LPHSA: Chicago, IL Vignette
Local Public Health System Assessment
The Chicago Partnership established a Systems Assessment Committee to identify the extent to which organizations in Chicago contribute to the delivery of the Ten Essential Public Health Services. The committee's first step was to determine the categories of entities that participate in the local public health system. In addition to public health and related government agencies, the committee identified community health centers, hospitals, policy and advocacy organizations, coalitions, educational institutions, social service providers, philanthropy organizations, businesses, and religious communities. Committee members then generated a lengthy list of specific providers within each of these arenas.
A survey was developed to determine which of the 10 essential services agencies were providing and to provide examples of the ways in which they delivered those services. The survey was sent to more than 150 agencies, and generated 48 responses. Staff organized the responses by arena and service, and completed a larger matrix reflecting all arenas and noting which services were provided. The committee then met to review the findings.
Although the respondents represented only a fraction of Chicago providers, the matrix was nearly filled. This suggested that even though Chicago has many resources, a key issue may be how those resources are being used. It was also noted that many agencies are carrying out public health services, but some are doing so deliberately and others may be doing so incidentally. If the identified services are truly going to benefit the local public health system, they must be able to be folded into the system to improve the direction of their efforts.
It was agreed that a more refined analytic framework was needed to better understand the contributions being made to the development of the public health system. For immediate purposes, however, the information obtained would be very useful to characterize the system as it existed then.
There were two additional components to Chicago's system assessment. First, an extensive review was conducted of public health mandates in the City Municipal Code. The review revealed that the municipal code played three roles:
These mandates were then organized alongside the essential services; unsurprisingly, most fell under diagnosis and investigation of health problems, enforcement of laws and regulations, and policy and plan development.
The final component of the assessment was a mapping of existing community-based health improvement partnerships. It revealed that 16 of Chicago's 77 formally designated community areas are served by seven existing partnerships. Most communities are not served.