Public Health Overview

Course Information

• The course is Nursing, course code HEY442ET
• The course name is Public Health Nursing-T.
• The course week is a revision week
• The course is held on Thursdays from 9:00 to 12:50.
• The course Credit/ACTS Information is 4
• The grading is based on MCQs
• Dr. Hina Zahoor is the instructor
• The instructor's email is [email protected]
• The instructor's room is 305
• The office hours are from 9:00 to 5:00.

Public Health Definition

• Public health is defined as the science and art of preventing disease, prolonging life, and promoting health.
• Activities are carried out through organized community effort as noted by CEA Winslow in 1920.
• It involves mobilizing and engaging local, state, national, and international resources to assure conditions for people to be healthy, based on the Oxford Textbook of Public Health.

Mission of Public Health

• The Mission focuses on fulfilling society's interests by ensuring healthy conditions for the population
• Detels & Breslow defined this in 2002.

Health Policy and Management

• Health policy and management involves strategic planning, organization, and administration of health systems and services.
• Professionals in this field ensure efficient resource allocation, policy development, and quality healthcare delivery.
• Efforts revolve around creating equitable health policies, managing healthcare facilities, and optimizing systems to enhance accessibility and affordability of healthcare services.

Environmental Health

• It focuses on the relationship between the environment and human health.
• Environmental factors such as air and water quality, sanitation, food safety, and occupational hazards are examined for their impact on the human population.
• Experts mitigate environmental risks and advocate for policies to protect communities from harmful exposures.

Biostatistics

• Biostatistics uses statistical methods to interpret biological and health-related data.
• Biostatistics facilitates the design of studies and the analysis of complex health data
• Researchers use statistical models to make informed decisions for public health interventions.
• Biostatisticians collaborate with epidemiologists and other specialists.

Public Health Nursing

• It is a nursing specialty focused on public health, also known as community health nursing.
• Lillian Wald of the Henry Street Settlement coined the term.
• Public Health Nurses (PHNs) are community health nurses and integrate community involvement and knowledge with clinical understandings of health and illness experiences.

Role of Public Health Nurse

• Public Health Nurse assesses health trends and identifies health risk factors specific to communities.
• Public Health Nurse assigns priorities for health-related interventions to provide the most significant benefit
• Public Health Nurse advocates with authorities to improve access to health services in underserved communities.
• Public Health Nurse designs and implements health education campaigns and activities for disease prevention.
• Public Health Nurse provides information on local health programs and services to improve access to care.
• Public Health Nurse services to at-risk populations, records and analyzes medical data, and develops relationships with patients.
• Public Health Nurse manages budgets for community health programs, refers people to other services, and delivers medical care.

Evolution of Public Health Concepts

• 1880-1920 was the Disease control phase focused on sanitary reforms and aimed at controlling man's physical environment like water and sewage disposal.
• 1920-1960 was the Health promotional phase, with added focus on health promotion and initiated personal health services like Mother & Child, school health, industrial health, mental health, and rehabilitation services.
• From 1960-1980, the social engineering phase prioritized social and behavioral aspects of disease and health.
• This was done to lessen Chronic Diseases burden on society, and the concept of risk factors emerged.
• 1981-2000 AD had a "Health for all phase" that focused on reducing healthcare inequalities and ensuring individuals lead socially and economically productive lives.

Modern Public Health

• The rise in average life span is credited to public health achievements like vaccination programs, infectious disease control, safety policies, family planning, and safe drinking water.
• The focus shifts towards chronic diseases including cancer, AIDS, diabetes, and heart diseases.

Modern Public Health Concepts

• "Public Health 2.0" aims to make public health more accessible through participatory technologies.
• Public Health 3.0 challenges business and community leaders, lawmakers, and policymakers to incorporate health into all governance areas.

Epidemiology

• Primary determinants is the causative agent of a disease (bacteria, virus etc) or disorder
• The primary determinant can be bacteria or viruses, like a automobile in accidents
• Secondary factors can be socio-economic or environmental situations such as malnutrition or respiratory infections.

Descriptive and Analytic Studies

• Descriptive studies generate hypotheses and answer what, who, where, and when.
• Analytic studies test hypotheses and answer why and how.

Descriptive Epidemiology

• Descriptive Epidemiology is about examining distribution of a disease in population and its basic features
• Distribution concerns time, place and person.

Descriptive Studies Characteristics

• Person: Individual details like age, sex, occupation,
• Place: Geography of events like hospital, home, work
• Time: When did events like diagnosis or testing occur

Analytic Studies: Developing Hypotheses

• Analytic Studies are educated guesses based on an association with scientific testing
• Data (Who, What, Where and When) can be used to develop hypotheses
• A key point is to have narrow focus in final hypothesis refinement

Types of Cohort Studies

• Prospective cohort studies group participants according to past or current exposure with future follow-up.
• Retrospective cohort studies occur when potential exposure and outcomes have already occurred when the study begins

Case-Control Studies

• The purpose of case-control studies is to study rare diseases and multiple exposures related to a single outcome
• Participants are selected based on if they have outcome of interest of not

Healthcare Regulations in Turkey

• Turkish Criminal Code No. 5237 regulates bribery and misconduct.
• Bribery is prohibited under Article 252.
• Public officials can’t receive gifts and there is regulations for pharmaceutical companies

The Turkish Criminal Code

• Article 280 of the Turkish Criminal Code requires healthcare professionals to report certain crimes.
• Healthcare professionals who do not report a crime can face up to one year in prison.
• The law includes physicians, dentists, pharmacists, midwives, nurses, and other health-related providers.

Definition of Prevention

• Prevention encompasses actions to eradicate, eliminate, or minimize the impact of disease and disability.
• Prevention involves primary, secondary, and tertiary levels that are the best context for definition

Levels of Prevention: Primordial Prevention

• Primordial prevention occurs before risk factors emerge which is achieved through health education.
• Examples include discouraging smoking, preventing childhood obesity, and creating bikeways.

Primary Prevention

• Primary prevention addresses risk factors already present in society before disease starts.
• Health promotion and health education are aspects central to primary prevention.
• Ottawa Chapter (November 1986) was developed with promotion for health
• The Jakarta Declaration happened July 1997
• Mass and population health tactics are WHO approaches

Health Promotion Elements

• Education, environment change, nutritional advise, change in behavior and are main elements

Examples of Primary Prevention

• Providing safe water and sanitary latrines
• Controlling insects and rodents and promoting breastfeeding
• Improving socioeconomic status. and helmet use
• Promoting Vitamin A prophylaxis

Approaches to Primary Prevention

• The WHO recommends the Population strategy for chronic diseases, and the High-risk strategy.
• "Population strategy" is for everyone irrespective of risk and can reduce population blood pressure
• The high-risk is for individuals high risk through clinical methods

Secondary Prevention

• Strategy is to diagnose the disease early, before any complications develop.
• Examples is looking for malaria cases and breast cancer screening

Tertiary Prevention

• Strategies involves limiting further damage during a stage of irreversibility and to rehabilitate
• Disease: A person may have an issue and loses limb
• Impairment: Refers to abnormaility in physiology
• Disability: Is an inability to perform
• Handicapped: Individuals who can't fulfil responsibilities

Rehabilitation

• Rehabilitation involves restoration of function.
• Rehabilitation involves restoration of dignity and livelihoods
• Types can include vocational, social or physiological

Health Protection Levels

• Risk to public is measure through environment and food, monitored by European agencies

European Air Quality

• Good Air Quality pose no risk
• Moderate Quality impacts sensitive groups
• Poor Air Quality health impact. and limit outdoor activities
• Very Poor Air is Significant to health and remain indoors
• Extremely Poor - emergency may need health measuring

Food Safety & Disease

• Inspected on different levels
• Routine inspections
• Surveillance
• Alerts
• Action

Disease Response

• Measured in different phase, from interpandemic to recovery

Choosing Health Screening Risk and Factors

• Age, Gender, Medical and smoking History should into account for health measures

Health Screen Rules

• If you have a have prior history, ensure you are screened
• Singapore has grouped test into 3 rules
• These are whether suitable, whether it benefit or that individual is harm.

Community Identification

• Community identification involves a systematic data survey to assess health of community
• Identify data sources and data collected, with use of surveys

Community Communication

• Communication increase awareness
• Promotes better well being
• Helps access health resources

Community Communication Principles

• Must simple, understandable, and respect diversity
• Involves feed back from members

Methods of Community Communication

• Involves intercommunication and discussions

Healthy education

• Aim at identifying and involving with community

Role of Health educators

• Deliver and motivate on information
• Advocate for health
• Has barriers like language, culture and misinformation

Family Health Nursing

• Health nursing will ensure acceptance and participation of all

Home visit purpose

• Providing simple aids and counselling