scholarly journals Public Health Federalism?

2021 ◽  
pp. 19-32
Author(s):  
Mitch Kunce
Keyword(s):  
Public Health ◽  
Utility Maximization ◽  
The United States ◽  
Jel Classification ◽  
Tax Rates ◽  
Neoclassical Model ◽  
Local Public Health ◽  
Joint Determination ◽  
Health Quality

Abstract This paper develops a general equilibrium model of competitive jurisdictional choice that provides insights into what is being coined 'public health federalism'. Using a standard neoclassical model of production combined with a utility maximization hypothesis, jurisdictions choose both tax rates and a level of local public health quality. Incorporating the joint determination of both tax decisions and the choice of public health standards can give rise to some interesting interrelationships between local tax revenues and public health considerations. Additionally, the model is extended to address the fiscal realities of sub-state jurisdictions in the United States. Beleaguered in a second-best setting, devolved efficiency becomes a target difficult to hit. We show that when jurisdictions rely on taxing mobile factors and mobile factor productivity is enhanced by relaxing public health mitigation, jurisdictions will choose lower levels of public health quality. JEL classification numbers: H73, I18, R13. Keywords: Federalism, Decentralized authority, COVID - 19, Public health mandates.

scholarly journals Public Health Federalism?

2021 ◽  
pp. 19-32
Author(s):  
Mitch Kunce
Keyword(s):  
Public Health ◽  
Utility Maximization ◽  
The United States ◽  
Jel Classification ◽  
Tax Rates ◽  
Neoclassical Model ◽  
Local Public Health ◽  
Joint Determination ◽  
Health Quality

Abstract This paper develops a general equilibrium model of competitive jurisdictional choice that provides insights into what is being coined 'public health federalism'. Using a standard neoclassical model of production combined with a utility maximization hypothesis, jurisdictions choose both tax rates and a level of local public health quality. Incorporating the joint determination of both tax decisions and the choice of public health standards can give rise to some interesting interrelationships between local tax revenues and public health considerations. Additionally, the model is extended to address the fiscal realities of sub-state jurisdictions in the United States. Beleaguered in a second-best setting, devolved efficiency becomes a target difficult to hit. We show that when jurisdictions rely on taxing mobile factors and mobile factor productivity is enhanced by relaxing public health mitigation, jurisdictions will choose lower levels of public health quality. JEL classification numbers: H73, I18, R13. Keywords: Federalism, Decentralized authority, COVID - 19, Public health mandates.

scholarly journals Mangroves, garbage, fishing: Bringing everyday ecology to Sydney’s industrial Georges River

2010 ◽  
Vol 5 (1) ◽  
Author(s):  
Heather Goodall ◽  
Allison Cadzow ◽  
Denis Byrne
Keyword(s):  
Public Health ◽  
Waste Disposal ◽  
Environmental Science ◽  
Local Level ◽  
The United States ◽  
City Development ◽  
Local Data ◽  
Local Public Health ◽  
Post War ◽  
The Impact

Post war problems of rising urban, industrial pollution and intractable waste disposal are usually considered as technical and economic problems only, solutions to which were led by experts at State level, and filtered into Australia from the ferments occurring in the United States and Britain in the 1960s and 70s. This paper investigates the change which arose from the localities in which the impact of those effects of modern city development were occurring. In particular, this study looks at a working class, industrial area, the Georges River near Bankstown Municipality, which was severely affected by Sydney’s post-war expansion. Here, action to address urgent environmental problems was initiated first at the local level, and only later were professional engineers and public health officials involved in seeking remedies. It was even later that these local experts turned from engineering strategies to environmental science, embracing the newly developed ecological analyses to craft changing approaches to local problems. This paper centres on the perspective of one local public health surveyor, employed by a local municipal council to oversee waste disposal, to identify the motives for his decisions to intervene dramatically in river health and waste disposal programs. Rather than being prompted to act by influences from higher political levels or overseas, this officer drew his motivation from careful local data collection, from local political agitation and from his own recreational knowledge of the river. It was his involvement with the living environments of the area – the ways in which he knew the river - through personal and recreational experiences, which prompted him to seek out the new science and investigate emerging waste disposal technologies.

A Cost-Benefit Analysis of a Potential Supervised Injection Facility in San Francisco, California, USA

2016 ◽  
Vol 47 (2) ◽  
pp. 164-184 ◽  
Author(s):  
Amos Irwin ◽  
Ehsan Jozaghi ◽  
Ricky N. Bluthenthal ◽  
Alex H. Kral
Keyword(s):  
Public Health ◽  
United States ◽  
San Francisco ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Effective ◽  
The United States ◽  
Local Public Health ◽  
Supervised Injection ◽  
Overdose Deaths

Supervised injection facilities (SIFs) have been shown to reduce infection, prevent overdose deaths, and increase treatment uptake. The United States is in the midst of an opioid epidemic, yet no sanctioned SIF currently operates in the United States. We estimate the economic costs and benefits of establishing a potential SIF in San Francisco using mathematical models that combine local public health data with previous research on the effects of existing SIFs. We consider potential savings from five outcomes: averted HIV and hepatitis C virus (HCV) infections, reduced skin and soft tissue infection (SSTI), averted overdose deaths, and increased medication-assisted treatment (MAT) uptake. We find that each dollar spent on a SIF would generate US$2.33 in savings, for total annual net savings of US$3.5 million for a single 13-booth SIF. Our analysis suggests that a SIF in San Francisco would not only be a cost-effective intervention but also a significant boost to the public health system.

AIDS in the Pacific

1988 ◽  
Vol 2 (4) ◽  
pp. 221-223 ◽  
Author(s):  
JT Villagomez
Keyword(s):  
Public Health ◽  
United States Public Health ◽  
Risk Behaviour ◽  
The United States ◽  
American Samoa ◽  
Marshall Islands ◽  
Local Public Health ◽  
The Pacific ◽  
The Republic ◽  
The Government

This article summarises current AIDS and HIV infection epidemiology, population risk behaviour factors, local public health and governmental responses to AIDS and cooperative strategic plans for a Pacific “War on AIDS” among the United States Public Health Service and the Pacific jurisdiction public health agencies. The Pacific Island Health Officers Association is comprised of the Republic of Palau, the Government of Guam, the Commonwealth of the Northern Marianas Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, American Samoa and the State of Hawaii.

scholarly journals The Effects of Community Size, Control Over Agenda, and Contextual Variables on Zika Virus Preparation of Public Information Officers at Local Public Health Departments

2019 ◽  
Vol 2 (1) ◽  
pp. 97-119 ◽  
Author(s):  
Elizabeth Avery
Keyword(s):  
Public Health ◽  
Public Information ◽  
Size Control ◽  
The United States ◽  
Health Departments ◽  
Community Size ◽  
Local Public Health ◽  
Public Health Departments ◽  
Public Information Officers ◽  
Local Public Health Departments

As Zika emerged as a major global health threat, public information officers (PIOs) at local public health departments across the United States prepared for outbreaks of the virus amid great uncertainty. Using the crisis and risk emergency communication (CERC) model to inform this study, PIOs (n = 226) at public health departments were surveyed to assess how community size, perceived control over health agenda, and other considerations such as resources and federal influences affected their satisfaction with Zika preparedness in their departments. These contextual, indirect factors may moderate planning efforts for Zika and other health emergencies and thus should be considered in crisis management and planning models such as CERC.

scholarly journals A Survey of Tick Surveillance and Control Practices in the United States

2020 ◽  
Author(s):  
Emily M Mader ◽  
Claudia Ganser ◽  
Annie Geiger ◽  
Laura C Harrington ◽  
Janet Foley ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Data Communication ◽  
The United States ◽  
Tick Control ◽  
Accurate Information ◽  
Surveillance Program ◽  
Local Public Health ◽  
Pathogen Testing ◽  
And Control

Abstract Tickborne diseases are an increasing public health threat in the United States. Prevention and diagnosis of tickborne diseases are improved by access to current and accurate information on where medically important ticks and their associated human and veterinary pathogens are present, their local abundance or prevalence, and when ticks are actively seeking hosts. The true extent of tick and tickborne pathogen expansion is poorly defined, in part because of a lack of nationally standardized tick surveillance. We surveyed 140 vector-borne disease professionals working in state, county, and local public health and vector control agencies to assess their 1) tick surveillance program objectives, 2) pathogen testing methods, 3) tick control practices, 4) data communication strategies, and 5) barriers to program development and operation. Fewer than half of respondents reported that their jurisdiction was engaged in routine, active tick surveillance, but nearly two-thirds reported engaging in passive tick surveillance. Detection of tick presence was the most commonly stated current surveillance objective (76.2%). Most of the programs currently supporting tick pathogen testing were in the Northeast (70.8%), Upper and Central Midwest (64.3%), and the West (71.4%) regions. The most common pathogens screened for were Rickettsia spp. (Rickettsiales: Rickettsiaceae) and bacterial and viral agents transmitted by Ixodes (Acari: Ixodidae) ticks. Only 12% of respondents indicated their jurisdiction directly conducts or otherwise financially supports tick control. Responses indicated that their ability to expand the capacity of tick surveillance and control programs was impeded by inconsistent funding, limited infrastructure, guidance on best practices, and institutional capacity to perform these functions.

scholarly journals The United States: A system built on fragmentation

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H. Jarman
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
Health Care System ◽  
The United States ◽  
Universal Health Care ◽  
Local Public Health ◽  
The Us ◽  
Universal Health ◽  
Care System

Abstract Background The United States is effectively a laboratory for ways to produce public goods, such as public health, on the cheap. Its c. 90,000 governments compete for residents, businesses, taxes, development, and jobs while also trying to compensate for the lack of universal health care coverage. They all have structural incentives to provide services as cheaply as possible. The effects are diverse and poorly mapped. They can mean innovation in organizational forms, a different and typically less expensive skill mix among the workers, poor quality, or simple under provision. The exact mix can often be hard to identify. It can also mean extreme responsiveness to funding from higher levels of government such as the states or federal government. Methods A comparative historical analysis (CHA) based on government documents, law, and secondary sources. Results The distinctively expansive scope of US public health actions is largely due to the country’s failure to establish a universal health care system, and the diversity of US public health tasks reflects local adaptation of tens of thousands of governments. This means that public health in the United States retains much of the activity it had in, for example, the UK before the establishment of the US. In particular, and even in states that accepted the Medicaid expansion in the Affordable Care Act (ACA), local public health departments provide a substantial amount of direct care and fill in for gaps in health care provision. Conclusions The US public health system is highly fragmented like the governments that run it, and therefore diverse. Reflecting the failures of the US health care system, it carries out many more tasks that in other countries are seen as health, especially primary, care.

Domestic Legal Preparedness and Response to Ebola

2015 ◽  
Vol 43 (S1) ◽  
pp. 15-18 ◽  
Author(s):  
James G. Hodge ◽  
Matthew S. Penn ◽  
Montrece Ransom ◽  
Jane E. Jordan
Keyword(s):  
Public Health ◽  
Virus Disease ◽  
Developed Countries ◽  
The United States ◽  
University Hospital ◽  
African Countries ◽  
Extensive Discussion ◽  
Local Public Health ◽  
Emory University ◽  
State And Local

While the global threat of Ebola Virus Disease (EVD) in 2014 was concentrated in several West African countries, its effects have been felt in many developed countries including the United States. Initial, select patients with EVD, largely among American health care workers (HCWs) volunteering in affected regions, were subsequently transported back to the states for isolation and treatment in high-level medical facilities. This included Emory University Hospital, which sits adjacent to the federal Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.The first domestic case of EVD occurred in late September in Dallas, Texas. Additional exposures of two HCWs generated an array of legal issues for state and local public health authorities, hospitals, and providers. Consideration of these issues led to extensive discussion among lawyers, public health practitioners, and other attendees at a late-breaking session on EVD and Legal Preparedness at the 2014 National Public Health Law conference. In this commentary, session presenters from CDC and Emory University share their expert perspectives on legal and policy issues underlying state and local powers to quarantine and isolate persons exposed to or infected with Ebola, as well as facets of hospital preparedness underlying the successful treatment of patients with EVD.

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