Local health departments' mission to the uninsured.
It is often maintained that local health departments (LHDs) should not directly provide personal health services. However, our nationally representative sample revealed that most LHD directors (87%) believed LHDs must directly provide these services, primarily because they perceived a high level of unmet need among the uninsured. While only a minority believed LHDs should focus exclusively on the core functions, this proportion rose dramatically when we asked directors to assume that there were no uninsured people. Directors who perceived a high level of unmet need among the uninsured in their jurisdictions were much less likely to believe that LHDs should exclusively focus on the core functions. In theory, LHDs have a unique responsibility for assuring that the uninsured and vulnerable have access to personal health services. However, a majority of directors (67%) acknowledged that they have no enforceable means of assuring access to services the health department did not directly provide.
Keane
Christopher
C
Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 211 Parran Hall, 130 DeSoto Street, Pittsburgh, Pennsylvania 15261, USA.
Marx
John
J
Ricci
Edmund
E
D001291:Attitude of Health Personnel; D006297:Health Services Accessibility / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006801:Humans; D009111:Local Government; D017057:Medically Uninsured; D009937:Organizational Objectives; D010548:Personal Health Services / Q000600:supply & distribution*; D011635:Public Health Administration; D014481:United States