Public and Global Health 2023.pptx

Public and Global Health D R. C O N T R E RA S PREVENTIVE MEDICINE FA L L 2 0 2 3 Objectives- Public Health 1. List the usual functions of a typical public health department/district. 2. Describe the components of the public health system. 3. List the 10 essential public health services according...

Public and Global Health D R. C O N T R E RA S PREVENTIVE MEDICINE FA L L 2 0 2 3 Objectives- Public Health 1. List the usual functions of a typical public health department/district. 2. Describe the components of the public health system. 3. List the 10 essential public health services according to the CDC. 4. Differentiate public health from population health. 5. Analyze the effects of healthcare infrastructure on population health. 6. Discuss the following CDC initiatives to address population health: • 6/18 initiative • Health Impact in 5 Years (HI-5) initiative Objectives- Global Health 1. Define Global Health and important determinants. 2. Discuss the role nongovernmental organizations (NGOs) play in influencing global health. 3. Identify the top ten causes of global death. 4. Discuss the top global health security risks that affect the world today and how they may be mitigated. 5. Identify the external factors that influence global health. Public Health Introduction Public Health = the science of protecting and improving the health of populations.  Focuses on what we, as a society, do collectively to assure the conditions in which people can be healthy. • • • • • • Prevent the spread of disease Protect against environmental hazards Preventing injuries Promoting healthy behaviors Responding to disasters and assisting communities in recovery Assuring quality and accessibility of health services Core to the mission= addressing the social determinants of health Health equity= everyone having “a fair and just opportunity to be as healthy as possible” … requires removing obstacles to health such as poverty, discrimination, and their consequences. Public Health System THE PUBLIC HEALTH SYSTEM IS COMPOSED OF: •federal agencies •government agencies (other than public health) •clinical care delivery systems •STLTs (state, tribal, local, and territorial health departments) •the media •community-based organizations •private and nonprofit associations •educational institutions •private industries USUAL FUNCTIONS OF TYPICAL PUBLIC HEALTH DEPARTMENT: •adult and childhood immunizations •communicable disease control •community outreach and education •epidemiology and surveillance •environmental health regulation (e.g. food safety services, restaurant inspections) •tuberculosis testing Essential Public Health Services 1.Monitor health status to identify and solve community health problems 2.Diagnose and investigate health problems and health hazards in the community 3.Inform, educate, and empower people about health issues 4.Mobilize community partnerships and action to identify and solve health problems 5.Develop policies and plans that support individual and community health efforts 6.Enforce laws and regulations that protect health and ensure safety 7.Link people to needed personal health services and assure the provision of healthcare when otherwise unavailable 8.Assure competent public and personal healthcare workforce 9.Evaluate effectiveness, accessibility, and quality of personal and population-based health services 10.Research for new insights and innovative solutions to health problems Ten Essential Public Health Services The Essential Public Health Services align with the three core functions of public health: assessment, policy development, and assurance Essential Public Health Service •1. Monitor health status Example Activities Community health assessment; registries Ways to Address SDOH Include SDOH measures in community health assessments; engage communities in assessment efforts Include community-level determinants of health in investigations (e.g., address deteriorating housing conditions to prevent lead poisoning and other health hazards) •2. Diagnose and investigate Investigate infections and water-, food-, and vectorborne disease outbreaks •3. Inform, educate, and empower Health education and health promotion programming •4. Mobilize community partnerships Partner with private sector, civic groups, nongovernmental organizations, faith community •5. Develop policies Strategic planning; community health improvement planning Leverage evidence-based policies in nonhealth sectors that affect SDOH and health outcomes (e.g., safe and affordable housing policies). Develop community health improvement plans that address SDOH •6. Enforce laws Review and enforce regulations and laws that affect public health Develop strategies to ensure enforcement of existing regulations and laws that affect SDOH (e.g., housing and health codes, laws to prevent violence against women and children) •7. Link to/provide care Establish links with primary care; engage in activities that ensure access to care Educate community members about eligibility for and access to programs such as: Medicaid, Supplemental Nutrition Assistance Program. Ensure essential health benefits are provided equitably •8. Assure competent workforce Public health workforce development and training; public health workforce research Support staff training efforts that help workers incorporate SDOH into job responsibilities. Promote hiring of workforce that reflects population being served •9. Evaluate Program evaluation and continuous quality improvement activities Ensure evaluation and research designs include interventions that address SDOH inequity. Use performance management and quality improvement methods to explore and address root causes of health problems •10. Research Identifying and sharing best practices; public health services and systems research Expand research agendas to include SDOH and health outcomes. Use community-based participatory research designs. Apply evidencebased practices to address health inequity and demonstrate improved health outcomes Ensure education efforts address social and structural determinants of health inequities (e.g., structural racism). Ensure access to culturally and linguistically appropriate approaches to community health Engage partners associated with SDOH (e.g., housing authorities, law enforcement, schools, and community organizations) Addressing SDOH • Addressing the social determinants of health requires a systems-thinking approach. • Necessitates institutional and sociopolitical changes that involve working together with a range of stakeholders who have the capacity and authority to influence practice in their respective spheres. • The community itself is an important stakeholder!!! • Public health is a subset of health care focused on improving the health outcomes and overall well-being of the public at large. • Population health is a subset of public health focused on improving the health outcomes and well-being of a specific group of people or community within the public at large. • May focus efforts on very specific groups such as geographic location, ethnicity, age, or shared disability, etc. Measuring population health outcomes Interprofessional Collaborative Practice Training with other disciplines is beneficial in a number of ways. • Teamwork can enable resiliency to adjust to unforeseen changes. • Team members with different expertise can inform complex decisions. • Effective team processes can promote effective communication. • Helps team members understand roles and lines of authority. • Encourages working together with mutual respect. CORE COMPETENCIES FOR INTERPROFESSIONAL COLLABORATIVE PRACTICE Domain Competency Values/Ethics for Interprofessional Practice Work with individuals of other professions to maintain a climate of mutual respect and shared values Roles/Responsibilities Use the knowledge of one’s own role and those of other professions to appropriately assess and address the healthcare needs of patients and to promote and advance the health of populations Interprofessional Communication Communicate with patients, families, communities, and professionals in health and other fields in a responsive and responsible manner that supports a team approach to the promotion and maintenance of health and the prevention and treatment of disease Teams/Teamwork Apply relationship-building values and the principles of team dynamics to perform effectively in different team roles to plan, deliver, and evaluate patient/population-centered care and population health programs and policies that are safe, timely, efficient, effective, and equitable Health Impact in 5 Years (HI-5) initiative • Focus on social determinants of health (SDOH) Goal: highlight non-clinical, community-wide approaches that have evidence reporting 1) positive health impacts, 2) results within five years, 3) cost effectiveness and/or cost savings over the lifetime of the population or earlier Global Health What is Global Health? • Health of all people on our planet •“Public health for the world” • Recognizing that the world is interconnected • Acknowledges the globalization of public health risks (e.g. infectious agents, unhealthy food/drinks, legal and illicit drugs, tobacco use, etc.) • Determinants beyond the individual-- taxation of tobacco; control of air pollution; access to healthcare; safe water supply, etc. Health is affected by the dissemination of ideas, behaviors, and cultural and recreational practices which reach and influence all corners of the world in an ever shorter time, spreading as effectively as infectious diseases. Stats and Facts • WHO has estimated an additional 250,000 deaths per year between 2030 and 2050 will be attributable to climate-associated increases in malnutrition, malaria, diarrhea, and heat stress, especially in elderly people. • The most neglected of basic services is access to safe drinking water and sanitation. • more than 40% of the world’s population are affected by water scarcity • over 650 million people lack access to improved drinking water sources • almost 900 million still resort to open defecation • NGOs • can often act more swiftly than traditional agents and are less constrained by political and other factors. • exert pressure on formal agencies and governments to change policies and practice • can disproportionately influence what services are delivered where • 40% of healthcare in sub-Saharan Africa is delivered through the faith-based sector Causes of Death 1. Cardiovascular Disease 8. Neonatal causes 2. Neoplasms 9. Diarrheal diseases 3. Injuries 10.Chronic liver disease 4. Chronic respiratory disease 11.HIV/AIDS 5. Diabetes 12.Tuberculosis 6. Lower respiratory infections 13.Malaria 7. Neurologic diseases Consider the burden of disease while people are aliv Noncommunicable Disease Top 4 Cardiovascular Disease, Cancer, Chronic respiratory disease, & Diabetes • account for about 70% of global mortality or approximately 40 million deaths annually • half of deaths from cardiovascular disease, and almost a quarter from cancers • Clinical approach entails screening, detection, treatment, and palliative care. • Intervention on tobacco use, excessive alcohol use, unhealthy diet, and physical inactivity. • One in four people in the world will be affected by mental or neurological disorders at some point in their lives • People with severe mental illness have up to 60% higher chances of dying prematurely from NCDs. Global Health Security • A disease threat anywhere is a disease threat everywhere. Today’s top global health security risks include: • • • • Emergence and spread of new infectious diseases Ever-increasing globalization of travel and trade, enabling disease to spread Rise of drug-resistant, disease-causing pathogens Potential for accidental release, theft or illicit use of dangerous pathogens CDC strengthens capabilities in these four core areas to fight top global health security risks: • Surveillance systems to quickly catch outbreaks before they spread • Laboratory networks to accurately diagnose diseases and identify new pathogens • Workforce development of frontline staff to identify, track, and contain outbreaks at their source • Emergency Management systems to coordinate response efforts when crises occur “Prevent, Detect, Respond” Global Health and the Future • Universal Healthcare (?) • Prioritization of maternal and child health services • Eradication of polio • Numerous external factors will continue to influence global health: • • • • • • • conflict and terrorism population displacement refugee crises Migration environmental and climate change cultural pressures and their influence on lifestyles demographics The most likely and devastating challenge to health security would be an outbreak of infection with highly pathogenic airborne agent that could rapidly develop into a pandemic. - 2017 References Beck A.J., & Kulik P.G. (2022). Public health practice in the united states. Boulton M.L., & Wallace R.B.(Eds.), Maxcy-Rosenau-Last Public Health & Preventive Medicine, 16e. McGraw Hill. https://accessmedicine-mhmedical-com.ezproxy.franklinpierce.edu/content.as px?bookid=3078&sectionid=256019851 CDC.gov Essential Public Health Services https://www.cdc.gov/publichealthgateway/publichealthservices/essentialhealt hservices.html De Cock K.M., & Mutisya I, & Mwabe J, & Holmes K (2022). The history and emergence of global health. Boulton M.L., & Wallace R.B.(Eds.), MaxcyRosenau-Last Public Health & Preventive Medicine, 16e. McGraw Hill. https://accessmedicine-mhmedical-com.ezproxy.franklinpierce.edu/content.as px?bookid=3078&sectionid=256020463