Nhoroondo Yemitemo Youtano Hwevanhu Vose

Mutemo woutano hwavanhu vose muUnited States une midzi mikuru, yakabatanidzwa zvinoshamisa mukati mamazana maviri amakore apfuura. Kubatanidzwa kwehurumende kwapakuvamba kwakavamba neMarine Hospital Service, kwakagadzwa muna 1798 kugovera tarisiro kuvafambisi vengarava vanorwara nezvokutengeserana, iyo gare gare yakashanduka kuva yatinoziva zvino semadhipati outano hweU. Public Health Service. Kupinda kwapamusha nokukurumidza kwezana ramakore rechi19, kwakabatanidzwa nokushatisa kwenzvimbo yenzvimbo yeindasitiri nehosha dzinopfuurira dzechorrecule, yeyey fever, uye TB, kwakaparira kudikanwa kwokukurumidza kwemhinduro yakarongwa yehurumende yavose. Pakuvamba kwema 1900, kunoti kuvamba kutanga kuva namadhipati outano avo vamene, vachiziva kuti migariro yomunharaunda yomuno. Chishatimuchinyakare cha 1918 1918 chakauraya vanofungidzirwa kuva 675 000, zvakafurira kushatsa kushatidzwa muhurumende yose uye kugadzirirwa kwezvo.

Zviitiko zvinoverengeka zvinokosha zvakaumba nzvimbo inotarisirwazve yemazuva ano:

  • 1906 – Food and Drug Act: Mukupindura kushatisa zvokudya kwakapararira nemishonga ine ngozi, Congress yakaita Food and Drug Administration (FDA) kuva nechokwadi chemipimo mikuru yekotsekano. Ikoku kwakaratidzira kubatanidzwa kukuru kwemubatanidzwa mukudzivirira vatengi.
  • 1946 – Centers for Disease Control (CDC): Yakavambwa pakutanga kurwisa marariya mukati meHondo Yenyika II, CDC yakava sangano rinoparira hosha renyika, ichishanda zvikuru namasangano pamusoro pokunzverwa nokuvamba kwemhinduro.
  • 11963 – Ceaner Air Act: ichi chiito chakakatyamadzwa nokubudiswa kwemhepo nenzvimbo dzamabasa okugadzirwa kwezvinhu, ichi chiito chakagadza mipimo yetsika yepasi yokuenzana nemhepo, yakagombedzerwa neEvironmental Protection Agency (EPA) pashure pokusikwa kwayo muna 1970.
  • 1970 – Occupational Safety and Health Act: Kugadzirwa kweOSTA kunogadza mipimo yekotsekano yebasa inogombedzerwa, kuchideredza mwero yekuvadziko mumaindasitiri ose.
  • 2010 – Affordble Care Act: Uyu mutemo wakakudza kufukidzwa kwoutano, wakaraira mabasa anodzivirira, uye wakasimbisa misika yeinishuwarenzi yakavakirwa pahurumende.

Iyi nhambo inokosha inoratidzira nzwisiso inokura yokuti utano hwavanhu hunoda zvose zviri zviviri mipimo yehurumende yakasimba uye kugadzirwa kusingachinji kwehurumende kuti kuratidze zvinodikanwa zvomunharaunda nenzira inobudirira.

Basa Remitemo Yakatevedzana

Mitemo yehurumende inogovera mupimo mukuru wedziviriro unoshanda munyika yose, ichivimbisa kuti vaAmerica vose vanobetserwa nemipimo yekotsekano isingachinji.

Kutarisira Zvokudya Nezvinodhaka

FDA inotarisira kuchengeteka kwezvokudya, mirimo, zvishandiso zvemishonga, uye zvizorwa. Kutenderwa kwayo kwemishonga isati yaitwa kunoda kuongororwa zvakasimba kuti iratidze kuchengeteka nokushanda muzvinhu zvisati zvasvika vatengi. Muna 2023, FDA inotenderwa 55 yemishonga mitsva, iri kutoedzwa kwemakore. Sangano racho rinoongororawo zviitiko zvakaipa zvepashure pemapepa kupfurikidza nemiitiro yakaita seFDA System (FAARS). Kuchengeteka kwezvokudya ndimumwe mubato mukuru: Food Safety Moderficiation Act (FSMA) ya2011) inorega kuipisa kuti irambe yakasvibiswa kuti isarudze, nzira inoshanda yakaderedza kurwara kwezvokudya.

Centers for Disease Control and Prevention

CDC inoshanda sesangano rezvoutano renyika, kuronda kupararira kwehosha, kunzvera, uye kupa nhungamiro youtano hwevanhu. Mukati medenda reCOVID-19, CDC yakabatana nemadhipatimendi ezvoutano enyika kugovera zvirongwa zvokuedza, kuparadzira nhomba, uye mashoko enguva chaiyo. Kombishi yacho inoshandisawo National Notificial Shurtveillance System (NNNDSS), iyo inobatanidza mashoko anoshumwa nezvirwere zvinopfuura 120, ichiita kuti ipedziswe nokukurumidza tyisidziro dzokubuda sekuputika kwemabhakitipox 2022.

Agency Yokudzivirira Mbango

EPA inoisa ganhuriro pazvinoshatisa mumhepo nemvura mumitemo yakadai seCheador Air Act yeFiteing Water Act. Somuenzaniso, EPA’s National Awaent Air Servetution Divice (NAAQS) Mwero yerefu yakaderedzwa zvikuru, sulfur dioxide, uye nzvimbo inoparira kubvira muna 1970. Chirongwa chinodzorawo tsvina ine ngozi inoparadza tsvina kupfurikidza neResociation Conservation and Recovery Act (RRA), kudzivirira kushatasikwa kwevhu nemvura yapasi. Kunzvera 201 kwakaitwa neEPA kwakafungidzira kuti Cheafly Act kwakadzivisawoka rufu rusati zvarwa muna 2020 chete.

Kuchengeteka Kwebasa uye Kutarisirwa Kwoutano

OSHA inomanikidza mipimo yekotsekano yebasa munenge maindasitiri ose esangano ravanhu. Vashandirwi vanofanira kugovera rovedzo, midziyo inodzivirira, uye kurukurirano ine ngozi pasi pe “Kuziva kwakarurama” mipimo. Muna 2022, OSHA yakaita nzvero dzinopfuura 31 000, kubudisa mishumo yokuputswa sengozi dzinoderera nedzinoiswa makemikoro. Chirongwa chacho chinopawo mipimo yekurumidziro, yakadai seCHOVID-19 Health Catery ETS, kuti chipedze ngozi dzinokurumidza.

Mitemo yetsika haichinji; inochinja kupfurikidza nemiitiro inobatanidza ufakazi hwesayenzi nemuuyo wavose. Zvirongwa zvakafanana ne FDA uye CDC inochengeta mawebsite makuru ane nhungamiro inowirirana neyazvino uno, ichigovera kusvika kune zvinooneka kuzviito zvemitemo.

Basa Remitemo yeHurumende

Nepo hurumende yehurumende ichiisa miganhu yenyika, hurumende dzinochengeta chiremera chinokosha muTenth Amendment kuti idzore utano mukati memiganhu yayo.Izvozvi zvinozvibvumira kukurukura zvinhu zvinokosha zvomunzvimbomo — zvinopesana nezvoutano hwomumaguta, maindasitiri anorwisana nengozi dzetsika, uye zvinodikanwa zvakati zvetsika kana kuti zvechiverengero chavagari vemo. Madhipatimendi outano ehurumende anoshanda mumirau yawo amene, uye mirau yawo inowanzopfuura mwero womutemo.

Kupiwa Mazinesi Ounyanzvi Hwoutano

Hurumende imwe neimwe ine dare rayo imene rezvokurapa iro rinobvumira vanachiremba, vagadziri vemishonga, uye vamwe vanachiremba. Mabhodhi aya anogadza zvinodikanwa zvedzidzo, kuronga bvunzo, uye kunzvera zvichemo. Somuenzaniso, California inoda vanachiremba kupedza maawa 50 okupfuurira nedzidzo yokurapa makore maviri ari ose, nepo Texas achiraira maawa 24. Mitemo inosarudzawo mitemo yebasa ravanachiremba navabetseri, inotapura zvakananga kusvika kwokutarisira munzvimbo dzinochengetwa.

Gadziriro Dzoutano Dzavose

Gadziriro dzehurumende dzokudzivirira utachiona dzinopa nhomba kumamirioni avana navakuru kupfurikidza nenhano dzehurumende dzepurogiramu yavana nenzvero dzinorongwa nehurumende. Muna 2023, madhipatimendi outano enyika anoparadzira mamirioni 130 emushonga wepfuti wegore negore. Manyika anokwanisawo kudzivirira hosha dzisingaperi, zvakadai sepurogiramu yokudzora fodya yeNew York, iyo yakaderedza mwero yokusvuta kubva pa 21.5% muna 2003 kusvikira ku 11.8% muna 20222.

Utano Hwemhoteredzo

Mitezo yemotokari yakakomba yeCalifornia inogamuchirwa kutanga muna 1967, yakatangwazve mumichina inoderedza kushatisa nyika munyika yose. Mitemo inodzora kugadzirwa kwemvura yemutobvu inodzora kugadzirwa kwemvura muEPA.

Kugadzirira Kwekurumidziro

Madhipatimendi ezvoutano ehurumende ndiwo zvikurukuru anopa mhinduro kumigariro yezvoutano yomunzvimbomo, kuvambira kungwavaira dzomusikirwo kusvikira kusvotsvosve. Anochengeta mirwi yemigove yezvokurapa, inobatirana nezvipatara, uye inoita zvirongwa zvokubuda mugwenya nemirarira. Mukati me 2020 yemirazvo yehondo muOregon, vakuru vakuru vezvoutano vakatumira zviwiro zvendege zvinoshanda uye vakapa zviziviso zvokuvanda. [[FLT:] HHS[ inogovera mari yokuita nokuda kwengozi dzapa njodzi dzayo dzekurumidziro, asi Hurumende imwe neimwe inogovera mhinduro kunjodzi dzayo dzechienzi nemhepo, sedzinogadzirira kudengenyeka kwepasi muLouisiana kana kuti kudengenyeka kwepasi kwepasi muCalifornia.

Kubatana Pakati Pegadziriro Nehurumende

Utano hwevanhu hunobudirira hunotsamira pakushandira pamwe kusina mubatanidzwa pakati pemitengo yehurumende. Hurumende yehurumende inopa mari, unyanzvi, uye masangano emashoko, nepo masangano enyika anoshandisa zvirongwa nemigumisiro. Uku kubatana kunonyanya kuoma panguva dzenjodzi.

Kugoverana Kwemashoko Nechirwere

Kupfurikidza neNNNDS, CDC inowana mishumo yenhau yezuva nezuva inobva kunyika dzose 50, ichibvumira kuzivikanwa kwenguva chaiyo kwekuitika kwechirwere cheEbola. Mukati ma2014 marabhodhi eEbola, hurumende akaita kuongorora kwokutanga ndokutumira magirabhu kuCDC kuti itsigirwe, kuchigonesa mhinduro inowirirana yakapararira zvishoma mumusha. Dambudziko reCOVID-19 rakawedzera kugamuchirwa kwenhau yemagetsi inoshuma, ne95% yemasangano ezvokushanda pamwe chete zvino anoshandisa michina yemichina yemotokari inogoverana pakati pezvipatara nedhipatimendi.

Kurovedza Majoini Nokufambira Mberi Kwevashandi

Masangano eFederal akadai seCDC neHreat Resources and Service Administration (HRSA) anotsigira zvirongwa zvokurovedza zvehurumende nokuda kwenyanzvi dzezvipurisa, nyanzvi dzezvemarapiki, uye vanamukoti voutano hwevoruzhinji. Public Health Emergency Limbrenencys program, inoshandiswa neCDC, yakagovera mabhirioni $7,8 kuti igovara pakati pa 2019 na 2023 kuti ivake simba rokupindura. Mari iyi inotsigira kurovedza kwakafanana nemifananidzo yezvimbambaira uye kurasika kwemakemikoro, ichivimbisa kuti vashandi vehurumende vanogona kuita chiito nokukurumidza apo njodzi chaiyoiyo inorova.

Kutsigira Vakatanga Kutsigira Uye Vatengesi

Federal inopa mari pasi pePreventive Health and Health Services Block Grant inobvumira nyika kuronga zvinhu zvadzo zvimene zvokutanga, zvakadai sokudzivirira kufutisa muMississippi kana kuti utano hwamai muGeorgia. Zvikamu zvepurogiramu yeHwero X zvemari yemhuri yehurumende inogovera kudzivirira utachiona nokuedza STI. Mugore ra2022, CDC yakapa mari inokwana mabhiriyoni $1,6 mumari inodzorwa nehurumende nokuda kwokudzivirira hosha dzisingaperi, kubatanidza dzidzo yehosha yeshuga uye zvirongwa zvoutano hwemwoyo.

Kufambira Mberi Kwemitemo Nokuwiriraniswa Kwazvo

Apo nyika dzinoda kutora, vadzori vehurumende vanowanzotevera. Somuenzaniso, PFAS (per- polyfluoralkyl) yemvura inonwiwa, yakaitwa muna 2023, yakasunda EPA kukarakadza mwero mukuru wenyika. Nenzira yakafanana, kuraira kwemushonga wehurumende nokuda kwokupinda kwechikoro / kunovhurwa ne 50 yezvosero yezvirwere zvakadai segwirikwiti-panjhiro* inoita kuti pave negadziriro inotsigira hurumende kupfurikidza nokushandisa mari uye nhungamiro. EPA uye masangano ehurumende nguva dzose anoronga kugadzirwa kwechikoro, sezvirongwa 2024 zvokuderedza mhepo inosvibisa yenzvimbo dzenzvimbo dzenzvimbo dzeindaneti muRwizi yeOuni.

Matambudziko Pakudzorwa Kwoutano

Pasinei nokuti pane mitemo yakasimba, zvipingamupinyi zvikuru zvinotadzisa vanhu kuchengetedza utano hwavo zvakakwana.

Pesvedzero Dzezvamatongerwe Enyika Nokubatwa Kwomutemo

Mirairo youtano yavose inowanzova mudzvinyiriro yezvamatongerwe enyika, zvikurukuru apo inoisa mutengo kumaindasitiri ane simba. Kubhadharwa nezvokudya, fodya, uye zvikamu zvemakemikoro zvakanetesa zvinodikanwa zvokuratidzira ndokunonotsa kurambidzwa kwezvinhu zvinokuvadza. Somuenzaniso, chirambidzo chakakarakadzwa cheFDA pamidzanga yemidzanga yeminhomba chakaziviswa kutanga muna 2018 chakatarisana namakore okutsiviwa kwezvamatongerwe enyika pamberi pokukarakadzwa nenzira yepamutemo muna 2022. Nenzira yakafanana, dzimwe nyika dzakabvisa mitemo yomunzvimbomo pazvinorambidzwa zvepurasitiki kana kuti soda mitero, kuchiganhurira mano emaguta okukurukura nhau dzoutano panzanga.

Kutadza Kushandisa Mari Nemikana Yokushandisa Mari

Madhipatimendi akawanda ezvoutano enyika anoshanda nemari isingaperi. 2022 nomutezo weTrust for America’s Health akawana kuti kupedza mari yeutano yavose pamunhu mumwe nomumwe kwakaderera munyika 30 pakati pa2017 na2020, kunyange sezvo denda racho rakaratidzira kudikanwa kwegadziriro dzakasimba. Ikoku kusingadzoreki kunotungamirira kumadhipatimendi akachekererwa, kunonoka kunzvera, uye gadziriro dzemashoko dzechinyakare. Mukati mekuputika kwe 2024 dzegwirikwiti munyika nhanhatu munyika nhanhatu, pasi pemadhipatimendi outano yomunzvimbomo yakatambudzira kunzvera nokushandisa mirayiridzo yokuwana.

Kutsigira Kworuzhinji uye Kusaziva

Mitemo yezvoutano inoshanda bedzi kana ruzhinji ruchitevera. Kukwira kwemashoko asina kururama . Zvikurukuru mukati medenda reCOVID-19 (811) chivimbo mumishonga uye nhungamiro youtano. Nzvero ya2023 Pew Research Center yakawana kuti 55% bedzi yavaAmerica vaiva ne “chitsama chikuru” kana kuti“ chitsama chekuvimba muCDC, kubva muna 71% muna 2019. Uku kusava nechokwadi kunodzivisa kuwirirana nokuvhara, kuparadzanisa, uye kurumbidza kupfuudza. Hurumende dzakapindura nenhimbeidzo dzedzidzo yavose, asi dzinodzivisa zvikuru nhema dzinoda nhamburiko dzinopfuurira.

Kuwedzera Kwengozi Dzoutano Nokuriritira

Mishonga mitsva yakadai sokudzivisa kurwisa utachiona, kuchinja kwezvinoitika zvokupisa kwakanyanyisa, uye kuteyiwa kwemhuka dzinogara mumhuka kunodikanwa kuita chiito chokukurumidza. Zvisinei, miitiro yebureaucracy inogona kunonoka. Somuenzaniso, EPA yakatora makore 30 kupedza mitemo inoganhurira kudzikanya kupisa kwemvura yokunwa, kunyange zvazvo njodzi dzoutano dzakanga dzanyatsopupurirwa. Nenzira yakafanana, kurambidzwa kwehurumende kwezvinodziyamwisa kazhinji kazhinji kazhinji kunobva pakubvumirana kwesayenzi. HOSA[FLT]] yakashorwa nokuda kwokukundikana kubudisa dzvinyiriro yenhamo yendangariro yechigarire nokuda kwevashandi vapanze, pasinei kukwira kwetembiridzo yetembiriso nerufu.

Nguva Yemberi Yemitemo Youtano Hwavose

Sezvo sayenzi nenzanga zvichichinja, naizvozvowo gadziriro dzokutungamirira idzo dzinodzivirira utano hwavanhu.

Utano Hunodzivirira Netarisiro Yemano

Mitemo yehurumende neyamabhii iri kuchinja zvikuru kukudzivirira panzvimbo pekuita. Centers for Medicare & Medicaid Services (CMS) yakafutunura kufukidza nokuda kwemibato inodzivirira sekuongorora kenza uye kudzivirira kwebiannual. Nhanho dzehurumende dzaparefu, dzakadai se “Health Parace" shopu yemari yemari kumigumisiro yakafanana nezvinoramwa zvechipatara. Mitemo yomunguva yemberi ingaraira kupfuudzwa kwokuvamba kworuzivo rwokudzivirira ruzivo rwamakemikoro, zvakadai sokuedza magene nokuda kwezvirwere zvenhaka, uye kuisa purogiramu dzemararamiro akanaka kupfurikidza nechikwereti cheOregondidha kana kuti kukwira kwemishuwa.

Utano Hwamadhigirii Nokupinda Mumvura

Kugamuchirwa kwokukurumidza kwetelehealth mukati medenda kwakaratidzira bviro yemichina. FDA iri kutanga gadziriro itsva yokudzora uchenjeri hwokugadzirwa (I) mumichina yezvokurapa, kubatanidza maatomu anogona kucherekedza migariro yakadai seretipathy kana kuti sepsis. Mabhodhi ezvokurapa ari kubvisa mapepa emari anodzoresa mabhii etsotsi anobvumira kushandiswa kwemichinjikwa kwemijadha. Zvisinei, itiro pamusoro pemitengo yemajere ebasa rehurumende dzichadatesiro itsva, zvimwe kutsiva basa remite rehurumende rinodzivirira mamiriro ezvinhu enyika akafanana nemitemo yorudzi yeAmerica yeDam nedziviriro.

Kuchinja Kwemamiriro Okunze uye Utano Hwako

Zviitiko zvemamiriro okunze zvakaipisisa zvinoti syndromic jasis, masango anopisa, magetsi anopisa, magetsi anoisa njodzi dzoutano zvakananga nedzisina kunanga. CDC’S CHETH-Really States & Cities Initive inobetsera kuvamba zvirongwa zvokupisa uye gadziriro dzokuongorora dzinoda kuongorora kuti kupisa kunobva pakupisa kunoitika munguva chaiyo. EPA inokarirwa kuisa ganhuriro dzorumano padzino inodziya inodzisa mumhepo inobva mumiti yemagetsi nemotokari, izvo zvichabudisa zvinobatsira zvinobatanidza utano nokuda kwoutano. SaColorado yakaita mitemo inoda kuti zvisarudzo dzoutano nokuda kwezvirongwa zvikuru zvokuvandudza zvinhu, ichivimbisa kuti kukura kwemhepo itsva hakuiipidziri njodzi kana kuti mafashamo.

Vanoda Utano Nenzanga

Vadzori vari kuziva kuti miuyo youtano yakaumbwa nezvinhu zvakadai sedzimba, dzidzo, uye mari. HHS [Hofisi yeMinority Health inotsigira mipimo yetarisiro inoitwa nenzira yetsika, nepo nyika dzinoverengeka dzakaita zvirongwa zvoutano zvisina kutsarukana zvokunzvera kushayika mukufa kwavana, mwero yemitengo, uye hosha dzinogara. Mitemo yomunguva yemberi ingabatanidza mutero wemutero wechipatara kumitengo chaiyo, zvakadai sokuderedza misiyano inobvumirwa pakati pamapoka edzinza. Utano hwenzanga hunoda kunzvera, hunotodikanwa neIR yezvipatarati, sezvingabvira ichava yakakomba zvikuru uye inobatanidza zvitengo zvezvokudya nokupinda mukufambisa.

Mumhedziso, mirau yehurumende nehurumende inoita gadziriro yakabatana iyo inochinjirwa nguva dzose kudzivirira utano hwavanhu. Kuvambira pamazuva apakuvamba eutsanana nokuparadzaniswa nokupinda mumugariro wokunze kusvikira kuzvinetso zvazvino uno zvehosha nechinjo yemamiriro okunze, iyi nzira yokugadzira zvinhu miviri inogovera zvose zviri zviviri kusachinja kwerudzi uye kuchinjika kwomunzvimbomo. Kupindwa kwemari kunopfuurira, batira pamwe yezvibvumirano zvavose kuchava kunokosha kuva nechokwadi chokuti miraudzo inoramba ichishanda, ichiwirirana, uye inogamuchira tyisidziro dzoutano dzamangwana.