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dc.contributor.authorSharif, Fatimaen_US
dc.date.accessioned2016-11-24T07:00:28Z
dc.date.available2016-11-24T07:00:28Z
dc.date.issued2015-06-02en_US
dc.identifier.othervt_gsexam:5398en_US
dc.identifier.urihttp://hdl.handle.net/10919/73500
dc.description.abstractRecent public health scholarship finds that health outcomes are explained by the social and individual determinants of health rather than the individual-level determinants alone. The individualistic perspective has dominated the 20th century institutionalization of public health in the United States where the public health system has tended to focus largely, if not exclusively, on individual factors. This persistent orientation lies in contrast to another set of perspectives that have also persisted, focused on social causes, which are currently dominant in contemporary public health academic literature and in major, international health organizations. Whether the orientation within the United States is due to a prevailing paradigm among public health officials or is the result of new ideas about health causation being dampened under organizational weight is unknown. Despite public health being central to decreasing morbidity and mortality in the 20th century, significant gaps remain in researchers' understanding of what influences practice in the American public health system. My dissertation research investigates the broad outlines of the determinants of health as understood by state public health administrators. I study how the understanding of the determinants of health affects the practice of public health through analyzing how the ideas of state public health administrators interact with the organizational dynamics of the public health organizations they lead. This mixed-methods dissertation uses survey research and in-depth interviews and quantitative and qualitative analysis. I find that state public health officials' professionalization, length of tenure, level of education, and gender affect the perspective of health causation to which they adhere. I also find that the state public health officials with a social health frame more commonly report they are situated in organizations that are learning environments. Both organizational and ideational factors influence public health practice. The interview data expand this finding to paint a complex picture of organizational and ideational factors influencing one another as well as resulting practices. This research reveals that state public health officials often have strong health frames that are only able to shape the edges of their practice due to the political and organizational dynamics interacting with state public health departments.en_US
dc.format.mediumETDen_US
dc.publisherVirginia Techen_US
dc.rightsThis Item is protected by copyright and/or related rights. Some uses of this Item may be deemed fair and permitted by law even without permission from the rights holder(s), or the rights holder(s) may have licensed the work for use under certain conditions. For other uses you need to obtain permission from the rights holder(s).en_US
dc.subjectpublic health practiceen_US
dc.subjectpublic health policy implementationen_US
dc.subjectsocial determinants of healthen_US
dc.subjectlearning organizationsen_US
dc.subjectsurvey researchen_US
dc.titlePublic Health Officials' Perspectives on the Determinants of Health: Implications of Health Frames on Policy Implementation in State Health Departmentsen_US
dc.typeDissertationen_US
dc.contributor.departmentSchool of Public and International Affairsen_US
dc.description.degreePh. D.en_US
thesis.degree.namePh. D.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.grantorVirginia Polytechnic Institute and State Universityen_US
thesis.degree.disciplinePublic Administration and Public Affairsen_US
dc.contributor.committeechairJensen, Laura Smietankaen_US
dc.contributor.committeememberKhademian, Anne M.en_US
dc.contributor.committeememberDull, Matthew Martinen_US
dc.contributor.committeememberHult, Karen M.en_US


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