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Public Health and Health Care: Integration, Disintegration, or Eclipse

Published online by Cambridge University Press:  01 January 2021

Peter D. Jacobson  and
Wendy E. Parmet
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Abstract

Many observers have argued that the US health care system could be more efficient, and achieve better outcomes if providers focused more on improving the community's health, not just the welfare of individual patients. The passage of the Affordable Care Act (ACA) in 2010 seemed to herald the promise of such reforms, and greater integration of the health care and public systems. In this article, we reassess the quest for integration, a quest we call the “integration project.” After examining the modest steps taken so far toward integration, we consider some conceptual barriers to integration as well as some of the risks it might portend for the public health system. Our assessment contributes to wide-ranging debates among public health advocates, practitioners, and policymakers as to the health care system's role in protecting public health, and how the public health system can best be organized to meet expected population health challenges.

Type
Symposium Articles
Information
Journal of Law, Medicine & Ethics , Volume 46 , Issue 4: Next Steps in Health Reform , Winter 2018 , pp. 940 - 951
Copyright
Copyright © American Society of Law, Medicine and Ethics 2018

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References

Institute of Medicine, The Future of the Public's Health in the 21st Century (Washington, DC: National Academies Press, 2003): at 24–25.Google Scholar
Kinner, K. and Pellegrini, C., “Expenditures for Public Health: Assessing Historical and Perspective Trends,” American Journal of Public Health 99, no. 10 (2009): 178–191. For a discussion of the definitions of and distinctions between public health and health care, see L. Hardcastle et al., “Improving the Population's Health: The Affordable Care Act and the Importance of Integration,” Journal of Law, Medicine &Ethics 39, no. 3 (2011): 317-327.Google Scholar
Trust for America's Health, A Funding Crisis for Public Health and Safety: State-by-State Public Health Funding and Key Health Facts (2018): at 4, available at <https://www.tfah.org/wp-content/uploads/archive/assets/files/TFAH-2018-InvestInAmericaRpt-FINAL.pdf> (last visited December 10, 2018). (last visited December 10, 2018).' href=https://scholar.google.com/scholar?q=Trust+for+America's+Health,+A+Funding+Crisis+for+Public+Health+and+Safety:+State-by-State+Public+Health+Funding+and+Key+Health+Facts+(2018):+at+4,+available+at++(last+visited+December+10,+2018).>Google Scholar
Organisation for Economic Co-operation and Development, OECD Health Statistics 2017: Health Expenditure and Financing, Nov. 10, 2017, available at <http://stats.oecd.org/Index.aspx?DataSetCode=SHA> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Central Intelligence Agency, The World Factbook Country Comparison: Life Expectance at Birth, available at <https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Central Intelligence Agency, The World Factbook Country Comparison: Infant Mortality Rate, available at <https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Cunningham, T.J. et al., “Vital Signs: Racial Disparities in Age-Specific Mortality Among Blacks or African Americans — United States, 1999-2015,” Morbidity and Mortality Weekly Report 66, no. 17 (May 5, 2017): 444–456; M. F. MacDorman and T.J. Matthews, Understanding Racial and Ethnic Disparities in U.S. Infant Mortality Rates, September 2011, available at <https://www.cdc.gov/nchs/data/data-briefs/db74.pdf> (last visited November 7, 2018).CrossRefGoogle Scholar
Case, A. and Deaton, A., “Mortality and Morbidity in the 21st Century,” Brookings Papers on Economic Activity (2017): 397–443, at 398.Google Scholar
Hardcastle et al., supra note 2.Google Scholar
Trust for America's Health, supra note 3 at 21; Institute of Medicine, supra note 1, at 7-8.Google Scholar
E.g. Kindig, D., “What are We Talking About When We Talk About Population Health,” Health Affairs Blog, April 6, 2015, available at <https://www.healthaffairs.org/do/10.1377/hblog20150406.046151/full/> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Berwick, D.M., Nolan, T.W., and Whittington, J., “The Triple Aim: Care, Health, and Cost,” Health Affairs 27, no. 3 (May/June 2008): 759–769.CrossRefGoogle Scholar
Id.Google Scholar
Hardcastle et al., supra note 2, at 319.Google Scholar
Institute of Medicine, supra note 1, at 81.Google Scholar
Hardcastle et al., supra note 2, at 321.Google Scholar
National Academy of Sciences, Population Health Implications of the Affordable Care Act: Workshop Summary (Washington, DC: National Academies Press, 2014): at 2.Google Scholar
See Agency for Healthcare Research and Quality, Practice Facilitation Handbook: Module 20. Facilitating Panel Management, available at <https://www.ahrq.gov/professionals/prevention-chronic-care/improve/system/pfhandbook/mod20.html> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Casalino, L.P. et al., “Accountable Care Organizations and Population Health Organization,” Journal of Health Politics, Policy and Law 40, no. 4 (2015): 821–37, at 821-822.CrossRefGoogle Scholar
Id.; Alley, D. et al., “Accountable Health Communities-Addressing Social Needs through Medicare and Medicaid,” New England Journal of Medicine 374, no. 1 (2016): 8–11, at 8, 10.Google Scholar
Erwin, P.C. and Brownson, R.C., “Macro Trends and the Future of Public Health Practice,” Annual Review of Public Health 38 (2017): 393–412, at 393, 395.Google Scholar
Brandt, A.M. and Gardner, M., “Antagonism and Accommodation: Interpreting the Relationship Between Public Health and Medicine in the United States During the 20th Century,” American Journal of Public Health 90, no. 5 (2000): 707–715.Google Scholar
Murray, C.J. L. and Frenk, J., “Ranking 37th — Measuring the Performance of the U.S. Health Care System,” New England Journal of Medicine 362, no. 2 (2010): 98–99.CrossRefGoogle Scholar
This section is adapted from Gostin, L. O., Jacobson, P. D., Hyman, D. A., and Studdert, D. M., Law and the Health System, 2nd ed. (St. Paul, MN: Foundation Press, 2014).Google Scholar
Hardcastle et al., supra note 2, at 323.Google Scholar
See infra text accompanying notes 31-84.Google Scholar
Parrish, R.G., “Measuring Population Health Outcomes,” Preventing Chronic Disease 7, no. 4 (2010): 1–11.Google Scholar
Id.Google Scholar
National Association of County & City Health Officers, Changes in Size of Local Health Department Workforce — Longitudinal Analysis of 2008 and 2010 Profile Data, Washington, DC, July 2011, available at <https://www.naccho.org/uploads/downloadable-resources/Changes-in-Size-of-Local-Health-Department-Workforce-Longitudinal-Analysis-of-2008-and-2010-Profile-Data.pdf> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Personal experience of PDJ as Chair of Washtenaw Country Bd. of Health.Google Scholar
E.g., American Public Health Association, “What is Public Health?” available at <https://www.apha.org/what-is-public-health> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Sommers, B.D. et al., “Three Year Impacts of the Affordable Care Act: Improved Medical Care and Health among Low-Income Adults,” Health Affairs 36, no. 6 (2017): 1119–1128, at 1119 (references omitted).CrossRefGoogle Scholar
Id.Google Scholar
Han, X. et al., “Has Recommended Preventive Service Use Increased After Elimination of Cost-Sharing as Part of the Affordable Care Act in the United States,” Preventive Medicine 78 (September 2015): 85–91.Google Scholar
Id.Google Scholar
Cassidy, A. et al., “Preventative Services Without Cost Sharing,” Health Affairs, Health Policy Brief, December 28, 2010, available at <https://www.healthaffairs.org/do/10.1377/hpb20101228.861785/full/healthpolicybrief_37.pdf> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Id.Google Scholar
42 U.S.C. § 1395jjj(LEXIS through PL 115-96). Other ACA provisions include new payment models, such as bundled payments. Commonwealth Fund, “The Affordable Care Act's Payment and Delivery System Reforms: A Progress Report at Five Years,” available at <http://www.commonwealthfund.org/publications/issue-briefs/2015/may/aca-payment-and-delivery-system-reforms-at-5-years> (last visited November 7, 2018). (last visited November 7, 2018).' href=https://scholar.google.com/scholar?q=42+U.S.C.+§+1395jjj(LEXIS+through+PL+115-96).+Other+ACA+provisions+include+new+payment+models,+such+as+bundled+payments.+Commonwealth+Fund,+“The+Affordable+Care+Act's+Payment+and+Delivery+System+Reforms:+A+Progress+Report+at+Five+Years,”+available+at++(last+visited+November+7,+2018).>Google Scholar
Muhlestein, D. and McClellan, M., “Accountable Care Organizations in 2016: Private and Public-Sector Growth and Dispersion,” Health Affairs Blog, April 21, 2016, available at <http://healthaffairs.org/blog/2016/04/21/accountable-care-organizations-in-2016-private-and-public-sector-growth-and-dispersion/> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
It is important to remember that ACOs are not the first health care organizations that offer such services. For a fuller discussion see Tanenbaum, J., “Can payment Reform be Social Reform? The Lure and Liabilities of the ‘Triple Aim,’” Journal of Health Politics, Policy and Law 42, no. 1 (2017): 53–71.CrossRefGoogle Scholar
Schulz, J., DeCamp, M., and Berkowitz, S., “Regional Cost and Experience, Not Size or Hospital Inclusion, Helps Predict ACO Success,” Medicine 96, no. 24 (June 2017): 1–6.Google Scholar
Fraze, T. et al., “Housing, Transportation, and Food: How ACOs Seek to Improve Population Health by Addressing Nonmedical Needs of Patients,” Health Affairs 35, no.11 (2016): 2109–2115, at 2110-2111.Google Scholar
Shortell, S.M. et al., “An Early Assessment of Accountable Care Organizations’ Efforts to Engage Patients and Their Families,” Medical Care Research and Review 72, no. 5 (2015): 580–604, at 593.Google Scholar
Clough, J.D. and McClellan, M., “Implementing MACRA: Implications for Physicians and for Physician Leadership,” JAMA 25, no. 22 (2016): 2397–2398.Google Scholar
P. Casalino et al., supra note 19, at 822; Shortell, S.M. et al., “Accountable Care Organizations: The National Landscape,” Journal of Health Politics, Policy and Law 40, no. 4 (2015): 647–668,CrossRefGoogle Scholar
Casalino et al., supra note 19, at 822.Google Scholar
Id at 826.Google Scholar
Id at 831; Yasnoff, W.A., Shortliffe, E.H., and Shortell, S.M., “A Proposal for Financially Sustainable Population Health Organizations,” Population Health Management 17, no. 5 (2014): 255–256.Google Scholar
Casalino et al., supra note 19, at 831.Google Scholar
Tanenbaum, supra note 40, at 66-67.Google Scholar
IRC § 501(r)(2012).Google Scholar
Crossley, M., “Health and Taxes: Hospitals, Community Health and the IRS,” Yale Journal of Health Policy, Law and Ethics 16, no. 1 (2016): 51–110, at 54.Google Scholar
Id at 64.Google Scholar
Zuckerman, D., Hospitals Building Healthier Communities — Embracing the Anchor Mission, The democracy Collaborative at the University of Maryland, March 2013, available at <https://democracycollaborative.org/content/hospitals-building-healthier-communities-embracing-anchor-mission> (last visited November 7, 2017).Google Scholar
Prybil, L. et al., “Improving Community Health through Hospital-Public Health Collaboration: Insights and Lessons Learned from Successful Partnerships,” Commonwealth Center for Governance Studies, Inc., 2014, at 41, available at <https://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1001&context=hsm_book> (last visited November 7, 2017).+(last+visited+November+7,+2017).>Google Scholar
Meadows, P.D. et al., National Collaborative for Health Equity Scan: Michigan, Final Report to the W. K. Kellogg Foundation, Battle Creek, Michigan, 2017 (on file with the authors).Google Scholar
Affordable Care Act §§ 4002, 4201, 42 U.S.C. §§ 300u-11, -13 (2012).CrossRefGoogle Scholar
Yeager, A., “Cuts to Prevention and Public Health Fund Puts CDC Programs at Risk,” The Scientist (Feb. 9, 2018), available at <https://www.the-scientist.com/?articles.view/articleNo/51701/title/Cuts-to-Prevention-and-Public-Health-Fund-Puts-CDC-Programs-at-Risk/> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Centers for Disease Control and Prevention. Community Transformation Grants – Small Community Awards Summary of Proposed Project Activities, (2013), available at <https://www.cdc.gov/nccdphp/dch/programs/communitytransformation/small-communities/awardees.htm> (last visited August, 7, 2017).+(last+visited+August,+7,+2017).>Google Scholar
Centers for Medicare & Medicaid Services, Accountable Health Communities Model (2017), available at <https://innovation.cms.gov/initiatives/ahcm> (last visited November 7, 2018). See also, Udow-Phillips, M., O’Grady, K., Meadows, P., “Nine Lessons for Leaders of Health and Human Services Integration Initiatives,” Health Affairs Blog, July 10, 2018, doi: 10.1377/hblog20180709.359520.+(last+visited+November+7,+2018).+See+also,+Udow-Phillips,+M.,+O’Grady,+K.,+Meadows,+P.,+“Nine+Lessons+for+Leaders+of+Health+and+Human+Services+Integration+Initiatives,”+Health+Affairs+Blog,+July+10,+2018,+doi:+10.1377/hblog20180709.359520.>Google Scholar
Centers for Medicare & Medicaid Services. Accountable Health Communities Model, (2017), available at <https://innovation.cms.gov/initiatives/ahcm> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Casalino et al., supra note 19, at 831.Google Scholar
Tipirneni, R., Vickery, K. Diaz, and Ehlinger, E., “Accountable Communities for Health: Moving From Providing Accountable Care to Creating Health,” Annals of Family Medicine 13, no. 4 (2015): 367–369, funding has also come from Medicaid demonstration projects. Id. For a further discussion of Medicaid-community collaborations to address the social determinants of health, see E. Martinez-Vidal, D. I. Chang, and T. McGinnis, “Overcoming Challenges to Medicaid Investments in Social Determinants,” Health Affairs Blog, June 13, 2018, available at <https://www.healthaffairs.org/do/10.1377/hblog20180612.152825/full/> (last visited November 7, 2018).CrossRefGoogle Scholar
Hester, J., “A Balanced Portfolio Model for Improving Health: Concept and Experience,” Health Affairs 37, no. 4 (2018): 570–578. For potential challenges in obtaining population health data to address the SDOH, see Cantor, M.N. and L. Thorpe, “Integrating Data on Social Determinants of Health into Electronic Health Records,” Health Affairs 37, no. 4 (2018): 585-590.CrossRefGoogle Scholar
“Kresge and M-1 RAIL partners pledge to resolve last issues surrounding Detroit light rail project,” The Kresge Foundation, June 4, 2012, available at <https://kresge.org/news/kresge-and-m-1-rail-partners-pledge-resolve-last-issues-surrounding-detroit-light-rail-project> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
“Rutland Regional Medical Center (RRMC) and Neighbor-Works of Western Vermont (NWWVT) are Partnering to Support Patients in Creating Healthy Homes,” NeighborWorks of Western Vermont, June 20, 2016, available at <https://www.nwwvt.org/2016/06/20/healthcare-and-housing-coalesce-to-help-those-suffering-from-chronic-health-problems/> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Id.Google Scholar
“Community Investing,” Trinity Health, available at <http://www.trinity-health.org/community-investing> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Hennepin County M. Hennepin Health-PMAP. Hennepin Health Web site, available at <http://www.hennepinhealth.org/members/hennepin-health-pmap> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Alley, supra note 20, at 8.Google Scholar
Id.Google Scholar
Mettessich, P.W. and Rausch, E.J., “Cross-sector Collaboration to Improve Community Health: A View of the Current Landscape,” Health Affairs 33, no. 11 (2014):1968–1974. See also, F.D. Scutchfield et al., “Public Health and Hospitals: Lessons Learned From Partnerships in a Changing Health Care Environment,” American Journal of Public Health 106, no. 1 (2016):45-48.CrossRefGoogle Scholar
Not all of the partnerships between providers and community groups result from these types of organizations. Others result from more-focused grants or a hospital's community benefits program.Google Scholar
Prybil et al., supra note 55, at 38.Google Scholar
Id. at 36-37.Google Scholar
See infra text accompanying notes 88-92.Google Scholar
Tanenbaum, supra note 40, at 65.Google Scholar
Rudolph, L. et al., Health in all Policies: A Guide for State and Local Governments, American Public Health Association and Public Health Institute, Washington, DC, 2013.Google Scholar
de Leeuw, E., “Engagement of Sectors Other Than Health in Integrated Health Governance, Policy and Action,” Annual Review of Public Health 38 (March 2017): 329–349; Gase, L.N., Pennotti, R., and Smith, K.D., “Health in all Policies: Taking Stock of Emerging Practices to Incorporate Health in Decisionmaking in the United States,” Journal of Public Health Management Practice 19, no. 6 (2013):29-540; Wernhamand, A. and Teutsch, S.M., “Health in All Policies for Big Cities,” Journal of Public Health Management Practice 21, suppl. 1 (2015):S56–S65.CrossRefGoogle Scholar
Hall, R.L. and Jacobson, P.D., “Examining Whether the Health-in-All-Policies Approach Promotes Health Equity,” Health Affairs 37, no. 3 (2018): 364–370.CrossRefGoogle Scholar
Id.Google Scholar
See supra text accompanying notes 12-13.Google Scholar
Triple Aim for Populations, Institute for Healthcare Improvement, available at <http://www.ihi.org/Topics/TripleAim/Pages/Overview.aspx> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
See, e.g., Tanenbaum, supra note at 40, 53-71.Google Scholar
Roubein, R., “Timeline: The GOP's Failed Effort to Repeal ObamaCare,” The Hill, September 26, 2017, available at <http://thehill.com/policy/healthcare/other/352587-time-line-the-gop-effort-to-repeal-and-replace-obamacare> (last visited November 7, 2018). (last visited November 7, 2018).' href=https://scholar.google.com/scholar?q=Roubein,+R.,+“Timeline:+The+GOP's+Failed+Effort+to+Repeal+ObamaCare,”+The+Hill,+September+26,+2017,+available+at++(last+visited+November+7,+2018).>Google Scholar
In June 2018, the Trump Administration announced that it would not defend the ACA in a challenge brought by several states in federal court in Texas claiming that with the repeal of the provision in the ACA requiring that individuals have insurance, the ACA was no longer constitutional. See Goldstein, A., “Trump Administration Won’t Defend ACA in Case Brought by GOP States,” Washington Post, June 7, 2018, available at <https://www.washingtonpost.com/national/health-science/trump-administration-wont-defend-aca-in-cases-brought-by-gop-states/2018/06/07/92f56e86-6a9c-11e8-9e38-24e693b38637_story.html?utm_term=.4968d02ec0bd> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Yaeger, supra note 58. Consolidated Appropriations Act, 2018, H.R. 1625, 115th Cong. (2018).Google Scholar
Pear, R., “Without the Insurance Mandate, Health Care's Future May Be in Doubt,” New York Times, December 18, 2017, available at <https://www.nytimes.com/2017/12/18/us/politics/tax-cut-obamacare-individual-mandate-repeal.html> (last visited November 7, 2018). (last visited November 7, 2018).' href=https://scholar.google.com/scholar?q=Pear,+R.,+“Without+the+Insurance+Mandate,+Health+Care's+Future+May+Be+in+Doubt,”+New+York+Times,+December+18,+2017,+available+at++(last+visited+November+7,+2018).>Google Scholar
Pear, R., “Obamacare Sign-ups at High Levels Despite Trump Saying It's ‘Imploding,’” New York Times, December 21, 2017, available at <https://www.nytimes.com/2017/12/21/us/politics/health-obama-care-affordable-care-act.html> (last visited November 7, 2018). (last visited November 7, 2018).' href=https://scholar.google.com/scholar?q=Pear,+R.,+“Obamacare+Sign-ups+at+High+Levels+Despite+Trump+Saying+It's+‘Imploding,’”+New+York+Times,+December+21,+2017,+available+at++(last+visited+November+7,+2018).>Google Scholar
Internal Revenue Service et al., Final Rule, Short-Term, Limited Duration Insurance, 83 FR 38212 (Aug. 3, 2018).Google Scholar
Exec. Order No. 13813, 82 Fed. Reg. 48,385 (Oct. 12, 2017).Google Scholar
Pear, R., Ruiz, R.R., and Goodstein, L., “Trump Administration Rolls Back Birth Control Mandate,” New York Times, October 6, 2017, available at <https://www.nytimes.com/2017/10/06/us/politics/trump-contraception-birth-control.html> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Willink, A. and DuGoff, E.H., “Integrating Medical and Nonmedical Services — The Promises and Pitfalls of the CHRONIC Care Act,” New England Journal of Medicine 378, no. 23 (2018): 2153–2155.Google Scholar
Shah, N.D., “Continuing Resolution Creates New Tools for ACOs,” American Health Lawyers Association, March 27, 2018, available at <https://www.healthlawyers.org/Members/PracticeGroups/TaskForces/ACO/alerts/Pages/Continuing_Resolution_Creates_New_Tools_for_ACOs.aspx> (last visited August 8, 2018).+(last+visited+August+8,+2018).>Google Scholar
Centers for Medicare and Medicaid Services, Medicare Shared Savings Program Notice of Proposed Rulemaking (CMS-1701-P), “Accountable Care OrganizationsPathways to Success,” August 9, 2018, available at <https://www.federalregister.gov/public-inspection/ and https://www.cms.gov/newsroom/fact-sheets/proposed-pathways-success-medicare-shared-savings-program> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Cunningham, P.W., “The Health 202: Trump Administration Pulls Back from Key Medicare Goals,” Washington Post, Feb. 20, 2017, available at <https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2018/02/20/the-health-202-trump-administration-pulls-back-from-key-medicare-goals/5a8737f430fb047655a067d4/?utm_term=.7a277b4fc0b2> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Manchester, J., “Illinois Congressman Voices Objections to Men Purchasing Prenatal Care,” CNN, March 10, 2017, available at <http://www.cnn.com/2017/03/10/politics/shimkus-prenatal-care-comments/index.html> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Tanenbaum, supra note 40, at 65-67.Google Scholar
Salinsky, E., “Governmental Public Health: An Overview of State and Local Public Health Agencies,” National Health Policy Forum, Background Paper no. 77 (August 18, 2010): at 11–16, available at <https://www.nhpf.org/library/background-papers/BP77_GovPublicHealth_08-18-2010.pdf> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
“Achievements in Public Health 1900-1999: Changes in the Public Health System,” Morbidity and Mortality Weekly Report 48, no. 50 (December 24, 1999): 1141–1147, available at <https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4850a1.htm> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Institute of Medicine, The Future of Public Health (Washington D.C.: National Academy Press, 1999), available at <https://www.ncbi.nlm.nih.gov/books/NBK218224/> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Id.Google Scholar
E.g. N.Y. Statewide Coal. of Hispanic Chambers of Commerce v. N.Y.C. Dep’t of Health and Mental Hygiene, 23 N.Y.3d 681 (N.Y. 2014).Google Scholar
Billioux, A. et al., “Standardized Screening for Health-Related Social Needs in Clinical Communities,” National Academy of Medicine, Discussion Paper, May 30, 2017, NAM.edu/perspectives. Cf. A. Garg, R. Boynton-Jarrett, and P.H. Dworkin, “Avoiding the Unintended Consequences of Screening for Social Determinants of Health,” Journal of the American Medical Association 316, no. 8 (2017): 813-814.Google Scholar
Tannebaum, supra note 40, at 64-65.Google Scholar
Id at 55-57.Google Scholar
Institute of Medicine, For the Public's Health: Revitalizing Law and Policy to Meet New Challenges (Washington, D.C.: National Academies Press, 2011): at 32.Google Scholar
Parmet, W., “Dangerous Perspectives: The Perils of Individualizing Public Health Problems,” Journal of Legal Medicine 30, no. 1 (2009): 83–109, at 90-96.Google Scholar
See Tanenbaum, supra note 40, at 55-57.Google Scholar
Id at 65. See also, Jacobson, P.D. and Gollust, S.E., “Privatization of Public Services: Organizational Reform Efforts in Public Education and Public Health,” American Journal of Public Health 96, no. 10 (2006):1733–1739.Google Scholar
Leider, J.P. et al., “Perceived Impacts of Health Care Reform on Large Urban Health Departments,” Journal of Public Health Management Practice 21, no. 1 supp. (2015): s66–S75, at s71.Google Scholar
Some researchers worry that funding for even this may fall. See Balaban, V. et al., “Tuberculosis Elimination Efforts in the United States in the Era of Insurance Expansion and the Affordable Care Act,” Public Health Reports 130, no. 4 (2015): 349–354, at 349.Google Scholar
Hancock, J., “Hospitals Find Asthma Hot Spots More Profitable to Neglect than Fix,” Washington Post, December 6, 2017, available at <https://www.washingtonpost.com/national/health-science/hospitals-find-asthma-hot-spots-more-profitable-to-neglect-than-fix/2017/12/06/5d136476-da6e-11e7-a241-0848315642d0_story.html?utm_term=.5158e0cf2ac1> (last visited November 7, 2018).+(last+visited+November+7,+2018).>Google Scholar
Institute of Medicine, Committee for the Study of the Future of Public Health, The Future of Public Health (Washington D.C.: National Academy Press, 1988): 7.Google Scholar