Variation of Public Health Adminstration in the U.S.- Something to rejoice or address?

In a health policy and management class that I took earlier, we were asked to read, “Major Component and Themes of local public Health Laws in Select U.S. Jurisdictions,” by McCarty, et al. Found here.

After reading, “Major Component and Themes of local public Health Laws in Select U.S. Jurisdictions,” by McCarty, et al, I’m overcome by a mixed, bitter-sweet, reaction regarding the variation in approaches to public health administration and enforcement at the local level in the U.S (1). While I find it a celebration that local jurisdictions address community health with their unique ordinances that are catered to fit their particular community, I find it an alarm that there seems to be a lack of uniform application throughout the U.S. with certain best, evaluated regulations/ordinances.

An example that caused my alarm is local public health laws concerning the regulation of food. I believe, the regulation of food should be carefully thought, and carried out, addressing the nuances that accompany the complexity that follows it. In the study, the municipalities that were observed to have ordinances that regulate the category of food were grouped into five subcategories, namely: “(1) food handlers and distribution; (2) mobile food units; (3) restaurant licensing, inspections, and sanitation; (4) milk; and (5) meat(1).” There was great dissimilarity among the various ordinances on how many of those five subcategories each addressed. It would be beneficial if the ordinances across jurisdictions would adhere to a “Guidelines-Manual”, for example, and sync their individual jurisdictions accordingly, which would allow the entirety of the population to benefit from the same quality experienced through the best jurisdiction’s ordinance.

Aside from one such example of my cause for alarm, I do believe the diversity and specific catering of ordinances across jurisdictions to their community is something to be celebrated. Being Americans, we pride ourselves in our diversity, thriving way of living with various cultures, and by the uniqueness and individuality that accompanies each state, city, county, and community. What better way to address our unique needs and philosophical reflection than with ordinances that show great flexibility and such individualized attention?

I am not sure which is better, complete synchrony or absolute variation, and perhaps it changes across situations, but with public health, it may be beneficial to strike a balance between the two, to reflect the individuals that we are but at the same time have a universal quality.


1. McCarty, et al. “Law and the Public’s Health.” Public Health Reports. 2009. 124: 458-462.

Copyright © Sherley J. Edinbarough (Surely, Sherley and/or SurelySherley), 2014.

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