered Dietitians are called

upon within the community to contribute to the improvement of the public health of Hunterdon