Medicine and Society 1 Review PDF

Public Health is the science and the art of preventing disease, prolonging life, and promoting health through organized community efforts The public can be as small as a a local neighborhood or as large as a village or an entire city; in the case of a pandemic it may encompass seve...

Public Health is the science and the art of preventing disease, prolonging life, and promoting health through organized community efforts The public can be as small as a a local neighborhood or as large as a village or an entire city; in the case of a pandemic it may encompass several continents. Health is not only the absence of disease, but also a state of complete physical, mental and social well-being (according to the World Health Organization) Public health has the following three core functions: 1. Assessment 2. Policy development 3. Assurance The disciplines of public health can be divided somewhat arbitrarily into six areas: Epidemiology ;the study of populations to find the causes of health and disease Statistics; Statistics is the discipline that collects and analyzes data, finds causation, and calculates probabilities Biomedical sciences study the biological basis of human health and disease, how these infectious agents are spread and how they affect the human body. social and behavioral sciences analysis of human behavior environmental sciences preventing - the spread of disease through water, air, and food Whereas medicine is concerned with individual patients, public health regards the community as its patient, trying to improve the health of the population. Medicine focuses on healing patients who are ill; public health focuses on preventing illness. Assessment constitutes the diagnostic function, in which a public health agency collects, assembles, analyzes, and makes available information on the health of the population. Policy development, like a doctor’s development of a treatment plan for a sick patient, involves the use of scientific knowledge to develop a strategic approach to improving the community’s health. Assurance is equivalent to the doctor’s actual treatment of the patient. a political decision is generally necessary before action can be taken to solve it. Define the health problem. Identify the risk factors associated with the problem. Set the plans - Develop and test community-level interventions to control or prevent the cause of the problem. Implement interventions to improve the health of the population. Monitor those interventions to assess their effectiveness Intervention is - a generic term used in public health to describe a program or policy designed to have an impact on a health problem. There exist 3 level of prevention: primary prevention prevents an illness or injury from occurring at all, by preventing exposure to risk factors secondary prevention Activities intended to minimize the risk of progression of or complications from a disease or to minimize damage from an injury Tertiary prevention seeks to minimize disability by providing medical care and rehabilitation services. an agent a host the environment Agent, Host and environment is called epidemiological triad  any new proposal for a public health regulation might cost jobs, add to the price of a product, or require a tax increase. It might also cut into a company’s profits. Consequently, industries resist change: 1. Milk producers resisted pasteurization; 2. landlords resisted building codes; and 3. automobile manufacturers resisted design changes to improve safety. The difficulty of economic impact - conflicts with the tobacco industry. economic difficulty, people are often unwilling to pay short-term costs to obtain a longterm benefit Risk against other risks. (No pesticides or No crops and food) Individual liberty Health and safety, together with economic well-being, are the major factors that contribute to the general welfare. When the harm is less direct, however, the issues become more controversial Most controversial are governmental restrictions on people’s freedom to harm themselves Tragedy of the commons means: The overuse of a shared resource restrict people’s freedom for the purpose of protecting their own health and safety. requirements to wear seat belts when traveling in a car and helmets when riding a motorcycle restrictions on use of many drugs, such as heroin, cocaine, LSD Prohibition of alcohol Such laws inspire allusions to “the tyranny of health” and “the health police,” although Paternalism - Restriction of people’s individual freedom with the aim of protecting their health and safety Public health experts argument in favor of limiting individual liberty for the common good is consistent with their view of public health as social justice. Political interference with science refers to the manipulation or distortion of scientific evidence or findings for political gain or to support a particular policy agenda. This can occur in various ways such as: suppressing scientific research or data, censoring scientific publications, appointing unqualified individuals to scientific positions, or cherry-picking (choose) scientific evidence to support a predetermined position. Lead to policies that are not based on sound evidence. Example of COVID-19 Some leaders also promoted unproven treatments or prevented public health officials from speaking out about the pandemic. Example of climate changing Example of Vaccinations Example of environmental health Government’s role is determined by law; at the federal, state, and local levels. Many nongovernmental organizations (NGOs) play an important role in public health, especially through educational programs and lobbying This process expands the concept of the public health system to include, for example: hospitals, businesses, charitable and religious organizations. public health activities may be delegated by the state to local governments. to collect data about the population, to immunize children before they enter school, to regulate the environment for purposes of sanitation, and to regulate safety Federal role in public health to “collect taxes... To pay the debts and provide for the common defense and the general welfare.”` To prevent a person from harming others To defend the interests of incompetent persons such as children or the mentally disabled In some cases, to protect a person from harming himself or herself John Snow about a cholera epidemic He formulated the hypothesis that cholera was spread by polluted drinking water recognize that an epidemic is occurring before many people start dying, governments also use a system called epidemiologic surveillance, requiring that certain notifiable diseases be reported as soon as they are diagnosed. Notifiable disease - A disease that the law requires to be reported to public health authorities as part of the public health surveillance system. detect an emerging epidemic at an early stage. Chronic disease - A disease that is marked by long duration or frequent recurrence, usually incurable but not immediately fatal. cardiovascular disease, cancer, diabetes, Alzheimer’s disease, acquired immunodeficiency syndromes Risk factor – is a characteristic that has been demonstrated statistically to increase a person’s chance of developing a disease or being injured. a link between lung cancer and tobacco smoking. incidence rate—the number of new cases in a defined population at risk over a defined period of time prevalence rate—the number of existing cases in a defined population at a single point in time. epidemiologic studies, that can be performed: Observational studies Cohort Studies: In a cohort study, a group of people is followed over time to determine the incidence of a specific disease. The study population is generally defined by exposure status (e.g., exposure to a specific risk factor) or by disease status. Case-Control Studies: In a case-control study, individuals with a specific disease (cases) are compared to a group without the disease (controls). The aim is to identify risk factors that may be associated with the disease. Cross-Sectional Studies: In a cross-sectional study, data is collected at a single point in time from a population to determine the prevalence of a disease or health condition. Experimental studies interventional studies that are designed to test the efficacy of a specific treatment or intervention. Randomized Controlled Trials (RCTs): In an RCT, individuals are randomly assigned to a treatment group or a control group. The aim is to compare the outcomes of the two groups to determine the efficacy of the treatment. Ecological studies Ecologic studies investigate the correlation between population-level exposure to risk factors and the incidence of disease or health outcomes. Case-reports detailed description of a single case of a disease or health condition The control group may be given a placebo—an inactive substance similar in appearance to the drug or vaccine being Randomized Double blind Phase I studies test a new drug for the first time in a small group of people (about 20-80) to see if it safe, to find the right dose, and to know the side effects. Phase II studies are done in more people (about 100-300) to see how well the new drug treats a disease. Phase III studies are done in large groups of people (about 1000 to 3000) to see if the new drug works well, has side effects, and how it compares to other drugs. Phase IV studies are done after the treatment is approved by the U.S. Food and Drug Administration (FDA). Cohort study is a type of observational study where a group of individuals who share a common characteristic or experience are followed over a period of time to observe and analyze the incidence and outcomes of specific health-related events or diseases. prospective cohort study, the study participants are identified and followed forward in time, while in a retrospective cohort study, the study participants are identified based on historical data and followed backward in time.