title: Health care reform and the role of public health agencies.
abstract: Experience in developing a local public health program, covering a period of approximately 45 years, is described. Included are the assessment and analysis of problems, policy formulation, plan development, and program implementation. A study of problems of seasonal farm workers, particularly those who migrate, is described, as well as a health services delivery program based on this study. Attention is given to incorporation of medical care with core public health services, and the use of a multidisciplinary team. Special features required to overcome cultural, language, educational, and other barriers are outlined. Adaption of knowledge gained from the migrant health project toward meeting needs of the county's medically underserved population is described. Involvement of the community, including representatives of private and public sectors, in the development and implementation of plans is emphasized. Maintaining appropriate emphasis on preventive aspects is discussed, together with mobilization of financial and other support. The importance of qualified public health staff is also emphasized: residency programs for physicians and dentists and training for other personnel are described.
authors.affiliation: Graduate Programs in Public Health, Palm Beach County Public Health Unit, West Palm Beach, Florida 33402, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Brumback
authors.forename: J M
authors.initials: JM
authors.lastname: Malecki
mesh_terms: D005431:Florida; D018166:Health Care Reform / Q000331:legislation & jurisprudence*; D006284:Health Plan Implementation / Q000331:legislation & jurisprudence; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence*; D006801:Humans; D008489:Medical Indigency / Q000331:legislation & jurisprudence; D011158:Population Growth; D011634:Public Health / Q000331:legislation & jurisprudence*; D013221:State Health Plans / Q000331:legislation & jurisprudence; D014171:Transients and Migrants / Q000331:legislation & jurisprudence; D014481:United States