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Introduction to Public Health Course Topics

• Public Health Definition and Key Terms
• History of Public Health
• A Public Health Approach
• Core Functions and Essential Services of Public Health
• Stakeholder Roles in Public Health
• Determining and Influencing the Public's Health

Learning Objectives

• Describe the purpose of public health.
• Define key terms used in public health.
• Identify prominent events in the history of public health.
• Recognize the core public health functions and services.
• Describe the role of different stakeholders in the field of public health.
• List some determinants of health.
• Recognize how individual determinants of health affect population health.

Public Health Defined

• It is the science and art of preventing disease, prolonging life, and promoting health through organized efforts.
• It includes informed choices of society, organizations, public and private communities, and individuals.
• This definition is attributed to CEA Winslow.

The Mission of Public Health

• It is to fulfill society's interest in assuring conditions in which people can be healthy, according to the Institute of Medicine.
• It aims to provide maximum benefit for the largest number of people, according to the World Health Organization.

Public Health Key Terms

• Clinical care involves the prevention, treatment, and management of illness.
• Clinical care aims to preserve mental and physical well-being through medical and allied health services; also known as health care.
• Determinant refers to a factor that contributes to the generation of a trait.
• Epidemic or outbreak indicates an occurrence of cases of an illness.
• Epidemic also indicates specific health-related behavior, or other health-related events clearly in excess of normal expectancy, in a community or region.
• The terms "epidemic" and "outbreak" are used interchangeably.
• Epidemic usually refers to a larger geographic distribution of illness or health-related events than outbreak.
• Health outcome is the result of a medical condition that directly affects the length or quality of a person's life.

Sanitation and Environmental Health Historical Events

• 500 BCE: Greeks and Romans practiced community sanitation measures.
• 1840s: The Public Health Act of 1848 was established in the United Kingdom.
• 1970: The Environmental Protection Agency was founded.

Pandemics

• Influenza: 500 million infected worldwide in 1918.
• Polio: Vaccine introduced in 1955; eradication initiative launched in 1988.
• HIV: 34 million living with HIV worldwide; there has been a 20% decline in new infections since 2001.

Preparedness for Disaster Response

• Biologic Warfare: Plague was used as a weapon of war during the Siege of Kaffa.
• September 2001: Public health surveillance was conducted after the 9/11 attacks.
• Hurricane Katrina: Emergency services, public health surveillance, and disease treatment were provided.

Prevention Through Policy

• Book of Leviticus: It represents the world's first written health code.
• Tobacco Laws: Laws banning smoking in public places.
• Obesity: Food labeling and promotion of physical activity.

A Public Health Approach

• Involves surveillance to define the problem.
• Identify risk factors to determine the cause.
• Evaluate interventions to see what works.
• Implement strategies to execute the solution.
• It progresses from problem identification to response.

Public Health Core Sciences

• Prevention Effectiveness.
• Surveillance.
• Epidemiology.
• Public Health.
• Informatics.
• Laboratory.

Cholera - A Public Health Approach

• Cholera, a fatal intestinal disease, was rampant during the early 1800s in London, causing death to tens of thousands.
• Cholera was commonly thought to be caused by bad air from rotting organic matter.
• John Snow is best known for tracing the cholera outbreak source and is considered the father of modern epidemiology.
• In 1854, cluster of cholera cases in London.

Risk Factor Identification - Cholera

• Cluster of Cholera Cases and Pump Site Locations
• Intervention evaluation required stopping exposure to contaminated water supply on a larger scale.
• Interventions included stopping exposure to the entire supply of contaminated water in the area

Implementation - Cholera

• John Snow's research convinced the British government that the source of cholera was water contaminated with sewage.

Three Core Functions of Public Health

• Assessment: Systematically collect, analyze, and make available information on healthy communities.
• Policy Development: Promote the use of a scientific knowledge base in policy and decision-making.
• Assurance: Ensure provision of services to those in need.
• The Institute of Medicine put these forth in "The future of public health," Washington, DC: National Academies Press; 1988.

Ten Essential Public Health Services

• Monitor Health
• Diagnose and Investigate
• Inform, Educate, Empower
• Mobilize Community Partnership
• Develop Policies
• Enforce Laws
• Link to / Provide Care
• Assure a Competent Workforce
• Evaluate
• Research

Core Functions at Government Levels

• Federal Level:
• Assessment: National tobacco public health surveillance.
• Policy Development: Smoking ban on commercial flights.
• Assurance: Federal grants for antismoking research.
• State Level:
• Assessment: Monitor state tobacco use.
• Policy Development: Increase tobacco tax.
• Assurance: Funding for campaign through Proposition 99.
• Local Level:
• Assessment: Report on local tobacco use.
• Policy Development: County laws prohibiting smoking in bars.
• Assurance: Resources to help smokers quit in multiple languages

Partners in the Public Health System

• Community
• Clinical Care Delivery System
• Government Public Health Infrastructure
• Ensuring the Conditions for Population Health
• Employers and Businesses
• Academia
• The Media

Nongovernmental Organization Examples

• Professional membership organizations: American Public Health Association
• Associations related to a specific health concern: American Cancer Society
• Organizations of citizens focused on health concerns: Americans for Nonsmokers Rights
• Foundations that support health projects and influence public policy development: Bill and Melinda Gates Foundation

Health Care as a Partner in Public Health

• Public Health:
• Population focus
• Public health ethic
• Prevention or public health emphasis
• Joint laboratory and field involvement
• Clinical sciences peripheral to professional training
• Public sector basis
• Health Care:
• Individual patient focus
• Personal service ethic
• Diagnosis and treatment emphasis
• Joint laboratory and patient involvement
• Clinical sciences essential to professional training
• Private sector basis

Other Partners in Public Health

• Media
• Vehicle for public discourse
• Health education and promotion
• Health communication
• Social media as catalyst
• Employers and Businesses
• Employer-sponsored health insurance programs
• Wellness initiatives and benefits
• Healthy workplaces and communities
• Government Agencies
• City planning
• Education
• Health in all policies
• Academia
• Education
• Training
• Research
• Public Service

Health Determinants

• Genes and biology.
• Health behaviors.
• Social or societal characteristics.
• Health services or medical care.
• Social/Societal Characteristics; Total Ecology determine health of a population the most.
• Followed by Health Behaviors, then Medical Care and lastly Genes and Biology.