Kuiswa kwoutano muUnited States kunotsamira pabasa rakaoma rehurumende, rehurumende, uye remo. Pakati paivava, hurumende dzomunzvimbomo(country), maakanisi, uye maruwa ezveutano chaiwo) zvinobatira senzvimbo yokutanga youtano hwevoruzhinji negadziriro yebasa. Masangano ayo vagari vamo vanosangana nawo pakutanga pakutsvaka dziviriro, kunzverwa kwezveutano hwemhoteredzo, tarisiro yezvokurapa, uye nzanga. Kunzwisisa ukuru, zvinetso, uye mibato yezvoutano yehurumende yomunharaunda kunokosha nokuda kwevagadziri vemiitiro yemitemo, nyanzvi dzezvoutano, uye vatsigiri venzanga zvakafanana.

Basa rehurumende dzomunzvimbomo mukutarisira utano rakava renetseke zvikuru muzana ramakore rapfuura. Nhamburiko dzezvoutano dzapakuvamba dzakanangidzirwa pautsanana, kuparadzana, uye kudzora hosha dzinotapukira. Nhasi, madhipatimendi omunzvimbomo ezvoutano (LHD) anotarisira mugwagwa mukuru unobatanidza kudzivirira hosha kusingaperi, amai uye vana, utano hwetsika, uye kugadzirira kwekurumidziro. Madhipatimendi outano omunharaunda anokasha muUnited States, anoshanda vanhu kubva pazviuru zvishomanene kusvikira kumamiriyoni anoverengeka avagari vemo. Masangano aya anowanzova mambure okudzivirira njodzi nokuda kwezvipo zvinochengetedzwa, anoita kuti basa rawo rive chinhu chinokosha kukubatsira vanhu vagari vemo.

Kushanduka - shanduka Kwenhau Kwezvoutano Hwehurumende Yomunzvimbomo

Mavambo okubatanidzwa kwehurumende yomunzvimbomo muzvoutano anodzokera shure kuzana ramakore rechi 19, apo maguta akatangwa ezvoutano kuti arwise cholera, yellow fever, uye kupararira kwetibhii. Kuumbwa kwedhipatimendi rokutanga routano muBaltimore muna 1798 kwakaratidzira kuzivikanwa kwapakuvamba kwokuti hurumende yaiva nomutoro wokudzivirira utano hwenzanga.

Zana ramakore rechi20 rakaunza chinjo. Social Security Act ya1935 yakagovera mari yehurumende nokuda kwamabasa outano hwaamai navana, mazhinji awo akaitwa kupfurikidza namadhipatimendi ezvoutano omunzvimbomo. Community Mental Act ya1963 yakachinja tarisiro kubva kumasangano makuru kugadziriro dzakavakirwa panzanga, kuisa zvinodikanwa zvitsva kuhurumende dzomunzvimbomo. Nguva pfupi yapfuura, Affordable Care Act (ACA) yakakudza kufukidzwa nokuiswa mukudzivirira, namadhipatimendi ezvoutano omunzvimbomo achiita basa guru mukubetsera nokugadziridza nzanga uye kugadziridzwa kwoutano.

Nhasi, hurumende dzemo dzinofanira kuongorora nzvimbo yakaumbwa nokusiyana kweutano, kukwegura, zvirwere zvinotapukira zviri kubuda, uye migumisiro inoramba ichivapo yedenda reCOVID-19. Dambudziko racho rakafumura zvose zviri zviviri simba uye kukura kwegadziriro dzoutano dzemo, zvichiita kuti mari irambe ichiwanika uye kuti pave nokubudirira kwemabasa.

Mabasa Muutano Hwevanhu Vose Hwamazuva Ano

Hurumende dzomunzvimbomo dzine mitoro yenheyo youtano yavose iyo inodzivirira nzanga dzose. Iyi mibato inowanzorongwa kumativi ose eMitemo 10 yePurceal Public Health Services yakagadzirwa neCenters for Disease Control and Prevention (CDC). Nzvimbo dzinokosha dzinosanganisira:

  • Kuongorora nokutanga kwehosha: kuongorora zvirwere zvinoshumwa, kuongorora miitiro, uye kubudisa magumo asati apararira.
  • [ Kudzikamiswa kwoutano hwendangariro:[[FLT]] Kunzvera maresitorendi, madziva okushambira, gadziriro dzokushambira, uye migove yemvura yokunwa kudzivisa chirwere.
  • [ Kusimudzirwa kweHealth nedzidzo: Kuronga nokuendesa nhimbe pamisoro yakadai sedziviriro, tsinga dzefodya, uye mubato womuviri.
  • [ Kukura nokudzikamisa: Kusarudza vakuru vakuru pamirairo ine chokuita noutano uye kusimbisa mitemo youtano yavanhu.
  • [ Kugadzirira nokupindura: kuronga nokuda kwengwavaira dzomusikirwo, kumuka kwehosha, uye zvinoitika zveugandanga.

Mibato Yokutarisira uye Kuwedzera Kwezvirwere

Madhipatimendi outano omunzvimbomo ndiwo anowanzotanga kuziva mitoo yechienzi yechirwere munzanga. Kupfurikidza nokunzvera kwerabhoritari, zviitiko zvinoshuma, uye nzvero yehosha, zvinozivisa kutanga kwehosha dzinopfuudzwa nezvokudya, hosha dzenhomba, uye kumuka kwetyisidziro dzakadai seutachiona hweWest Nile kana kuti mativi eCovid. Kunzvera uku kunotsamira pamibatanidzwa yemashoko yakasimba uye kubatira pamwe navanopa utano, zvikoro, uye marabhorotari.

Pakanyanya kupararira njodzi, vakuru vakuru vezvoutano vomunharaunda yacho vakatanga kuudza vanhu kuti vasakwanisa kuzvidzivirira, voga voga kana kuti vovharwa zvivako zvisina kukotsekana.

Utano Hwemhoteredzo Nechengeteko

Utano hwemhoteredzo hunoramba huri mumwe wemibato inooneka zvikurusa uye yakareba yehurumende yomunzvimbomo. Vanasaiza uye nyanzvi dzezveutano hwemhoteredzo zvinoitisa kunzverwa kwemiitiro kwemaresitorendi, zvitoro zvezvokudya, uye nzvimbo dzokugadzira zvokudya kuti zvivakire kutarisirwa kwezvokudya zvakakotsekana. Vanotarisirawo gadziriro yokunatsa, kunzvera mvura zvakanaka, uye udzori hwengozi dzemutobvu mudzimba. Munzvimbo dzakawanda, hurumende dzomunzvimbomo dzinodzora zvirongwa zvokudzora utachiona kuti zvideredzeredze michetura nenhove zvinokwenyesa zvirwere zvakadai seLyme disease neWest Nile virus.

Kuchinja kwemamiriro okunze kuri kuwedzera zvinetso zvoutano. Madhipatimendi outano omunzvimbo dziri kuwedzera kugadzirisa zvirwere zvinokonzerwa nokupisa, kusvinura kwemhepo kunokonzerwa noutsi hunopisa, uye kukanganisa utano hwezviitiko zvemamiriro okunze. Uku kuwedzera kuri kuita kunoda kubatana kutsva nemadhipatimendi okuronga, masangano anotarisira njodzi, uye masangano emhoteredzo.

Kuchengetwa Kwebasa Routano Hwakananga

Mukuwedzera kumabasa outano hwavanhu vose emwero wavanhu, hurumende zhinji dzomunzvimbomo dzinotarisira zvakananga nzvimbo dzezvoutano nepurogiramu dzinozadza nzvimbo dzinotambudza mugadziriro yezvoutano. aya mabasa anokosha zvikurukuru mumaruwa uye mumaguta umo maroja ari mashoma.

Masangano Outano Munzanga uye Zvipatara Zvekuchengeteka

Hurumende dzomunzvimbomo dzinotsigira uye dzinotarisira nzvimbo dzezvoutano dzomunzanga idzo dzinogovera tarisiro huru, masangano emazino, mazano outano, uye mishonga pachikero chemari inotsvedzerwa panzvimbo dzinotsamira pamari inobhadharwa. Nzvimbo idzi dzinowanzonzi Federal Almonomoned Health Center (FQHCs) kana kuti FHC inotaridzika sedzinokwaniriswa, dzichivakwa kuti dzigone kupiwa mari yadzo neyamutezo yemari. Muna 2022, nzvimbo dzeutano dzenzanga dzakabatira varwere vanopfuura mamiriyoni 30 muUnited States, vakawanda vavo vakanga vasina kuchengetwa kana kunyoreswa muMedicaid.

Zvipatara zvomuruwa zvinoumba chimwe chinhu chinoumba basa rakananga. Zvipatara zvinenge 25 muzana zvezvipatara zvose zveUnited States ndezvehurumende kana kuti dzomunzvimbomo. Zvipatara izvi zvinowanzoshanda senzvimbo dzokuvadziko, zvinodzidzisa zvipatara, uye mambure okudzivirira njodzi anogovera tarisiro isina kukodzera kuva nemari shoma uye kushaya basa. Zvipatara zvemari zviri muzvipatara zvose zvomunharaunda zvakawedzera nemhaka yokuderera kwemari inobhadharwa, kuwedzera kwemari yokutarisira kusingabhadharwi, uye kuperevedza kwevashandi.

Gadziriro Dzoutano Hwevana

Madhipatimendi outano omunzvimbomo anotarisira purogiramu dzoutano dzaamai navana dzinotsigirwa nesangano reTheat V breat nehurumende. Idzi dzinosanganisira kushandira pamwe kwekutarisira mwana asati aberekwa, zvirongwa zvokushanyira mhuri dzinoberekwa, kuongorora, uye kukura kwapamberi pevana. Vakadzi, vana, uye vana (Wic) purogiramu yezvokudya zvehurumende inowanzoitwa nedhipatimendi routano romunzvimbomo, kugovera zvokudya zvokuwedzera, dzidzo yezvokudya zvinovaka muviri, uye kupfumisa tsigiro yokuwana vakadzi vane pamuviri vaduku.

Zvisinei, mwero wemari yokushandisa mari haina kufambirana nendyiko dzinokwira, zvichitungamirira kukuperevedza kwavashandi uye kuderedza basa mune dzimwe nzvimbo.

Kutanga Utano Hworuzhinji Nokusimudzira Utano

Hurumende dzeko dzinogadzira uye dzinoshandisa zvirongwa zvinochinja mufambiro, mamiriro ezvinhu emhoteredzo, uye zvinodzivirira utano.

Kurapa Nehosha Dzinotapukira

Madhipatimendi outano omunzvimbomo anokosha pakuparwa kwedziviriro. Anoshandisa makiriniki anodzivirira kudzivirira nhomba, anonzvera nhomba dzechikoro, uye anopindura kuvamba kwehosha dzenhomba dzenhomba dzakadai segwirikwiti neperetisis. Mukati mede reCovid, LHDs yakabatanidza nhimbe dzekudzivirira, kusvika vanhu vari mungozi kupfurikidza nekiriniki dzemotokari, nzanga, uye kukwikwidza.

Mwero yokudzivirira vana nevakuru inoramba iri mutoo mukuru wokushanda nokuda kwamadhipatimendi outano omunzvimbomo. Chirongwa cheCDC chinogovera nhomba dzapachena kuvana vanokwaniriswa, uye LHD kazhinji kazhinji ndiwo maHFC makuru anopa misha munzanga dzinochengetedzwa. Kuchengeta kubhadharwa kukuru kwemutezo kunoda dzidzo yavose inopfuurira, kuvimbisana, uye kudzikamisa mutemo.

Kudzivirira Zvirwere Zvisingaperi

Zvirwere zvisingaperi zvakadai sehosha yemwoyo, chirwere cheshuga, kenza, uye kufema zvinoparira 70% yenzufu dzose muUnited States. Hurumende dzomunzvimbomo dzinotaura izvi migariro kupfurikidza nezvirongwa zvinotsigirwa noufakazi zvinosimudzira kushanda kwomuviri, kudya kwakanaka, uye kutengesa fodya. Nzanga dzakawanda dzakashandisa miitiro yokuvandudza kuwana zvokudya zvitsva, kugadzira nzvimbo dzakachengeteka dzokurovedza muviri, uye kudzora kutengeswa kwefodya.

Madhipatimendi outano omunzvimbomo anoshandisawo zvirongwa zvokuongorora kenza yemazamu, yechibereko, uye yemuraundi, kazhinji kazhinji achidenha kubhadharwa kwakaderera uye vakadzi vasina kudzivirirwa kupfurikidza neCDC's National Breast and Cervical Cancer Early Explorion Program. Zvirongwa zvokudzivirira chirwere cheshuga, zvirongwa zvokudzora kumhanya kweropa, uye purogiramu dzepamusha dzinoshanyira imo igadziriro dzokuwedzera kupindira kwehosha dzisingaperi.

Matambudziko Akuru Anotarisana Nemashandiro Outano Omunzvimbomo

Pasinei zvapo nebasa radzo rinokosha, hurumende dzomunzvimbomo dzinorwisana nedenho dzinopfuurira idzo dzinonetesa mano adzo okuita mabasa okutarisira utano anobudirira.Idzi denho dzakawedzerwa nedenda, iro rakazivisa utera hukuru hwokuvaka mugadziriro youtano yavose.

Kushandisa Mari Yezvirongwa uye Kushandisa Mari

Madhipatimendi outano omunharaunda anotsamira pamibatanidzwa yezvipo zvehurumende, mari yehurumende, kudzorwa kwemari, uye mari yebasa romunzvimbomo. Iyi mari inowanzova isingadeyi kujekeswa, inoganhurirwa kupurogiramu dzakati, uye isingasviki kumibato. Pakati pa2010 na2019, mari inotairwa pautano hwavanhu yakaderera munyika dzakawanda, ichibvisa simba reLHD rokuita chimwe chinhu ndokuchengeta mabasa enguva dzose.

Denda racho rakaunza kuwedzera kwokushandisa mari yehurumende kupfurikidza neCareS Act and American Replation Plan, asi mari yakawanda iyi inoganhurirwa uye haigoni kushandiswa kuvaka zvinhu zvinogadzirwa nenguva refu. Madhipatimendi outano zvino anotarisana nedombo rakadzika sezvo mari iyi inopera, achimanikidzira kusarudza kwakaoma pamusoro pokushanda kwavashandi nepurogiramu.

Kushaya Basa Nokuneta

Vashandi vezvoutano vehurumende vari kukwegura, neboka guru revashandi vanofanirwa nokurega basa. Kushanda nesimba uye kukanganwa zvinetso zvinowedzerwa nokusarongeka kwemibhadharo pakati pemabasa outano avanhu nemabasa ehurumende, mikana yakaganhurirwa yokufambira mberi pabasa, uye mamiriro ezvinhu okushanda anonetsa. Dambudziko racho rakawedzera kuneta pakati pevashandi vezvoutano, vakatarisana nokunetswa, dzvinyiriro yezvamatongerwe enyika, uye zvinoitika zvinorwadza pabasa.

Mukuwirirana nenzvero ya 2023 yakaitwa neNational Association of County and City Health Actigiers (NACCHO), inodokuva hafu yamadhipatimendi outano omunzvimbomo akashuma kuva ane mwero kusvikira kumwero yakakwirira yavashandi.

Vanoda Utano Nenzanga

Hurumende dzomunzvimbomo dzinonangidzirwa zvikuru pakunangidzira ngwariro pautano hwezviwiriranwa zvinoda kuti munhu ari wose anofanira kuva nebanza rakarurama rokuwana mwero wake wakakwirira zvikurusa woutano. Ikoku kunoda kudzora zvirambidzo zvenzanga zvakadai sokusagadzikana kwedzimba, kusachengeteka kwezvokudya, mhinganidzo dzezvokufambisa, uye urudzi. Zvisinei, madhipatimendi outano omunzvimbomo kazhinji kazhinji kazhinji haasati ane zviwiso nechiremera zvokupesvedzera izvi zvinhu zvenzanga nezvemari.

Kushandira pamwe nezviremera zvedzimba, maruwa ezvikoro, masangano ezvokufambisa, uye mahofisi okubudirira kwezvemari zvinokosha asi zvakaoma kuchengeta. Kuunganidzwa kwemashoko pamusoro pekusawirirana kweutano kuri kuvandudzika, asi vakawanda veLHD havagoni kushandura mashoko kuva chinjo dzemiitiro inoshanda.

Kushandira Pamwe Kunoshanda

Kana zvichinzi hurumende inoita kuti zvinhu zviome, kushanda pamwe chete kwazova chinhu chinokosha pakutarisira utano.

Kushandira Pamwe Kwavose

Hurumende dzomunzvimbomo dzinobatirana nenzira inowedzera nemiitiro yezvoutano yavanhu, masangano akavakirwa panzanga, uye anotarisira gadziriro dzezvoutano kuti ape mabasa. Somuenzaniso, vedhipatimendi rezvoutano reruwa vangabatira pamwe negadziriro yechipatara yomunzvimbomo kuti vatarisire nzvimbo youtano yenzanga, kana kuti nemhindu isina purofiti kuti vagovere betsero dzoutano dzinofamba-famba kuvanhu vasina misha. Uku kuyanana kunogona kuvandudza kubudirira, unyanzvi hwezvikamu zvavanhu, uye kuderedza kugadzirwa kwemabasa.

Kuzvidavirira kwezvibvumirano zvakadai sokushanda, utano hwevanhu hunoda kuongororwa, uye kurongwa kwenhengo dzemhuri kunobatsira kuti kubatana kuenderane nevavariro dzoutano dzevanhu pane kuti kuve nevavariro dzemhindu dzomunhu oga.

Kudzidza Nokutsvakurudza

Madhipatimendi akawanda outano omunzvimbomo anoshanda pamwe chete namayunivhesiti kuti asimbise ufakazi hwawo nesimba rokurapa. Madhipatimendi outano, anotsigirwa nemari kupfurikidza nezvipo zvokunzvera, vadzidzi vanopa mari navadzidzi muLHD kuti vaitise nzvero dzinoda kunzvera, kuyera mapurogiramu, uye kusimudzira mapepa okunyora mashoko. Uku kubatira pamwe kunowedzera simba rerovedzo youtano yavose apo kugovera mikana inokosha yokurovedza chizvarwa chinotevera chenyanzvi dzoutano.

Kubatana kwakadaro kunobatsira kuti pave nemukaha pakati pokutsvakurudza nokushandisa, zvichiratidza kuti zvinhu zviripo zviripo.

Zviyero Zvitsva Nenzvero Dzehosha

Hurumende dzakawanda dzomunharaunda dzakatanga nzira itsva dzokupa nadzo vanachiremba dzinodzidzisa nezvebasa racho.

Muguta racho rakashanda nevagari vomunharaunda kuti vazive zvinokonzera kusawirirana kweutano uye rakaita kuti pave nezvirongwa zvakadai seVane utano hwakanaka mupurogiramu yeHood, iyo yakachinja nzvimbo dzisina vanhu kuva mapindu uye nzvimbo dzakasvibira.

MuSan Francisco, Department of Public Health Expand Health San Francisco, gadziriro youtano inogovera tarisiro yokutanga, mirimo inonyorwa nachiremba, uye tarisiro yechipatara kuvagari vasina kuiswa mishonga. Purogiramu yacho inoshandisa muenzaniso wepamusha wezvokurapa, inobatanidza mugoverani mumwe nomumwe nomutarisiri wenguva dzose. United States San Francisco akawana vandudziko dzinobetsera mukutarisirwa kwehosha dzisingarapiki uye yakaderedza shanyo dzemadhipati ekurumidziro.

Nzanga dzomumaruwa dzakatangawo kugadzira zvigadzikiso. MuMontana, Butte-Silver Health Department yakagadzira nzvimbo inotakurwa youtano iyo inoenda kumisha yemigodhi iri kure, ichigovera kudzivirira, kuongorora utano, uye kushandisa mishonga. Purogiramu yacho inoshandisa ruzivo rwokugadzira zvinhu kuti ibatanidze varwere nenyanzvi dziri mumataundi, kukunda miganhu yenzvimbo kuti itarisire.

Kugoverana kwechanza chinokakavara ndiimwe nzira inovimbisa. MuWisconsin, madhipatimendi maduku okurapa maduku anoverengeka omumaruwa akaumba Wisconsin Public Health Colotinative, achigoverana mutungamiriri wezvokurapa, nyanzvi yezvokupora kwemhoteredzo, uye vashandi vezvoutano. Urongwa uhwu hwakaderedza ndyiko dzokudzora, hwakavandudzika, uye hwakagonesa madhipatimendi okutora rutivi kupa mabasa ayo asina angagona kutsigira mukuzvimirira.

Mirayiridzo Yeramangwana Yezvoutano Hwehurumende

Nguva yemberi yezvoutano hwehurumende yomunzvimbomo ichaumbwa namasimba anoverengeka: kuvandudzika kwemichina, kuchinja kwechiverengero chavagari vemo, kuchinja kwemamiriro okunze, uye mamiriro okunze anochinja. Telehealth, iyo yakawedzera zvikuru mukati medenda racho, inopa mikana yokutambanudzira kusvika kutarisiro chaiyo munharaunda dzakachengetedzwa. Madhipatimendi outano omunzvimbomo ari kunzvera kunenge kumusha, kushanyira varwere vari kure, uye mabasa outano hwemichina yekombiyuta.

Kushandiswa kwemitemo yazvino uno chinhu chikuru. MaLHD akawanda achiri kutsamira pamakombiyuta akavakirwa papepa kana kuti akagara nhaka ayo anoganhurira mano awo okufamba nenzira dzakati, tarisiro inorongeka, uye mushumo kuhurumende nehurumende. Mitengo yemipiro muzvinyorwa zvoutano zvemagetsi zvinobatira pamwe, nzvimbo dzokutarisira, uye kutsinhana mashoko outano munzanga kunogona kuvandudza kushanda nokubudirira.

Chinjo dzemitemo pamwero wehurumende nehurumende dzichapesvedzerawo mabasa ehurumende yomunzvimbomo. Kugadzirwa kwemari yegadziriro dzoutano yavose munyika yose, yakakarakadzwa namamwe mapoka okugona kugovera mari yakadzikama, inochinjika nokuda kwemabasa outano hwavanhu. Kubatana kukuru pakati poutano hwavanhu, kuendesa utano, uye mabasa enzanga anowanzonzi muenzaniso wenzanga yenzanga, kugonesa hurumende dzomunzvimbomo kupedza zvinhu zvinobudirira zvikuru.

mhedziso

Hurumende dzomunzvimbomo dzinokosha kugadziriro yezvoutano muUnited States uye kupota nyika. Dzinoita mabasa outano anokosha, dzinoshandisa mambure okudzivirira ngozi, uye nhamburiko dzoutano dzemunzanga yose. Zvinetso zvadzo zvinotarisana ne(sagadzikana kwenzanga, kuperevedza kwamabasa, uye kudikanwa kwamabasa (jere) kunokosha asi hakunetsi. Nokushandisa purojekiti, kubatana kweboka, uye mitoo mitsva, hurumende dzomunzvimbomo dzinogona kupfuurira kudzivirira nokuvandudza utano hwenzanga dzadzo.

Sezvo nyika inotarisisa gadziriro youtano yakasimba zvikuru uye inoenzana, basa rehurumende yomunzvimbomo rinofanira kusimbiswa, kwete kuderedzwa. Kutsigira madhipatimendi outano omunzvimbomo nemari inotsigirwa, ruzivo rwazvino uno, uye vashandi vane unyanzvi ibasa rinoiswa munheyo dzoutano hwavanhu. Mitengo inoisa mari musimba rezvoutano rehurumende yomunzvimbomo ichagadzirira zviri nani nokuda kwedenda rinotevera, rakashongedzerwa zviri nani kugadzirisa hosha isingaperi, uye kuzova nenzvimbo iri nani yokufambisira mberi utano hwevagari vose.