There is a model standard for Public Health. How do New York state's powers and duties compare with “model standards”? Would you characterize New York Public Health agency as having broad or narrow responsibilities?
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Borders separating cities, counties, states, and countries are arbitrary, politically-derived invisible lines that do not block the spread of pathogens carried by humans, animals and plants that cross these invisible lines. It is, consequently, a primary responsibility of the federal government to establish basic requirements or standards to govern the public health systems of the 50 states that collectively comprise the United States of America. Title 42 of the United States Code addresses public health issues, including establishing the federal Department of Health and Human Services. Within the Department of Health and Human Services is the Centers for Disease Control, which conducts what it calls The National Public Health Performance Standards Program. Within this document, a link to which is provided below, is the model for public health systems at the state level, and it is against this model that one can assess the State of New York's public health system. When making such an assessment, however, the CDC cautions against judging too harshly, noting the following:
"The standards were set at the optimal level; for this reason, participating jurisdictions will likely see many differences between their own performance and the 'gold standard' presented in the instruments. System partners should seek to address these weaknesses and also recognize and maintain areas in which they are strong."
The State of New York has its problems, and its public health system which must cater to the most ethnically- and culturally-diverse, and most densely-populated, demographic in the nation, is no exception. The terrorist attacks of September 11, 2001, and the anthrax mailings targeting New York State officials (as well as officials in Washington, D.C.), however, served as a wake-up call to state officials regarding their public health system. Consequently, New York has made every effort to establish and maintain as proficient a public health system possible. That does not, however, mean that it meets the CDC's "gold standard," because it does not. As the United Health Foundation's national ranking indicates, New York has room for improvement in closing socioeconomic gaps in terms of quality of health care, but the state's biggest concerns remain tied to individual conduct as opposed to some government-wide deficiency. In other words, if New Yorkers could exercise greater discipline with regard to nutrition, the state's ranking would improve considerably, a phenomenon former governor Bloomberg attempted to address by limiting portions of unhealthy foods served in New York eateries (e.g., fast-food outlets).
Obesity aside (and New York is hardly alone in this area, as visitors to the Midwest will attest), New York State officials have made good faith efforts at building medical facilities to serve previously under-served demographics, and has maintained sufficiently rigorous standards with regard to levels of technical proficiency and physician care.
New York, as stated, is a heavily-populated state, especially the New York City metropolitan area, and its state statutory authorities are commensurate with the state's demographics. It is a major entry point for international visitors and immigrants, as well as remaining a major port for imports of all matter of goods. Consequently, residents live with a built-in high-level of threat from biological pathogens brought in by visitors, immigrants, produce, etc. It cannot be judged on the same level as much smaller states like Wyoming that have much smaller populations do not have maritime or international land borders. As such New York's public health infrastructure faces strains that exceed most other states. Taking that into account, one can conclude that it measures up well to the CDC standards.
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