Hello! My name is Jenna and I am yet another CU nursing student. 

The Core Public Health Services draft gives a thorough overview of how “Public Health” should best be implemented in Colorado communities, however it is lacking in a few areas. I believe that utilizing some of the strategies that nurses employ during a community health assessment may benefit public health services in Colorado.

-         During the assessment phase, it would be important to incorporate a system that identifies the problems of highest priority, especially when multiple problems exist (Stanhope & Lancaster, 2006). Identifying priorities can best be done by investigating: 1) how difficult it would be to address the problem, 2) the consequences if the problem is ignored, 3) the community and population outcomes if the problem is not fixed, 4) the cost of putting the solutions in place, 5) the impact of politics, values in the community, and funding on the measures needed to fix the problem, and 6) the expectations of the community (Stanhope and Lancaster, 2006). Priorities should be identified after answering these questions, and the problems with the highest priority should be focused on first. 

-         The planning stage may benefit from a deeper analysis of the problems the community faces. It would be important to investigate the source of the problem as well as the effects it may have on the community (Stanhope & Lancaster, 2006). If you can identify the source of the problem, then in the future you may be able to prevent it. Recognizing the relationships between problems may also be helpful (Stanhope & Lancaster, 2006). If one problem is affecting or leading to another problem, it may be possible to manipulate one factor and have two good outcomes.

-         Implementation of interventions for community health problems is a component of public health that was only briefly touched upon in the Core Public Health Services draft. When thinking about implementing solutions, the method of implementation must be considered. Who is going to decide upon the change? (Will it be voted on by the public? Will it be decided by the government? Will it be put into place by the public health nurses?) How is the change going to be brought about? How is the public going to be notified and educated? (By flyers? Phone calls? E-mail? Written letters? Education classes?) Who is going to distribute the information? (Public Health employees? Volunteers?) Who is going to pay for the workers, the interventions, and the subsequent evaluation of the changes put in place? It is important to understand how a change is going to be enacted, because every community is different, and the intervention will have no effect if it does not reach the community members.

Resources:

Stanhope, M., & Lancaster, J. (2006). Foundations of nursing in the community:

            Community-oriented practice. St. Louis: Mosby Elsevier.  

The Colorado Department of Public Health and Environment. (2009). The core public

health services draft. Retrieved on November 22, 2009 from http://www.cophip.org/applications/RegistrationManager/publicForum.asp?topicID=25

On June 4, 2008, Governor Bill Ritter signed the Colorado Public Health Reauthorization Act.  It requires boards, agencies, and public officials such as The Colorado Department of Public Health and Environment and The State Board of Health to collaboratively develop state and local public health plans that set priorities for the public health system in Colorado.  “The primary purpose of the Act is to assure that core public health services are available to every person in Colorado with a consistent standard of quality.”  (CDPHE,  2009).  The ten goals of the Colorado Statewide Public Health Improvement Plan are as follows: 

·         Goal 1:  Optimal community, environmental, and personal health

·         Goal 2:  Equitable access to core public health services

·         Goal 3:  Highest quality programs and services

·         Goal 4:  Accountability

·         Goal 5:  Collaborative leadership

·         Goal 6:  Effective use of public health resources

·         Goal 7:  A well-trained workforce to serve Colorado

·         Goal 8:  Communicate the value of public health

·         Goal 9:  Partnerships

·         Goal 10:  Community participation

Optimal community, environmental, and personal health are key points that any health care provider should identify as educational points with every patient.  The anticipated outcome of this goal, stated by the Colorado Department is “…the public health system will ensure optimal health for all Coloradans from birth to old age.”  (CDPHE,  2009).  Even though Colorado was ranked one of the slimmest states in the nation, Governor Bill Ritter tells CalorieLab, Inc. “We’re not spared from the national obesity epidemic, and we must remain vigilant in order to guard against it. We’re doing all we can to encourage Coloradans — especially our kids — to take advantage of the natural resources our state offers in order to stay fit, healthy and happy.”   (CalorieLab, Inc.  2008)

To give our nation the best chance at successfully integrating a healthier lifestyle for generations to come, our wisest option is to begin with our school age children.  Currently, and due to the financial climate in our nation, schools are experiencing budget cuts at alarmingly high rates.  These budget cuts nearly always affect the Physical Education aspects of our children’s education.  The poorly developed idea of forcing PE cuts not only limits the amount of education our children receive in this content area but also teaches them that their physical well-being is simply an option.  The successful implementation of this Act will give our children a better chance at learning what healthy lifestyles are as well as the opportunity to teach the generations after them the importance of living healthy.  That being said, is there any talk about additional funding for schools or options for schools to consider for this needed funding?   

CalorieLab, Inc.  (2008).  Mississippi is the fattest state for 3rd straight year, Colorado still leanest, D.C. loses weight.  Retrieved from http://calorielab.com/news/2008/07/02/fattest-states-2008/

Colorado Department of Public Health and Environment. (2008). Colorado public health reauthorization act – SB 08-194 Executive summary. Retrieved November 20, 2009, from the Colorado Department of Public Health and Environment’s Web site:  http://www.cdphe.state.co.us/opp/publichealthact/SB194execsum.pdf

Colorado Department of Public Health and Environment.  (CDPHE).  (2009).  Uniting Public Health Conference.   Preparing for bridge day: 2009 draft plan for improving Colorado’s public health system.  Retrieved 11/21/2009, from http://www.cophip.org/applications/RegistrationManager
/my_documents/my_files/final.COPHIP_Draft_For_Bridge_Day_9.30.09.pdf

·         Public Health System Roles and Relationships: working together as equal partners to provide the best opportunity to achieve the greatest returns across every region of Colorado (Colorado, 2009).

          The concept of “working together” is merely a small aspect of the holistic concept of communication.  “Communication is a complex, ongoing, dynamic process in which the participants simultaneously create shared meaning in an interaction.  The goal of communication is to approach, as closely as possible, a common understanding of the message sent and the one received” (Sullivan, 2009, p. 122).  In regards to Public Health Improvement, this is definitely a key concept.  If Public Health, as a whole, is going to improve, communication between different parties will be extremely vital.

            As I read through the 2009 Draft Plan for Improving Colorado’s Public Health System, I was truly impressed with it’s organization, goals, and corresponding expectations.  As Stanhope and Lancaster point out, the purpose of any program “is to ensure that the results of an organized activity are consistent with the expectations” (Stanhope, 2006, p. 294).  Although, we are unable (at this time) to measure the results, I feel that the draft is absolutely wonderful; it is well on it’s way to a both positive and productive end.  The goal that the draft gives regarding communication is as follows:

·         “Continually improve state and local governmental public health agency communications and collaborative relationships. Review and expand formal and informal networks for communication, technical assistance, mentors, consultants, and support teams available for state and local agencies.”

                                                                                                -(Colorado, 2009, p. 12)

            According to Stanhope and Lancaster, there are eight basic components you need to ask yourself in order to create a quality program; they are as follows: 

·         What is being done now?

·         Why is it being done?

·         Is it being done well?

·         Can it be done better?

·         Should it be done at all?

·         Are there improved ways to deliver the services?

·         How much is it costing?

·         Should certain activities be abandoned and/or replaced?

                                    -(Colorado, 2009, p. 12)

            As I took some time to study each question, the only issue I found lacking was that of cost.  There is nothing in this draft which specifically talks about the costs of increased communication, technical assistance, mentors, consultants, and support teams.  It leaves the reader wondering, “how much will this cost?” and “do we even have the money?” 

            Overall, I feel that the communication portion of the 2009 Draft Plan for Improving Colorado’s Public Health System, is very promising.  The only recommendation I would give it would be to add a section on finances.

References

Colorado Department of Public Health and Environment.  (CDPHE).  (2009).  Uniting Public Health Conference.  Preparing for bridge day: 2009 draft plan for improving colorado’s public health system.  Retrieved 11/21/2009 from http://www.cophip.org/applications/RegistrationManager
/my_documents/my_files/final.COPHIP_Draft_For_Bridge_Day_9.30.09.pdf

Sullivan, E., & Decker, P.  (2009).  Effective Leadership and Management in Nursing.  New Jersey: Prentice Hall.

Stanhope, M., & Lancaster, J.  (2006).  Foundations of Nursing in the Community – Community Oriented Practice.  St. Louis, Missouri: Mosby Elsevier.