Week 3: Public Health Topics

Week 3: Public Health

Public health significantly impacts daily life in various ways.
Public health issues can be highly controversial.
"Population health" differs from medical care, focusing on entire populations rather than individuals.
Evaluation plays a role in demonstrating effectiveness in evidence-based public health practices.
Prevention and intervention strategies differ, with prevention emphasizing disease avoidance and intervention addressing existing problems.
Socioeconomic status, including income, education, and occupation, strongly influences health outcomes.
Health-in-all-policies approach acknowledges the interdependence of health with other policy areas, highlighting the need for collaboration across sectors.
Public health law involves a range of key principles.
There are four distinct types of law: constitutional, legislative, administrative, and judicial.
Local, state, and federal agencies perform diverse roles in public health.
Public health agencies require different levels (local, state, federal) to coordinate among themselves.
Goals of governmental public health include various efforts in epidemic prevention, environmental safety, injury reduction, and promoting healthy behaviors.
Essential services of public health, along with the roles of federal agencies not exclusively categorized as health agencies, also comprise essential aspects of public health.
Collaboration with other governmental and non-governmental agencies is crucial.
The science and art of preventing disease, prolonging life, and promoting physical health.
Public health funding comprises a small fraction (<3%) of total U.S. health spending.
Funding and other controversies, US' individualistic culture, and the controversy surrounding individual rights versus collective well-being also play significant roles in the study.
Political decisions and social disparities influence public health.
Contraception, substance abuse, environmental protection, and vulnerable populations add to the complexities.

Population Health (21st Century)

Coordination of public health, healthcare, and public policy, grounded in shared evidence and systems thinking ("One Health").
Antibiotic resistance, climate change, and the full life cycle approach are key considerations.

Population Health

Life expectancy of Americans has increased significantly from 47 to 77 years.
Intervention strategies impact health (nutrition, housing, sanitation, vaccination, antibiotics, and occupational safety).

Public (and Population) Health vs. Medical Care

Population health aims at preventing illness in communities, while medical care focuses on treating existing illnesses in individuals.
Public health strategies focus on disease prevention, while medical care focuses on intervention.
Strategies involving population health and evaluating problems in communities are different from strategies used in treatment.

Prevention vs. Intervention

Primary prevention aims at preventing illnesses or injuries by avoiding risk factors.
Secondary prevention seeks to minimize the severity of illnesses by addressing them early.
Tertiary prevention focuses on reducing disability associated with diseases through medical care and rehabilitation.

Approaches to Population Health

Health care provides one-on-one individual medical services.
Traditional public health focuses on community-based interventions and strategies.
Public policy interventions encompass broader non-health-related areas impacting health.

Evaluating Effectiveness

Public health interventions assess the degree of problem elimination, analyze remaining problems, utilize before-and-after assessments, consider reach, effectiveness, implementation, and maintenance.
The assessment considers whether the target population is reached, whether interventions are integrated into clinical and/or public health practices, both in the short and long term.

Socioeconomic Status and Health

Socioeconomic status (SES) encompasses education, income, occupation, and access to goods and services.
Poverty, housing instability, and environmental factors impacting health are linked to socioeconomic status.
Health disparities result from socioeconomic inequalities.

Health in All Policies

Policies need to actively prioritize health and wellness.
Collaboration between sectors improves health, and policies that address health, equity, and sustainability are preferable.

Scope of Health Law, Policy and Ethics

Discussions consider the right to health care and balancing individual rights with societal needs.
Bioethical principles are necessary to address public health issues.

Legal Principles

Police power permits states to control sanitation, waste disposal, and environmental protections.
Negative means a government can be allowed to take action while not explicitly having to.
The Interstate Commerce Clause significantly influences federal authority regarding public health.
Due process protections are guaranteed by the 14th Amendment, guaranteeing procedural and substantive due process.
Four types of law, constitutional, legislative, administrative, and judicial.

Types of Law

Fundamental legal frameworks include constitutional, legislative, administrative, and judicial law.

Local, State, and Federal Health Agencies

Local, state, and federal public health systems function together to address and contain infectious diseases.
Each level plays a specific role in managing public health issues.

Roles of Local and State Public Health Agencies (Models)

Local agencies (county/city) operate based on home rule principles or function as branch offices of state agencies.

Local Health Department Responsibilities

Immunizations for those not covered by private systems, communicable disease surveillance, environmental health surveillance, inspection and licensing of restaurants, and public health programs (tobacco control, coordinating health screenings, and preparedness for disasters).

State Health Department Roles

Vital statistics collection, maintaining public health laboratories, licensing of health professionals, administering nutrition programs, regulating health facilities, drinking water standards, administration of state Medicaid programs, and overseeing medical examiner offices.

Views the equitable distribution of health services as a social responsibility.
Assumes that markets provide efficient resource allocation for health services.

Goals and Roles of Governmental Public Health Agencies

Defines goals and services of agencies through frameworks.
Aims to prevent epidemics, protect against environmental hazards, reduce injuries, foster healthy behaviors, and manage disaster responses.

Core Public Health Functions

Three core functions are performed by governmental public health agencies: assessment, policy development, and assurance.
The functions involve collecting and analyzing health data, establishing policies/recommendations, and guaranteeing health services.

The 10 Essential Public Health Services

Key areas in public health services encompass various core functions, including assessment, policy development, and assurance.
The essential services ensure everyday responsibilities, evaluation of core functions, and establishment of responsibilities.

Foundational Public Health Services

Public health agencies need fundamental skills and activities.
These skills include expertise and program-specific activities, capabilities that ensure overall success for the organization.

Roles of Federal Public Health Agencies

HHS is the central federal public health agency.
Agencies like NIH, CDC, FDA, HRSA, AHRQ, and SAMHSA fulfill various public health functions.
The Interstate Commerce Clause grants the federal government authority to regulate commerce; however, federal public health authority functions through states' acceptance of federal funding.

Roles of Global Health Organizations and Agencies

Public health efforts are global in scope.
National and international efforts involve collaboration, and funding originates from the UN, WHO, the World Bank, and other organizations.

Collaboration of Public Health Agencies

Effective collaboration among local, state, federal, and global agencies is crucial in organizing and ensuring successful implementation of public health work.
This involves parallel play (actions performed independently but within a framework), true collaboration (coordinated effort), and integration of efforts (unified, collective, whole-system focus).

Other Government Agencies Involved in Health Issues

EPA, OSHA, Department of Homeland Security, FDA, USDA, Department of Housing and Urban Development, and the Department of Energy have roles in environmental health, workplace safety, disaster preparedness, food safety, urban development, and environmental safety, respectively.

What NGO Roles in Public Health Does Public Health Play?

Various non-governmental organizations, including the American Red Cross, philanthropic associations, and others, play roles in disaster relief, public health education, research support, and policy advocacy.
Organizations like Physicians for Social Responsibility and Doctors without Borders offer services and advocate for global health needs.