Introduction to Public Health PDF

Introduction to Public Health   The world Health Organization (WHO) defined health 1 in1948, as “A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”.  Physical health: anatomical integrity and physiological...

Introduction to Public Health   The world Health Organization (WHO) defined health 1 in1948, as “A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”.  Physical health: anatomical integrity and physiological functioning of the body. It means the ability to perform routine tasks without any physical restriction. E.g., Physical fitness is needed to walk from place to place.  Mental Health: is the ability to learn and think clearly and coherently.  Social health: is the ability to make and maintain acceptable interaction with other people. E.g. to celebrate during festivals; to mourn when a close family member dies; to create and maintain friendship. 2 CEA Winslow defined public health as: “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”. Therefore, public health is the combination of sciences, skills and beliefs that is directed to the maintenance and improvement of the health of all the people through collective social actions. Key terms in the definition of public health are prevention and promotion. 3  There are three levels of prevention: Primary Prevention refers to prevent the disease and injury from occurring. It works with both the individual and the community. It may be directed to increase resistance to the agent (such as immunization or cessation of smoking), or may be directed at environmental activities to reduce the vector for a biological agent, such as mosquito vectors of malaria. Secondary Prevention is the early diagnosis and management to prevent complications from a disease. It includes steps to isolate cases and treat or immunize contacts to prevent further epidemic outbreaks. Tertiary Prevention involves activities directed to promote restoration, and maintenance of maximum function after the disease and its complications have been stabilized. 4  Health promotion is a key element in public health. it involves activities intended to enhance individual and community health well-being.  Health promotion elements include: 1. Addressing the population as a whole in health related issues as well as people at risk for specific diseases. 2. Directing action to seek out and remedy risk factors or causes of illness or death. 3. Promoting factors that contribute to a better condition of health of the population. 4. Encouraging health professionals’ participation in health education and health policy. 5. Initiating actions against health hazards ,including communication, education, legislation, fiscal measures, organizational change, community development and spontaneous local activities. 5  Nutrition: is the science of food, the nutrients and other substances therein, their action, interaction and balance in relation to health and disease.  Reproductive health: is a state of complete physical, mental and social being not only absence of disease or infirmity, in all matters relating to reproductive system and to its functions and process.  Environmental Health: The basic approach to environmental control is first to identify specific biologic, chemical, social and physical factors that represent hazards to health or well-being and to modify the environment in a manner that protects people from harmful exposures. The principal components of environmental health are water sanitation, waste disposal , etc. 6  Health Education: is defined as a combination of learning experiences designed to facilitate voluntary actions conducive to health. It is an essential part of health promotion.  Epidemiology: is the study of frequency, distribution, and determinants of diseases and other related states or events in specified populations. The application of this study to the promotion of health and to the prevention and control of health problems is evident.  Health Economics: is concerned with the alternative uses of resources in the health services sector and with the efficient utilization of economic resources such as manpower, material and financial resources. 7  Biostatistics is the application of statistics to biological problems; application of statistics especially to medical problems.  Health Service Management: is getting people to work harmoniously together and to make efficient use of resources in order to achieve objectives.  Ecology: is the study of relationship among living organisms and their environment. It is the science, which deals with the inter- relationships between the various organisms living in an area and their relationship with the physical environment. Human ecology means the study of human groups as influenced by environmental factors, including social and behavioral factors. 8  Research: is a conscious action to acquire deeper knowledge or new facts about scientific or technical subjects. It is a systematic investigation towards increasing knowledge. It aims at the discovery and interpretation of facts, revision of accepted theories, or laws in the light of new facts or practical application of such new theories or laws.  Demography: is the study of population, especially with reference to size and density, fertility, mortality, growth, age distribution, migration, and the interaction of all those with social and economic conditions. 9 Public Health vs. Health Care Public Health Health Care  Focus on population.  Focus on individuals.  Prevention & health promotion.  Diagnosis & treatment.  Environment & human  Clinical interventions. behavior interventions.  Social sciences integral,  Clinical sciences integral, social clinical sciences peripheral to sciences less emphasized. education.  Experimental studies.  Observational studies. Health care and public health are complementary. When they work collaboratively, all people benefit.  Public health key terms 10  Communicable disease: Disease transmitted directly from man to man or from animal to man. Disease transmitted indirectly from intermediate host such as insect.  Endemic disease: Disease or pathogen present or usually prevalent in a given population or geographic region at all times. Small outbreak in certain location. Ex. Sleeping sickness or malaria. Endemic diseases include Hyperendemic and Holoendemic. Hyperendemic: equally endemic in all age groups of a population. Holoendemic: endemic in most of the children in a population, with the adults in the same population being less often affected.  Public health key terms cont. 11  Epidemic disease: Disease occurring suddenly in numbers far exceeding those attributable to endemic disease; occurring suddenly in numbers clearly in excess of normal expectancy. Outbreak affect large mass of people. Ex. Epidemic of avian influenza. An endemic disease may become epidemic.  Pandemic disease: A widespread epidemic distributed or occurring widely throughout a region, country, continent, or globally. When spreads world wide. Ex. Influenza pandemic 1918-1919.  Sporadic disease: Scattered and infrequent cases.  Public health key terms cont. 12  Epizootic: Related to a rapidly spreading and widely diffused disease affecting large numbers of animals in a given region.  Incidence: Rate of occurrence of an event; number of new cases of disease occurring over a specified period of time; may be expressed per a known population size.  Prevalence: Number of cases of disease occurring within a population at any one given point in time.  Public health key terms cont. 13 Clinical care: Prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by medical and allied health professions; also known as health care. Determinant: Factor that contributes to the generation of a trait. Health outcome: Result of a medical condition that directly affects the length or quality of a person’s life. 14 Knowledge Check  Public health aims to provide ___________________ with the right to be healthy and live in conditions that support health. A. Groups of people. B. Individuals.  A(n) ________________________ is a disease occurrence among a population that is in excess of what is expected for a given time and place. A. Pandemic. B. Intervention. C. Epidemic. D. Prevention.  Public Health Approach 15 (Surveillance) (Risk Factor (Intervention (Implementation) Identification) Evaluation) Problem Response 16 Knowledge Check Match 1. What is the problem? A. Risk Factor Identification. 2. What is the cause? B. Surveillance. 3. What works? C. Implementation. 4. How do you do it? D. Intervention Evaluation.  Core Functions and Essential Services 17 of Public Health 18 Core Functions  The core functions of Public Health include Assessment, Policy Development, and Assurance. The ten essential Public Health services are listed below and categorized under the appropriate core function. I. Assessment: Systematically collect, analyze, and make available information on healthy communities. 1. Monitor health status to identify and solve community health problems (e.g., community health profile, vital statistics, and health status). 2. Diagnose and investigate health problems and health hazards in the community (e.g., epidemiologic surveillance systems, laboratory support). 19 Core Functions cont. II. Policy Development: Promote the use of a scientific knowledge base in policy and decision making. 3. Inform, educate, and empower people about health issues (e.g., health promotion and social marketing). 4. Mobilize community partnerships and action to identify and solve health problems (e.g., convening and facilitating community groups to promote health). 5. Develop policies and plans that support individual and community health efforts (e.g., leadership development and health system planning). 20 Core Functions cont. III. Assurance: Ensure provision of services to those in need. 6. Enforce laws and regulations that protect health and ensure safety (e.g., enforcement of sanitary codes to ensure safety of environment). 7. Link people to needed personal health services and ensure the provision of health care when otherwise unavailable (services that increase access to health care). 8. Assure competent public and personal health care workforce (e.g., education and training for all public health care providers). 9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services (e.g., continuous evaluation of public health programs). 10.Research for new insights and innovative solutions to health problems (e.g., links with academic institutions and capacity for epidemiologic and economic analyses). 21 Knowledge Check Which of the following is NOT a core function of public health? A.Assurance. B. Assessment. C.Authority. D.Policy development. 22 Knowledge Check The essential health services of monitoring health and diagnosing and investigating disease relate to which core public health function? A.Assurance. B. Assessment. C.Policy Development. 23  24 Public Health Systems  The concept of a “public health system”—a complex network of individuals and organizations that, when working together, can represent “what we as a society do collectively to assure the conditions in which people can be healthy” (Institute Of Medicine “IOM”, 1988).  The Institute of Medicine “IOM” was established in 1970 by the National Academy of Sciences for the examination of policy matters pertaining to the health of the public. 25 Public Health Systems 1. Health Care Delivery System defined as “All health care organizations and professional groups seek to continually reduce the burden of illness, injury, and disability, and to improve the health and functioning of the people. 2. Employers & Business: the main function of employers is the production and sale or direct provision of goods and services through the economic activities like health insurance. Employer-sponsored health insurance programs. Wellness initiatives and benefits. Healthy workplaces and communities. 26 Public Health Systems cont. 3. Media plays a number of roles in educating the public about health issues and reporting accurate health and science information to the public. Vehicle for public discourse. Health education and promotion. Health communication. Social media as catalyst.  Public Health Systems cont. 27 4. Academia performs three important functions within the public health system. (A) educate and train public health workers; (B) conduct basic and applied research in disciplines pertinent to public health; and (C) engage in community, public, and professional service. Education. Training. Research. Public Service. 28 Public Health Systems cont. 5. Governmental Public Health Infrastructure such as CDC “The success or failure of any government in the final analysis must be measured by the well-being of its citizens. Nothing can be more important to a state than its public health; the state’s paramount concern should be the health of its people” Franklin Delano Roosevelt. City planning. Education. Health in all policies. 6. Community described as a group of people who share some or all of the following: geographic boundaries; a sense of membership; culture and language; common norms, interests, or values; and common health risks or conditions. 29 Knowledge Check Match each stakeholder to its role in public health: 1. Vehicle for public discourse. A. Academia. 2. Health in all policies. B. Employers and businesses 3. Education and training. C.Government 4. Wellness initiatives and D. Media benefits. 30 Health Determinants 1. Genes and biology Sex. Age. Genetic makeup. 2. Health behaviors Smoking. Eating habits. Physical habits. 3. Social or societal characteristics e.g. air, water and sanitation quality. 4. Health services or medical care Quality health care. Insurance coverage.  Health Determinants 31 Social/Societal Medical Care Characteristics; Total Ecology Health Behaviors Genes and Biology 32  References:  Centers for Disease Control and Prevention (CDC). Introduction to Public Health. In: Public Health 101 Series. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2014. Available at: https://www.cdc.gov/training/publichealth101/public- health.html.  https://www.cdc.gov/violenceprevention/pdf/PH_App_Violence-a.pdf.  https://www.cdc.gov/publichealthgateway/publichealthservices/pdf/essential- phs.pdf. Online books:  National Academies of Sciences, Engineering, and Medicine. 2003. The Future of the Public's Health in the 21st Century. Washington, DC: The National Academies Press. https://doi.org/10.17226/10548.