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1. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com.
CHAPTER 3
Powers and
Responsibilities
of Government

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Federal Versus State
 U.S. Constitution states that a fundamental purpose of the government is “to
promote the general welfare.”
 Reserve clause is interpreted to mean that, since health is not mentioned in the
Constitution, responsibility for public health primarily belongs to the states.
 Interstate commerce provision justifies the activities of the Food and Drug
Administration (FDA).
 Power to tax and spend is widely used by federal government to control public
health policy.
– The federal government provides 65% of the funding for Medicaid.
 The New Federalism limited Congress’s powers and returned authority to the
states.

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Branches of Government: Federal, State, and Local
 Legislative
– Legislature passes statutes.
 Executive
– Public health agencies carry out the law.
– They may issue regulations consistent with statutes.
 Judicial
– Laws and regulations can be challenged in court.

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Local Public Health Agencies
 Local county and city health departments are often responsible for:
– Day-to-day public health tasks
– Core public health functions
– Providing medical care for the poor
 Funding sources are variable.
– City or county legislatures may not understand the importance of core functions.
– Mandates may be funded from state or federal governments.

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
State Health Departments
 Coordinate activities of local health agencies and provide funding
 Collect and analyze data provided by the local agencies
 Provide laboratory services
 Manage Medicaid
 License and certify medical personnel, facilities, and services
 Handle environment, mental health, social services, and aging issues, possibly
through separate state agencies
 Provide funding to hospitals to reimburse them for treating uninsured patients

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Federal Agencies
 Department of Health and Human Services (HHS)
– www.hhs.gov
 Centers for Disease Control and Prevention (CDC)
– www.cdc.gov
 National Institutes of Health (NIH)
– www.nih.gov
 Food and Drug Administration (FDA)
– www.fda.gov
 Centers for Medicare and Medicaid Services (CMS)
– www.cms.gov
 Agency for Healthcare Research and Quality (AHRQ)
– www.ahrq.gov
 Indian Health Service
– www.ihs.gov
 Environmental Protection Agency (EPA)
– www.epa.gov

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Federal Agencies (cont.)
 Occupational Safety and Health Administration (OSHA)
– www.osha.gov
 Department of Agriculture (USDA)
– www.usda.gov
 Department of Transportation
– www.transportation.gov
 Department of Labor
– www.dol.gov
 Department of Veterans Affairs
– www.va.gov
 Department of Defense
– www.defense.gov
 Department of Homeland Security
– www.dhs.gov

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Centers for Disease Control and Prevention
 CDC is the main epidemiologic and assessment agency for the nation.
 CDC publishes Morbidity and Mortality Weekly Report (MMWR).
 CDC’s National Center for Health Statistics collects data on the U.S. population
concerning all aspects of health.
 CDC also has centers to address infectious diseases, chronic disease, injury
prevention, and other issues.

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
National Institutes of Health
 NIH is the largest biomedical research complex in the world.
 Institutes exist for cancer; heart, lung, and blood; diabetes; aging; child health
and human development; and other topics.
 National Library of Medicine is an NIH institute.
 NIH has laboratories in Bethesda, MD and provides grant funding to
researchers at universities and research centers.
 NIH has a clinical center where medical researchers test experimental
therapies.
 NIH enjoys strong Congressional support.

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2021
by
Jones
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Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Nongovernmental Public Health Organizations
 Organizations that focus on specific diseases include:
– American Cancer Society
– American Heart Association
– American Diabetes Association
– Alzheimer’s Association
 Professional membership organizations include:
– American Medical Association
– American Nurses Association
– American Public Health Association
 Organizations that play an important role in defining the future of public health
include:
– National Association of City and County Health Officers
– Association of State and Territorial Health Officers
– Association of Schools and Programs of Public Health

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2021
by
Jones
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Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Philanthropic Foundations
 Rockefeller Foundation
 Robert Wood Johnson Foundation
 Pew Charitable Trusts
 Kaiser Family Foundation
 Commonwealth Fund
 Bill and Melinda Gates Foundation

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2021
by
Jones
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Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 1
 Choose a specific health problem.
 How might federal, state, and local levels of government divide responsibility for
addressing it?

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2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 2
 Choose a federal public health agency and visit its website.
 Identify an issue that it is currently dealing with and describe reasons for current
concern.
 Discuss any controversies that may be involved in actions that the agency has
taken or might need to take.

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2021
by
Jones
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Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 3
 Why is it important for nongovernmental organizations to be involved in public
health activities?

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2021
by
Jones
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Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 4
 Choose one of the philanthropic foundations listed on Slide 11 and visit its
website to learn more about the foundation’s activities.