Introduction to Public Health

• Public health is the science and practice of protecting and improving the health of people and their communities.
• Population health is the focus of public health, rather than individual health.
• Key aspects of public health include:
  • Prevention of disease and injury
  • Promotion of healthy behaviors
  • Protection from environmental hazards
• Public health uses a multidisciplinary approach.
• Public health addresses a range of health issues, which include:
  • Infectious diseases like COVID-19 and HIV/AIDS
  • Chronic diseases like heart disease and diabetes
  • Environmental health issues like air and water quality
  • Mental health
  • Injury prevention
  • Health equity and social determinants of health
• The operations of public health occur at local, national, and global levels through collaboration between government, academia, and private sectors.
• Core functions of public health include:
  • Assessment: Monitoring community health status and identifying health problems
  • Policy Development: Creating and implementing health policies and plans
  • Assurance: Ensuring access to necessary health services and enforcing health regulations
• The 10 Essential Public Health Services:
  • Assess and monitor population health
  • Investigate, diagnose, and address health hazards and root causes
  • Communicate effectively to inform and educate
  • Strengthen, support, and mobilize communities and partnerships
  • Create, champion, and implement policies, plans, and laws
  • Utilize legal and regulatory actions
  • Enable equitable access to care
  • Build a diverse and skilled workforce
  • Improve and innovate through evaluation, research, and quality improvement
  • Build and maintain a strong organizational infrastructure for public health

Public Health Model vs. Medical Model

• The public health model focuses on population health through prevention, health promotion, is set in communities, and aims for long-term outcomes.
• The medical model focuses on individual patient care through diagnosis, treatment, occurs in hospitals, and aims for immediate health outcomes.

Assessment Methods in Public Health

• Assessment is the systematic collection, analysis, and interpretation of health-related data.
• The purpose of assessment is to:
  • Identify public health problems
  • Set priorities for public health action
  • Evaluate effectiveness of interventions
• Assessment is continuous through assessment, planning, implementation, and evaluation.
• Types of Public Health Assessments:
  • Community Health Assessments
  • Health Impact Assessments
  • Environmental Health Assessments
  • Needs Assessments
  • Risk Assessments
  • Health Equity Impact Assessments
  • Surveillance Systems
• Primary data sources for public health assessments include:
  • Surveys (e.g., behavioral risk factor surveys)
  • Interviews (e.g., key informant interviews)
  • Focus groups
  • Biomarkers and clinical measurements
• Secondary data sources for public health include:
  • Vital statistics (birth and death records)
  • Disease registries (e.g., cancer registries)
  • National health surveys
  • Electronic health records
  • Claims data

Definition of Health

• The World Health Organization (WHO) in 1948 defined health as a state of complete physical, mental and social well-being.
• Strengths: takes a holistic approach and includes mental and social aspects while emphasizing positive health.
• Limitations: "complete" well-being may be unrealistic and doesn't account for changing health states over time.

Social Determinants of Health

• Social Determinants of Health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect health outcomes.
• The five key domains of Social Determinants of Health are:
  • Economic Stability
  • Education Access and Quality
  • Health Care Access and Quality
  • Neighborhood and Built Environment
  • Social and Community Context
• Social Determinants of Health account for about 80% of health outcomes

Health Equity

• Health equity is the state in which everyone has a fair and just opportunity to attain their highest level of health.
• Key aspects of health equity are:
  • Addressing systemic and structural barriers to health
  • Recognizing and rectifying historical injustices
  • Ensuring equitable distribution of resources and opportunities
  • Promoting cultural competence and humility in health care.
• Health equity is key to achieving optimal health for all populations.

Modern Public Health Definition

• Healthy People 2030 defines public health as the promotion and protection of the health of people and the communities where they live, learn, work and play.
• The key aspects of this definition include:
  • Collective action and shared responsibility
  • Focus on populations and communities
  • Emphasis on health promotion, protection, and disease prevention
  • Recognition of multiple factors influencing health

Key Terms

• Epidemiology: the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems.
• Key epidemiological concepts:
  • Incidence and prevalence
  • Risk factors and causation
  • Study designs (e.g., cohort, case-control)
  • Measures of association (e.g., relative risk, odds ratio)
• Epidemiology provides evidence for public health interventions.
• Health Promotion: the process of enabling people to increase control over, and to improve, their health (WHO Ottawa Charter, 1986).
• Key strategies for health promotion are:
  • Build healthy public policy
  • Create supportive environments
  • Strengthen community action
  • Develop personal skills
  • Reorient health services
• Health promotion empowers individuals and communities to take control of their health.
• Global Health: An area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide.
• Key features of global health include:
  • Transnational health issues and solutions
  • Emphasis on health equity and social justice
  • Interdisciplinary collaboration
  • Focus on population-based prevention
• Global health addresses health challenges that transcend national boundaries.
• Public health is crucial for improving population health and well-being, with a multidisciplinary approach addressing various health determinants.
• Emerging challenges in public health include:
  • Climate change and health
  • Digital health and data privacy
  • Health misinformation
  • Preparing for future pandemics
• Future directions for public health include:
  • Increased focus on health equity
  • Integration of technology and big data
  • Emphasis on community engagement and participatory approaches
  • Strengthening global health security