COMPLIANCE WITH THE RECOMMENDATIONS OF THE INSTITUTE-OF-MEDICINE REPORT, THE FUTURE-OF-PUBLIC-HEALTH - A SURVEY OF LOCAL HEALTH-DEPARTMENTS

In 1989 a survey of state health officials was conducted to ascertain the extent that the recommendations of the 1988 Institute of Medicine' s report, The Future of Public Health, were in place. We applied a sim ilar survey in 1996 to assess the level of implementation of the IOM r ecommendations at the local health department level. Agreement with th e specific IOM recommendations at the local level was, in almost all c ases, greater than 90%. However, when one views the extent of these re commendations in place, nearly half fall below 50% While there have be en improvements in areas such as education of the public and outreach towards legislators and voluntary health organizations, our results sh ow that there are still major shortcomings when it comes to implementi ng the recommendations, Lack of resources at the local level appears t o be the predominant cause of the low level of implementation, with re stricted authority and lack of support also contributing to the proble m. We feel the IOM recommendations can provide a strong foundation for our public health system, and hope these results help serve as a benc hmark for further study.