Programs and services

In the United States, the Department of Health and Human Services is responsible for coordinating health programs in the country. With more than 100 programs and services, the United States Department of Health and Human Services (HHS) aims to "protect the health of all Americans and provide essential human services, especially for those who are least able to help themselves."^[6] These federal programs consist of social service programs, civil rights and healthcare privacy programs, disaster preparedness programs, and health related research. HHS offers a variety of social service programs geared toward persons with low income, disabilities, military families, and senior citizens.^[7] Healthcare rights are defined under HHS in the Health Insurance Portability and Accountability Act (HIPAA) which protect patient's privacy in regards to medical information. HHS collaborates with the Office of the Assistant Secretary for Preparedness and Response and Office of Emergency Management to prepare and respond to health emergencies.^[8][9] A broad array of health related research is supported or completed under the HHS; secondarily under HHS, the Health Resources & Service Administration houses data warehouses and makes health data available surrounding a multitude of topics.^[10][11] HHS also has vast offering of health related resources and tools. Some examples of available resources include disease prevention, wellness, health insurance information, as well as links to healthcare providers and facilities, meaningful health related materials, and public health and safety information.^{[12][13][14][15][16][17]}

Health departments in the United States

There are several tiers of health departments in America: federal, state, tribal, insular areas, freely associated states, and local levels.^[18] In relation with state and local government, the federal government provides states with funding to ensure that states are able to retain current programs and are able to implement new programs. The coordination between all three levels is critical to ensure the programs being implemented are well structured for each level. The health department at state level needs to safeguard good relations with legislators as well as governors in order to acquire legal and financial aid to guarantee the development and enhancements of the programs. Assemblies are set up to guide the relationships between state and local health departments. The state sets up the regulations and health policies whereas the local health departments are the ones implementing the health policies and services.

Grants and contracts

The United States Department of Health and Human Services (HHS) acts as the most extensive grant funding agency in the country.^[19] While several grants are delivered to non-government agencies, the majority of HHS federal grants are administered to states, territories, and tribes.^[20] Beneficiaries of federal funds are prohibited from lobbying government officials for legislative influence or additional funding.^[21] HHS and the National Institutes of Health, are accountable to Congress for conducting research that is amenable to both federal and state regulatory policies and a cost-effective budget.^[22] HHS uses grants to finance and encourage government research interests. Additionally, HHS routinely sets fixed price and cost reimbursement contracts with private companies in order to obtain products and services for government operations.^[23] HHS aims to issue these contracts with adherence to federal contract laws, HHS acquisition policies, and local operating procedures.^[23]

History

There is some dispute at the local level as to the claim of being the first to establish a local board or health department. For example, The city of Petersburg, Virginia claims it established the first permanent board of health in 1780;^[24] The city of Baltimore, Maryland claims it is established the first US health department in 1793,^[25] Philadelphia, Pennsylvania followed 1794, claiming its Board of Health as "one of the first";^[26] and Boston, Massachusetts claims in 1799 it established the first board of health and the first health department, with Paul Revere named as the first health officer.^[27]

At the state level, Louisiana was the first state to create a state board of health in 1855,^[28] but it functioned primarily to influence regulations in New Orleans.^[29] Massachusetts was the first to establish a state board that functioned throughout its state with statewide authority in 1869.^[30]

At the national level, a simple National Board of Health functioned from 1879 to 1883,^[31] but it was not until 1939 that another federal agency that operated to manage public health on a national level was established, going from a federal agency called the Federal Security Agency that had health functions such as the United States Public Health Service (PHS), and the United States Food and Drug Administration (FDA). In 1953, that agency was reorganized and its health functions were elevated to a cabinet-level position to establish the United States Department of Health, Education and Welfare (HEW), which was renamed in 1980 to become the current and modern United States Department of Health and Human Services (HHS).