The Evolution of Public Health in the United States: A Report

This report provides a comprehensive overview of the development of public health in the United States, tracing its evolution from the colonial period to the present day. It highlights the shift from reactionary measures to proactive policies and the increasing involvement of federal and state governments in healthcare. The report emphasizes the importance of sanitation, disease control, and the establishment of healthcare institutions. It discusses the role of healthcare administrators in understanding public health needs and developing effective policies to address issues like infectious diseases, chronic diseases, and socio-economic health disparities. The report concludes that the evolution of public health in the U.S. has improved the quality of care and reduced health inequalities. The report stresses the importance of knowledge and skill of healthcare administrators in designing healthcare policy and improving the healthcare service quality further.

Discuss the Development of Public Health in U.S
Name of the Student
Name of the University
Author Note

1
Introduction
The main federal unit that is responsible for public health in the United States (U.S) is
U.S Public Health Service in the Department of Health and Human Services. The second
major units are Health Care Financing Administration and Department of Health and Human
Services. Other federal departments with responsibilities of controlling the public health
services in the US include Food and Nutrition Service in the Department of Agriculture, the
Office of Special Education and Rehabilitative Services of the Department of Education and
Environmental Protection Agency (Mossialos et al., 2016). The following report will discuss
the development of public health in the U.S. In doing so the paper will highlight how the
sequential development of public health caused the change in the overall service quality of
the U.S healthcare system. The paper will also highlight importance of a knowledgeable
healthcare administrator for proper execution of the healthcare service delivery.
Discussion
Evolution of the U.S public health
The U.S is a capitalistic nation and the presumption is that the ruling government
intervenes only when the markets fail. However, the healthcare sectors fail to function in a
manner that is consistent with the other competitive markets and thus the evolution of the U.S
healthcare system is not consistent with the other business market (Hill, 1912). The evolution
of the American health care system into its present state initiated during the colonial period
when the small agricultural communities were predominant. During the initial stages, the
federal government had limited role towards the development and implementation of the
health care strategies and thus leaving majority of the responsibilities over the shoulder of the
states and private sector organization. The state and the private sector organization mainly

2
concentrated over the re-actional measures for the health care. The reactionary measures were
temporary and immediately disappeared when the threat was abated. This lead to in-equal
distribution of the healthcare resources and lack of adequate healthcare support through the
year for satisfying the basic health needs. Later the private and local governing bodies set up
separate institutions to satisfy the needs of the population in the domain of sanitation, disease
outbreaks and housing (Choi et al., 2012).
Gradually the communities started growing post the American liberation war followed
the increased rate of urbanization and immigration. This further increased the need for the
promotion of sanitation need and increased the rate of healthcare problems like increased rate
of outbreak of the infectious disease (Carter, 2018). It is under this tenure the federal and the
state governments increased their roles towards the establishments and simultaneous
implementation of the healthcare policy. During mid 1800, Massachusetts was state to set-up
the first state of board of health (1988). At the local level, there occurred the establishment of
the non-profit community level hospital leading to the increase in the healthcare access
among the people who are from the poor socio-economic background. Under the non-profit
organization, charity was the main source of finance and the physicians provided services for
the poor at the exchange for the privilege of caring. By the turn of the century, the healthcare
department of Baltimore and New York started offering home visits by the public health
nurses in order to provide treatment and screening of infant mortality and tuberculosis. The
screening of tuberculosis helped to reduce the rapid spread of epidemic. First screening of
tuberculosis started in the year 1741 under public health surveillance under Rhode Island
(Thacker et al., 2012).
The epidemiological advances along with the growing emphasis over the scientific
basis of the medical practice lead to the generation of continued reforms in the healthcare
services. Mandatory bill was passed forcing the state level medical institutions to adhere the

3
standard curriculum for graduation courses of the doctors. The practicing physicians are now
required to hold registration under the American Medical Association (ANA, 1993). Making
the registration of the doctor mandatory under the ANA and giving uniform curriculum for
the state level medical institutions lead to the generation of skilled doctors, helping to reduce
the chances of the practice based errors (Kaur & Winchester, 2018).
Knowledge of the healthcare administrator
For the further development of the US public health services, and for the eradication
of the global diseases like HIV/AIDS, tuberculosis, malaria, proper knowledge of the
healthcare administrator is extremely important along with proper deployment of the human
resources in different filed of healthcare (Bloland et al., 2012).. The knowledge of the
healthcare administrators must be directed towards understanding of the health needs of the
people who resides under the poor socio-economic status and fetching information about the
urban diseases like the teenage pregnancy, substance abuse and type 2 diabetes. Information
about the health needs of the population along with successful skill development of the
healthcare professionals will help in the further refinement of the U.S healthcare services.
According the Centers for Disease Control and Prevention (CDC) priority must be given
towards the investment along with strengthening the different functions of public health
(Bloland et al., 2012). Raghupathi and Raghupathi (2018) stated that identification of the
correlation is the fundamental towards the development of the insights that will help in the
generation of the targeted management, preventive policies and mitigation and thus helping
to minimize the risks and costs of the chronic diseases.
Conclusion
Thus from the above discussion, it can be concluded that the evolution of the public health
service in the United States occurred through a series of steps. The first step was initiated

4
through the development of the separate group of bodies to take into consideration f the
sanitation, infectious diseases and the children nutrition. This was followed by development
of the similar curriculum for all the graduating doctors and making the registration of the
doctors mandatory under the ANA. This helped to decrease the overall healthcare cost
followed by improvement in the quality of care. Moreover, equitable distribution of the
resources helped in decreasing the health inequality prevalent in the U.S. It is the duty of the
public health administrator to develop proper knowledge about the health priority in order to
design new healthcare policy accordingly and thereby helping to improve the healthcare
service quality further.

5
References
Bloland, P., Simone, P., Burkholder, B., Slutsker, L., & De Cock, K. M. (2012). The role of
public health institutions in global health system strengthening efforts: the US CDC's
perspective. PLoS medicine, 9(4), e1001199.
Carter, E. D. (2018). Population control, public health, and development in mid twentieth
century Latin America. Journal of Historical Geography, 62, 96-105.
Choi, B. C. (2012). The past, present, and future of public health
surveillance. Scientifica, 2012.
Hill, H. W. (1912). Public Health—Past And Future. American Journal of Public
Health, 2(11), 871-874.
Kaur, J. S., & Winchester, B. (2018). The Evolution of Palliative Care within the American
Indian Health System. Cancer Health Disparities.
Mossialos, E., Wenzl, M., Osborn, R., & Sarnak, D. (2016). 2015 international profiles of
health care systems. Canadian Agency for Drugs and Technologies in Health.
Raghupathi, W., & Raghupathi, V. (2018). An empirical study of chronic diseases in the
United States: a visual analytics approach to public health. International journal of
environmental research and public health, 15(3), 431.
Thacker, S. B., Qualters, J. R., Lee, L. M., & Centers for Disease Control and Prevention.
(2012). Public health surveillance in the United States: evolution and
challenges. MMWR Surveill Summ, 61(Suppl), 3-9.