Thesis (M.S.)--University of Michigan, 1937.

Thesis (M.S.)--University of Michigan, 1937.

England came to have a nation-wide administrative system for public health in the 1870s. It consisted of the local councils which were designated as sanitary authorities and the Local Government Board (LGB) as the central department. This thesis explores how public health reform was pursued under this administrative system, by tracing the career of Arthur Newsholme (1857-1943), who served as Medical Officer of Health (MOH) for Brighton, 1888-1908, and as Medical Officer to the LGB, 1908-19. The main aim of the thesis is to examine the activities in which Newsholme was involved and his views, in order to consider the development of public health activities, or state medicine, in relation to the traditional notions of government and society in England, that underlay the administrative system such as 'minimal government', , local self-government' or 'voluntarism'. The first half of the thesis deals with public health reform in Brighton during Newsholme's years of office as local MOH. Particular attention is paid to how the scope of public health administration was decided through interactions between the MOH and the local council as a representative body of the community, and to how voluntary efforts were involved in its extension. The second half deals with Newsholme's administrative ideas and activities in the process of, and after, becoming the country's leading health official. By the time of his assumption of office at the LGB, Newsholme envisaged a comprehensive state medical service as the ultimate medical ideal. The thesis examines how he tried to pursue this ideal by means of reconciling it with traditional ideas of government. Special attention is paid to Newsholme's difference from his fellow reformers such as the Webbs and George Newman, particularly in respect of their recognition of the framework of centralllocal relations that underlay the administrative system, and concerning how reforms should or could be proceeded with by means of central bureaucratic initiatives.

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Thesis (M.H.A.)--University of Michigan, 1960. / Also issued in print.

Thesis (M.H.A.)--University of Michigan, 1960. / eContent provider-neutral record in process. Description based on print version record.

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Thesis equivalent (M.P.H.)--University of Michigan, 1945.

Thesis equivalent (M.P.H.)--University of Michigan, 1945.

Introduction: The public health system is of central importance in efforts to reduce the burden of chronic disease, yet there are no national data on organizational capacity (OC) or dissemination practices pertaining to chronic disease prevention (CDP) programming in the public health system. The aim of this thesis is to investigate OC and dissemination practices within the Canadian public health system. Two new conceptual models pertaining to these constructs were developed, and a survey of all public health organizations across Canada engaged in CDP was conducted in 2004-5. / Method: Data were collected in telephone interviews with persons most knowledgeable about CDP programming in 77 "resource" organizations that develop and transfer CDP innovations to other organizations, and 216 "user" organizations that adopt and deliver CDP programs in specific populations. Reliable measures of the constructs of interest were developed using principal components analyses. Levels of OC, its potential determinants, and involvement in CDP programming were compared across three types of organizations and across Canada. In addition, levels of 13 dissemination-related practices were compared across organizations and independent correlates of dissemination were identified in multiple linear regression. / Results: Levels of skill and involvement were highest for tobacco control and healthy eating programming; lowest for stress management, social determinants of health, and program evaluation. Any notable differences in skill levels favoured central Canada. Resource adequacy was low overall; lowest in eastern Canada and within formal public health organizations. Supports for OC were highest in central Canada and in grouped organizations. Dissemination practices most heavily engaged in included: Identification of barriers to adoption/implementation of the innovation, tailoring dissemination strategies and design of dissemination plan. There was little coherence across organizations in the number or types of dissemination practices engaged in. Skill at planning/implementing dissemination, external sources of funding, type of resource organization, attitude toward the process of collaboration, and user-centeredness were all positively associated with dissemination (R2=0,42; F value 8.20, p<0.0001). / Conclusions: These results provide a backbone for organizational research in public health systems. Strengths and gaps identified in OC and dissemination practices will guide strategic investment in the public health system.