Local health departments' mission to the uninsured |
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Authors: | Keane Christopher Marx John Ricci Edmund |
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Affiliation: | 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. |
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Abstract: | 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. |
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