Organizational Models at State and Local Levels

This week describe various organizational models for public health. These models vary considerably within the country. The health departments in New York state, for example, are free standing, reporting directly to the governor, whereas the health departments in North Carolina and Maryland are part of a "superagency." Some local health departments are an extension of the state health department, while others are autonomous from it, though influenced by the state. Still others are semiautonomous. Any of these departments might be responsible to the city or county government or a combination of them. There are benefits and disadvantages to each of these state and local models.

This assignment by reviewing the various organizational models, as described in your chapter, at the state and local levels. Consider these models in light of the principles of systems thinking.

Describe succinctly how the organizational models at either the state or local level differ in terms of their structure and operation.

Which organizational model would you most prefer to work in? Support your choice by discussing strengths and weaknesses that are inherent in these organizational models.

Identify one way in which systems thinking helps illuminate the strengths and/or weaknesses of your selected organizational model.
Course Text: Public Health Administration by Lloyd Novick, Cynthia Morrow, and Glen Mays

Chapter 3, "Organization of the Public Health Delivery System"

Because there is a broad range of services within public health and a variety of service providers, it is not surprising that there is no one single institutional model by which the public health system can be structured. This chapter describes various ways in which the governmental and nongovernmental organizations are structured and explains the nature of interorganizational partnerships that are becoming increasingly important in this country’s practice of public health.

Chapter 24, "Evidence for the Future"

What challenges and opportunities await public health in the future? Where is evidence particularly needed? This chapter highlights different areas within public health in which further research will be increasingly important; one example is the need for research on systems rather than simply on particular interventions, however important that is as well.
Article: Leischow, S., & Milstein, B. (2006).Systems thinking and modeling for public health practice. American Journal ofPublic Health, 96(3), 403 – 405.
Many public health issues can only be understood accurately by examining the dynamic interactions of various components of a system. Conventional kinds of problem framing and action planning rarely take into consideration the complexities of systems. This article discusses public health in the context of systems thinking. This approach focuses on connections among different components and the implications of their interactions, and it requires transdisciplinary thinking as well as active involvement of stakeholders.

Article: Trochim, W., Cabrera, D., Milstein, B., Gallagher, R., & Leischow, S. (2006). Practical challenges of systems thinking and modeling in public health.American Journal of Public Health, 96(3), 538 –546.

Although the value of systems thinking in public health is increasingly being acknowledged, there are many practical challenges to its effective implementation. Using concept mapping, a systems-based methodology, the authors identified eight categories of challenge and the dynamic interactions among them. They offer rules to address challenges and improve the organization of systems that protect the public’s health.