A Changing Service - Community health care facilities

Providing more evidence of the complexity of the United States’ health care delivery complex, community health facilities fill a void in health services at a very basic level. At least five different modes of providing health care need to be considered as community facilities.

School and College Health Programs

Once concerned primarily with the control of communicable diseases and screenings for dental, vision, and hearing problems, school and college health programs have taken on new functions. At the elementary and high-school levels, they may help with health and sex education programs, keep vaccination records, and consult with parents. Colleges and universities generally provide infirmary services, meaning inpatient care for acute illness. At larger schools, programs may deal with contraception and pregnancy problems, substance abuse, and neuroses.

Industrial Health Programs

Treatment of work-related injuries and minor illnesses remains a key function of industrial health programs. The programs also continue to give minor physical exams and to provide general medical and dental care. But they have expanded their services in recognition of the value of preventive medicine. Newer or more modern programs offer comprehensive worksite education and screening programs, alcohol abuse counseling, stop-smoking clinics, and aerobic fitness classes.

Health Screening

Provided by local health departments and voluntary health agencies (see Chapter 36), health screening varies from community to community as regards both availability and reliability. Depending on community funding, a local health department may or may not provide tests that screen for infectious or parasitic diseases, including sexually transmitted diseases (see Chapter 17), and chronic disorders such as high blood pressure, sickle cell anemia, or diabetes. Many health departments make referrals to follow-up medical care.

Neighborhood and Primary Health-Care Centers

Neighborhood and primary healthcare centers were established first in the 1960s to provide ambulatory care in underserved communities, both rural and urban. Staffed often by U.S. Public Health Service medical personnel or by nurse practitioners, the centers either limited their services according to income requirements or served specific communities. Because of cuts in federal spending, experts note, many such centers have been or are being phased out.

Women, Infant, and Child Care

Also federally funded, the women, infant, and child care program emphasizes provision of well-baby care, nutritious food, and nutrition education for pregnant women, infants, and children under three. Estimates indicate that the program saves three dollars for every dollar spent. But federal budget cuts have begun seriously to scale back the program.

Disease Prevention and Control

County or city health departments usually establish disease prevention and control programs to help control the spread of communicable diseases. Methods used include immunization, screening, and follow-up. Typical concerns include immunization for childhood diseases like diphtheria, measles, and polio; tuberculosis and sexually transmitted diseases; and influenza immunization for older persons.

User Contributions:

Comment about this article, ask questions, or add new information about this topic: