The role of state health departments in formulating policy: a survey on the case of AIDS.
OBJECTIVE
Public health departments have been criticized for not being on the cutting edge of health policy formation in the United States and, in particular, for being ineffective in dealing with acquired immunodeficiency syndrome (AIDS). This study examines the attitudes and influence of public health officials on this problem.


METHODS
A survey of state health department officials was supplemented by surveys of state legislature health committee chairs and hospital association directors, as well as by interviews with key AIDS policymakers and observers in six states.


RESULTS
Both in their own eyes and in the eyes of legislative leaders and hospital association officials, public health officials were considered to be the principal initiators of public policy on AIDS.


CONCLUSIONS
Contrary to the Institute of Medicine's 1988 report, state health departments are leaders in the fight against AIDS at the state level. Moreover, we argue that public health departments should be judged on how effectively they perform functions for which they have primary legal responsibilities, not for other roles for which they have been given neither responsibility nor resources.
Robins
L
L
Public Administration Program, Roosevelt University, Chicago, Ill.
Backstrom
C
C
D000163:Acquired Immunodeficiency Syndrome; D003625:Data Collection; D006291:Health Policy; D006801:Humans; D011050:Policy Making; D011057:Politics; D011635:Public Health Administration; D012954:Societies, Hospital; D013219:State Government; D014481:United States