The Core Functions of Public Health

Summary / Explanation

The core functions and 10 essential public health services form a crucial framework that guides public health practice. The 3 core functions were initially defined in the 1988 Institute of Medicine, now the National Academy of Medicine, report entitled The Future of Public Health. This report called for action to improve the poor state of public health and outlined the government's role in promoting population health.[1] The core functions include assessment of community health conditions and threats, policy development for promoting and protecting population health, and assurance of providing these interventions to communities.

In 1994, the Core Public Health Functions Steering Committee elaborated on the core functions by defining the 10 Essential Public Health Services. These services were revitalized in September 2020 to reflect current and future public health practices and increase focus on equity in defining public health's role in a comprehensive approach to impacting health outcomes.[2]

The update is still a vital component of public health infrastructure and informs the organization of state and local public health systems. The core functions are vital when public health entities and clinicians plan for and perform local, state, and national interventions.

Assessment

This component of the core functions allows organizations to collect, analyze, interpret, and monitor data to identify a particular community’s needs, current health status, emerging issues, and factors that affect health. Assessment informs policy development, effective interventions, and more.

The assessment core function includes the following essential services:

• Assess and monitor population health status, factors that influence health, and community needs and assets
• Investigate, diagnose, and address health problems and hazards affecting the population

Policy Development

Public policy is an effective method for community-level health improvement. Historically, many of the most effective large-scale public health interventions are due to local, state, and national policies. Public health professionals have an important role in policy development through policy analysis, communication with stakeholders, development of key community partnerships, advocacy, and policy implementation, including enforcement and monitoring.

The policy development core function includes the following essential services:

• Communicate effectively to inform and educate people about health, influencing factors, and areas of improvement
• Strengthen, support, and mobilize communities and partnerships to improve health
• Create, champion, and implement policies, plans, and laws that impact health
• Utilize legal and regulatory actions designed to improve and protect the public’s health

Assurance

The final core function ensures that the findings gathered through assessment and policy development are effectively implemented. Functionally, assurance involves allocating resources, ensuring a capable workforce and a robust public health infrastructure, and utilizing research and evidence-based interventions.

The assurance core function includes the following essential services:

• Assure an effective system that enables equitable access to individual services and care
• Build and support a diverse and skilled public health workforce
• Improve and innovate public health functions through consistent evaluation, research, and quality improvement
• Build and maintain a solid organizational infrastructure for public health