Chapter Summary

Public health policy refers to the laws, regulations, programs, behaviors, and decisions implemented in a society to promote public health. There is a direct correlation from access to health care, the cost of health care, and the quality of health care to health outcomes. High health care costs impact an individual’s ability to access health care services. Different payment models and care delivery models affect the quality of care. When individuals cannot access health care services, health outcomes, including maintenance of chronic disease processes, are compromised.

Although the U.S. Constitution does not include a right to health or health care, the federal government supports health care through Medicare, Medicaid, federal tax subsidies for employer-sponsored health care, and agencies such as the CDC and the HHS that work to improve the population’s health. Violations of health as a human right have serious consequences for individuals and populations. Discrimination in delivering health care services creates barriers to positive health outcomes, and underrepresented individuals tend to face higher rates of chronic diseases. Health policies can improve the systems through which health care services are provided and make it feasible for individuals with chronic health conditions to access necessary care. Public health nurses are integral to the APHA’s efforts to influence public policy. The tension between individual rights and public health continues to be salient in the United States; this was especially apparent during the COVID-19 pandemic.

Healthy People is a public health initiative that seeks to improve health outcomes in the United States. This 10-year HHS plan establishes public health priorities and data-driven objectives to improve public health and well-being over a decade. Healthy People 2030 includes 23 high-priority LHIs to improve health and well-being over the lifespan. Mechanisms for the delivery of public health policy interventions include fiscal policy, regulation, education, preventative treatment, and screening. The IHI Triple Aim is a framework to improve health care system performance on three levels (improving the client experience, improving population health, and reducing costs).

The FDA has broad regulatory authority and is responsible for protecting public health by ensuring the safety and efficacy of the food supply and all medical drugs, products, and devices. The global drug manufacturing supply chain affects the supply and cost of pharmaceutical drugs. Pharmaceuticals are one of the fastest-growing components of health care spending in the United States. The increase in drug costs impacts underrepresented and marginalized populations the most.