Miller C A, Moore K S, Richards T B
Department of Maternal and Child Health, School of Public Health, University of North Carolina, Chapel Hill 27599.
Public Health Rep. 1993 Nov-Dec;108(6):695-700.
Directors of 14 public health departments were surveyed for their perceptions on the impact of 20 critical events of the 1980s on public health performance. The departments were selected in 1979 from among those that were highly regarded by public health experts for exemplary performance, especially with regard to personal health services. The departments were the subjects of intensive case studies in 1979, 1983, and again in 1992. The public health functions that were most benefited in the 1980s were assessment and policy development. The assurance function was equivocally affected. Greatest positive impact was exerted by the acquired immunodeficiency syndrome-human immunodeficiency virus epidemic, by increase in fee income, and by the Institute of Medicine report, "The Future of Public Health." Negative influences, especially on the assurance function were exerted by loss of Federal grants, demographic changes, substance abuse, and economic downturn. Other critical events had equivocal or idiosyncratic effects. Analysis of public health practice according to the functions of assessment, policy development, and assurance appears to have utility for purposes of evaluation and planning.
对14个公共卫生部门的主管进行了调查，了解他们对20世纪80年代20个关键事件对公共卫生绩效影响的看法。这些部门于1979年从那些因其出色表现，特别是在个人卫生服务方面受到公共卫生专家高度评价的部门中挑选出来。这些部门在1979年、1983年以及1992年再次成为深入案例研究的对象。20世纪80年代受益最大的公共卫生职能是评估和政策制定。保障职能受到的影响不明确。获得性免疫缺陷综合征-人类免疫缺陷病毒流行、收费收入增加以及医学研究所的报告《公共卫生的未来》产生了最大的积极影响。联邦拨款减少、人口结构变化、药物滥用和经济衰退对保障职能产生了负面影响，尤其是对其产生了负面影响。其他关键事件产生了不明确或特殊的影响。根据评估、政策制定和保障职能对公共卫生实践进行分析，对于评估和规划目的似乎具有实用性。
