The CDC has identified 10 Essential Public Health Services that all communities should use to protect and promote health. They include (CDC, 2023d):
Public health professionals use these essential services to address health issues across the United States and ultimately improve population health outcomes. The 10 Essential Public Health Services do not expressly focus on health inequities and disparities; however, applying these principles to public health activities can help facilitate health justice across the population.
The essential services align with the three core functions of public health. The three core functions of public health include assessment , policy development , and assurance (CDC, 2023d).
The core functions of public health are carried out via activities specified in the 10 Essential Public Health Services. Please see Table 2.1, which displays connections between the 10 Essential Public Health Services and the core functions of public health as well as examples of activities public health professionals may employ to address systemic and structural barriers that contribute to inequities in health and care.
| Essential Public Health Service | Core Function | Activity to Address Health Inequities |
|---|---|---|
| 1. Assess and monitor population health status, factors that influence health, and community needs and assets | Assessment: Public health agencies and professionals collect, analyze, and evaluate data to understand the barriers, opportunities, and status of health in a population. Data are also used to identify health disparities and determine the need for resources to facilitate health and ameliorate injustices. | Identify inequities and monitor progress in ameliorating them |
| 2. Investigate, diagnose, and address health problems and hazards affecting the population | Assessment, assurance: Public health agencies and professionals study data to understand health problems and health risks, identify causes, and determine the best interventions to address health issues. | Examine and describe the causes of health inequities, including social determinants, exclusive policies, or inequitable access to health services and programming |
| 3. Communicate effectively to inform and educate people about health, factors that influence it, and how it can be improved | Assessment, policy development, assurance: Effective communication raises awareness and secures support for public health issues. Through effective communication, public health information is shared with community members and affected groups. Healthy behaviors and engagement in current public health services can be promoted. Effective communication supports involvement of community members as they can access accurate and timely health information and services. | Provide accessible and evidence-based health information to all people to empower clients, families, and communities in their own health processes |
| 4. Strengthen, support, and mobilize communities and partnerships to improve health | Policy development, assurance: Public health agencies and professionals collaborate with communities, organizations, affected groups, and other key parties to build partnerships and develop resources that address health needs and improve health outcomes. | Meaningfully involve community organizations, local leaders, or affected groups to identify barriers to health equity and develop strategies to address them that the community finds realistic, useful, and acceptable |
| 5. Create, champion, and implement policies, plans, and laws that impact health | Policy development: Policies are developed with support from and in response to the public health data collected and to prevent disease, avoid harm, and reduce risk in the community. | Ensure policies, plans, and laws facilitate equitable distribution of health resources and promote health equity across communities |
| 6. Utilize legal and regulatory actions designed to improve and protect the public’s health | Policy development, assurance: Public health departments and other agencies may implement and enforce regulations that protect the health of the public. | Ensure compliance with policies and programs developed to improve health equity, from nondiscriminatory practices to those that support healthy environments for all communities |
| 7. Ensure an effective system that enables equitable access to the individual services and care needed to be healthy | Assurance: Public health professionals work to ensure that all population members can access health services regardless of their current health, employment, education level, or other determinants. Public health agencies reduce barriers to care to facilitate equity in access and opportunity. | Remove barriers to accessing care through promoting the availability and access of health services, clinics, mental health services, social programs, and other resources |
| 8. Build and support a diverse and skilled public health workforce | Assurance: The public health workforce must have strength in numbers to adequately address health needs and strength in diversity and inclusion so that the workforce approximates the characteristics of the community served. | Promote inclusion and belonging in the public health workforce to support a more comprehensive understanding and community-relevant response to problems from public health agencies |
| 9. Improve and innovate public health functions through ongoing evaluation, research, and continuous quality improvement | Assessment, assurance: Public health agencies evaluate programs and policies continuously to determine effectiveness, identify areas for opportunity, and ensure that resources are properly allocated to support health. | Include measures of equity and access in ongoing evaluation to inform quality improvement initiatives that lead to better population health outcomes related to reducing health disparities |
| 10. Build and maintain a strong organizational infrastructure for public health | Assurance: Public health organizations, agencies, or departments carry out many functions essential to the well-being of the population. Administrative systems; information technology; and professionals to assess, plan, deliver, and evaluate services are just a few essential departments and duties of a public health organization that require adequate funding, equipment, technology, space, and personnel. | Guide organizational planning with principles of justice , belonging, equity , and inclusion to ensure eliminating disparities and inequities is a priority in public health |
Table 2.1 Essential Public Health Services, Core Functions, and Activities to Address Health Inequities
Public/Community Health in Practice will discuss how nurses in public/community health carry out the 10 Essential Public Health Services and three core functions of public health.