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ABSTRACT
This special article defines the public health principles and core public health functions that are combined to produce the public health services essential for a highly-functioning New Zealand health system. The five core functions are: health assessment and surveillance; public health capacity development; health promotion; health protection; and preventive interventions. The core functions are interconnected and are rarely delivered individually. Public health services are not static, but evolve in response to changing needs, priorities, evidence and organisational structures. The core functions describe the different ways public health contributes to health outcomes in New Zealand and provide a framework for ensuring services are comprehensive and robust.
The Ministry of Health and District Health Boards (DHBs) are mandated by the Health Act 1956 and the New Zealand Public Health and Disability Act 2000 to improve, promote and protect the health of their populations and to reduce health disparities. Our health system faces growing pressure due to an ageing population, an increasing burden of chronic diseases, increasing treatment costs, and fiscal constraints. In this context, effective delivery of public health services that help improve health status and manage health care demand is increasingly important.
Public health has been defined as the science and art of preventing disease, prolonging life and promoting health through the organised efforts of society.1 This special article describes the public health principles and the core public health functions that are combined in various ways by a range of providers to produce the public health services essential for a highly functioning New Zealand health system. It then outlines the implications of the core functions framework for public health service delivery.
The purpose of this special article is to:
* improve understanding of the ways public health services contribute to improved health outcomes; and
* help ensure that the health sector invests in an appropriate mix and configuration of public health services.
The core functions framework has been developed by the Public Health Clinical Network, formed by the clinical directors and managers of the 12 DHB Public Health Units and the Ministry of Health's Director of Public Health to provide leadership for and strengthen the performance and sustainability of public health units. Many public health services are delivered by providers outside District Health Boards...