Public Health Lecture 1 Introduction to Public Health - PDF

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Alexandria University Hospitals

Amany El-Bassiouny

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public health health determinants public health introduction public health education

Summary

This document is a lecture on introduction to public health. It covers various topics such as general rules, course details, objectives, and health determinants. The document is aimed at undergraduate students in public health.

Full Transcript

Public Health PMP505 Amany El-Bassiouny, PharmD, PhD Senior clinical pharmacist Alexandria University Hospitals General rules  Please silent your mobile phones  No students will be allowed to enter the lecture hall after 10 minutes of starting  Interaction is required  Y...

Public Health PMP505 Amany El-Bassiouny, PharmD, PhD Senior clinical pharmacist Alexandria University Hospitals General rules  Please silent your mobile phones  No students will be allowed to enter the lecture hall after 10 minutes of starting  Interaction is required  You are not allowed to record the lecture Course  Lecturers  Naglaa Elmongui, PhD  Amany El-Bassiouny, PharmD, PhD  Lecutres will be on Day???? Overall course objective  This course provides a pharmacy-focused and equity-driven approach to the fundamentals of public health with specific emphasis to pharmacy students. It is organized into two sections: Public Health Fundamentals and Public Health in Pharmacy Practice, and public Health in Practice focuses on several areas of current public health practice Course map Grades  Midterm  Coursework  Activities/assignments ???  Final 40 Public Health PMP505 Lecture 1 Introduction to public health Amany El-Bassiouny, PharmD, PhD Senior clinical pharmacist Alexandria University Hospitals Intended learning outcomes By the end of the lecture, you should be able to  Describe the purpose of public health.  Define terms usually used in public health.  Recognize core public health functions and services  Explain how health determinants affect the public health Public health What?  What is public health?  Why do we need public health? Public How? Why?  Where/ when health  How (public health approach) When/ where? Public health  What is health? Health is a state of complete physical,mental and social wellbeing, and not merely the absence of disease or infirmity, WHO, 1978 What is public health? Public health is the science and art of preventing disease, prolonging life, and promoting health through the organized efforts and informed choices of society, organizations, public and private communities, and individuals Why do we need public health? Public health is the science and art of preventing disease, prolonging life, and promoting health through the organized efforts and informed choices of society, organizations, public and private communities, and individuals  Health improvement  Health protection (prevention, control and monitoring)  Health care of the public  Prevent disease (health determinants), vaccination, levels of prevention,  Control the disease: screening, surveillance,  Ensure service delivery Why do we need public health?  Prevent disease Ensur Prevent Control  Levels of prevention servic Identify health determinants disease disease  delive  Promote healthy behavior  Vaccination Study of  Hand hygiene health Screening  Control the disease determinants  Surveillance  Ensure service delivery: Levels of Monitoring Screening Quality  preventions and servic  Quality of service & surveillance Health utilization Utilizat promotion Why do we need public health?  Prevent disease  Levels of prevention  Identify health determinants  Promote healthy behavior  Vaccination  Hand hygiene  Control the disease  Screening  Ensure service delivery  Quality of service & utilization  Surveillance/ monitoring Health determinants  Health determinants are certain factors that determine a person’s state of health  Examples Age, diet, physical activity, smoking, alcohol consumption, working conditions, cultural, genetics, socioeconomic factors, gender, environmental (air pollution), medical care.  Can you categorize these determinants into modifiable and non-modifiable? Health determinants Genes and Biology Health behavior We can group these determinants into:  Genes and biology  Health behaviors  Social or societal characteristics  Health services or medical care Which has the largest impact on Medical care Social characteristics health? Try to order them Levels of prevention  Primary Preventing the disease form occurring Involves reduction in exposure to risk factors, focusing either on the whole population or on high-risk subgroups Examples include healthy lifestyle interventions for the prevention of cardiovascular disease, or workplace-based interventions to reduce asbestos exposure  Secondary Prevent the disease progression Involves detecting disease at an early stage and undertaking prompt intervention to reduce the disease’s impact Examples include screening programmes, or prescription of statins for hypercholesterolaemia to reduce the likelihood of myocardial infarction or stroke Levels of prevention  Tertiary  Aims to reduce or mitigate long-term complications of a disease and maximize functioning  Examples are HbA1c monitoring in diabetes mellitus to minimize long-term micro-and macrovascular complications, or neuro-rehabilitation after head injury.  Primordial prevention  Prevention of the risk factors  Target: the whole population  Example: increasing taxes on cigarettes, increase safe walking paths, increase number of stores that sell healthy food Promoting healthy behavior  Health promotion and behavior change can occur on different levels of prevention.  Healthy behaviors that have an impact on public health include  Hand hygiene  Vaccination  Drink enough water  Brush your teeth regularly  Strategies to change behavior (behavior change model) Control the disease  Provide treatment for known patients  Screening detect unknown patients  Ensure service delivery to everyone with achieving equity  Quality of service & utilization: assure the quality of the provided service and that it is being utilized by customers  Surveillance/ monitoring of the provided health services to detect and address any problem Question Equity and equality  Equality is to give everyone the same opportunities, care, and services  Examples: the doctor spends the same time with all the patients regardless the severity of their cases  Making a vaccine available for all the population  Distributing a brochure about a health topic to all patients regardless of their disease  Equity is the absence of unfair, avoidable or remediable differences among groups of people  Individualizing health care (suggesting accessible food in case of poverty-related malnutrition)  Doctor spends time with the patients according to the complexity of the situation Needs assessment  In order to avoid health inequity, the health needs of a specific population should be identified and addressed  The process of identifying health needs is known as health needs assessment, which is one of the important tools in public health  Health needs assessment is done by epidemiological methods (surveillance), by consulting stakeholders, or by comparing needs of different populations.  You should differentiate between the need, demand, and supply  Need: what is actually needed by a population  Demand: what they wish to have  Supply: what is already provided to the population Question Areas of intervention of public health?  Environmental (air pollution, occupational hazards, clean water supply, sanitation…)  During disasters earthquakes, bioterrorism,  Epidemics, outbreaks, pandemics, endemics  Policy development How? The public health approach  In the mid-1800s, John Snow an English physician investigated a series of Cholera outbreaks in London to discover the cause of disease and to prevent its recurrence.  His work established the base of epidemiology science and public health approach Spot map of deaths from cholera in Golden Square area, London, 1854 Source: Snow J. Snow on cholera. London: Humphrey Milford: Oxford University Press; 1936. The public health approach Risk factor Intervention Surveillance Implementation identification evaluation What is What is What How do the the cause? works? you do it? problem? Problem Response Core functions of the public health Assessment Policy development Assurance Systematically collect, Promote the use of a Ensure provision of analyze, and make scientific knowledge services to those in available information on base in policy and need healthy communities decision making Monitor health Inform. Educate, empower Provide care Diagnose and investigate Community partnership Assure equity Develop policies Assure a competent workforce Enforce laws Evaluate Core functions of the public health  Give an example on the governmental level and on the local level on smoking or antimicrobial resistance as a public health problem Stakeholders Partners in the public health  Public health is a multidisciplinary system  Who are the partners (stakes) that may take part in the interventions, policy making, research, evaluation and education? Give an example of what they can do?  Community Behavior change  Nongovernmental organizations Interventions, funds  Government Policy making, legislation  Media Health promotion, health communication  Academia Education, training, research  Companies Interventions, research, funds  Clinical care delivery system Interventions Core sciences of public health  Because public health is a multidisciplinary system. An integration between different sciences is needed to perform the core functions Epidemiology of public health. Prevention Data effectiveness informatics Public health Public health Surveillance labs Core sciences of public health Identifies Surveillance the problem Choose the most Data collection and Prevention Data suitable interpretation effectiveness informatics intervention Public health Public Identify risk factors, Confirm the health Epidemiology where the disease diagnosis labs come from? Question  Definitions  Outbreak/ epidemic/ endemic/ pandemic

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