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9. Partnerships in Public Health: Working Together for a Mutual Benefit
- The University Press of Kentucky
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9 Partnerships in Public Health Working Together for a Mutual Benefit Stephen W. Wyatt, Kevin T. Brady, and W. Ryan Maynard For a clinician, providing comprehensive health care to an individual patient is complex and challenging, and it normally requires a wide variety of clinical disciplines over the individual’s lifetime. The growth in clinical specialties and even subspecialties over the years, along with the development of an evolving cadre of support disciplines, demonstrates that ensuring the health of one patient has become a team effort. If caring for the health of an individual patient is this complex, imagine the issues associated with ensuring the health of a population—the mandate presented to public health practitioners and public health systems. This mandate encompasses a breadth of issues that would cause the weak-hearted to run—and to run quickly—from the challenge. What challenges must public health address to keep the population healthy? They involve a range of issues, including environmental quality, restaurant inspections, disease surveillance, and disease prevention programs. The breadth and depth of these issues are quite daunting. Combine this with the reality that public health agencies and programs at the local, state, and federal levels are typically underfunded, understaffed, and underappreciated. This is a recipe for frustration, if not failure. Collaboration and partnerships are one potential solution to the scarcity of both human and fiscal resources. There is much to be done, resources are in short supply, and there are many critical opportunities that must be seized. This reality makes public health partnerships with business, education, and health care delivery systems a necessity, not a potential option to be considered. To disregard the need and the opportunity to partner could even be considered “malpractice.” The range of potential partners available to the public health practice community is not as limited as one might think. Several groups and types of organizations move to the top of the list as potential partners: voluntary health 194 Wyatt, Brady, and Maynard organizations, health-related foundations, health care delivery organizations, and companies or industries with health-related streams of business. Thinking broadly can expand this initial list significantly. For example, almost every business has a direct interest in improving the health of its workers. From there, it is not unreasonable to expand this interest to the health of the entire population in the company’s geographic region and how the company impacts it. Today, with all the demands on public health, practitioners cannot be bound by conventional thinking and traditional public health partners; they must be creative. As the proverbial saying (often attributed to Plato) goes: necessity is the mother of invention. For public health practice at the international, national, state, and local levels , this chapter explores the types of collaborations and potential partners available and provides examples and lessons learned from the published literature. Partnership Types Basically, there are two partnership types: informal and formal. Informal partnerships involve an exchange of information, endorsements, and ideas for actions that may lead to or evolve into more formal partnerships. Formal partnerships are typically characterized by the exchange of resources, expertise, dollars, staff time, branding, recognition, and so forth. Both types of partnerships may evolve into the next level of working relationship: collaborative agreements. The reasons for pursuing a partnership or a collaborative arrangement vary, but they often fall into several general areas: mutual benefit to the participating organizations, altruism, scientific advancement, or advancement of a specific health outcome. Collaborative agreements can also be informal or formal. Informal collaborative agreements tend to be based on verbal or oral commitments, whereas formal collaborative agreements often take the form of grants or contracts and purchase orders to initiate the exchange of resources. Formal collaborative agreements generally define the parameters of the potential or agreedon partnership, including the following: protection of interests, delineation of roles and responsibilities, limitations on other partners (e.g., not working with businesses with tobacco interests), time lines, authoritative assurances, scope of effort, and influence over a project or activity. There are four general types of collaborative agreements in public health practice settings: 1. Business agreements: Resources are normally fiscal and flow in one direction , from the business to the activity, with minimal input or representation from the business. [35.170.64.185] Project MUSE (2024-03-29 11:51 GMT) Partnerships in Public Health 195 2. Foundation agreements: Resources typically flow in both directions (more give-and-take), but both parties operate within specific parameters. 3. Coalitions: These typically involve multiple partners...