Enabling Services

At the second level of the pyramid are enabling services, which are those health and social services that support or enhance the health of aggregates. Aggregates are used to distinguish between individuals and populations; they are groups of individuals who share a defining char- acteristic, such as mental illness or a terminal disease. Examples of enabling services include

The Public Health Pyramid

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Direct healthcare services

Enabling services

Population-based services

Infrastructure services

of the program with meeting the needs of the broadest number of people with a given need. Reaching the same number of persons with a direct services program as with a population services program poses additional expense and logistic challenges.

The pyramid also serves as a reminder that stakeholder alignments and allegiances may be specific to a level of the pyramid. For example, a school health program (an enabling-level program) has a different set of constituents and concerned stakeholders than a highway safety program (a population-level program). The savvy program planner considers not only the potential program participants at each level of the pyramid but also the stakeholders who are likely to make themselves known during the planning process.

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