10 Essential Public Health Services

The 10 Essential Public Health Services is a US government document which codifies the responsibilities of public health agencies and institutions in the United States.

Organized according to the "three fundamental purposes of public health" — assessment, policy development, and assurance — the essential services include the following:

In 1988, the Institute of Medicine (IOM) released an assessment of the U.S. public health system titled, The Future of Public Health. The report described the network of county, state, and national public health agencies as being in "disarray" and prompted a national discussion about the state of public health in the country. Questioning the ability of existing public health systems to provide essential services, the report sought to establish a comprehensive framework delineating the "three fundamental purposes of public health." These purposes included "assessment, policy development, and assurance."

Though health policy academicians identified with and understood the IOM framework, policy makers found its highly conceptual language difficult to apply. Therefore, as part of President Clinton’s 1994 healthcare reform efforts, a federal working-group was tasked with reviewing and supplementing the framework. Under the auspices of both the Center for Disease Control and Prevention’s (CDC) Public Health Practice Program Office and the Office of Disease Prevention and Health Promotion, the group sought to

These efforts culminated in the publication of The Essential Services of Public Health in late 1994. Public Health Units The report was well received. Public health agencies and professional organizations began to align guidelines and employ self-assessment tools in support of the ten Essential Services. The CDC launched a number of research projects aimed at developing strategies for measuring how well public health agencies provided the services. Many of these studies were the first of their kind and ushered in an era of health agency monitoring and assessment.

In 2002, the CDC and several national public health associations launched the National Public Health Performance Standards Program (NPHPSP). With the goal of developing a consensus-based set of performance standards for state and local public health delivery systems, the NPHPSP adopted the Essential Public Health Services as "the fundamental framework" underpinning its assessment strategy. The NPHPSP consists of three instruments — The State Public Health System Assessment, The Local Public Health System Assessment, and The Local Public Health Governance Assessment — and covers the gamut of public health action as described by the Essential Public Health Services.

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