Introduction to Public Health PDF

Introduction to public health  Cont… Health is the word health is widely used in public communication. Health is a highly subjective concept. Good health ✓different things to different people, ✓its meaning varies according to individual and community expectations and context. Peo...

Introduction to public health  Cont… Health is the word health is widely used in public communication. Health is a highly subjective concept. Good health ✓different things to different people, ✓its meaning varies according to individual and community expectations and context. People who have a disease or disability - see themselves as being in good health if they are able to manage their condition. Cont… Lay Point of view: Persons are healthy when they are doing their activities with no apparent symptoms of disease in them. The New oxford Dictionary of English describes health as ‘the state of being free from illness or injury.’ Professional points of view: health is defined as s a measure of the state of the physical bodily Organs, and the ability of the body as a whole to function. It refers to freedom from medically defined diseases. Cont… WHO definition: The world Health Organization described health in1948, in the preamble to its constitution, as “A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Recently this statement has been expanded to include the ability to lead a “socially and economically productive life.” Cont… Physical health- is concerned with 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. Cont.… Mental Health- is the ability to learn and think clearly and coherently. E.g. a person who is not mentally fit (retarded) could not learn something new at a pace in which an ordinary normal person learns. 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 and intimacy, etc.  Cont… Emotional health - is the ability of expressing emotions in the appropriate way, for example to fear, to be happy, and to be angry. The response of the body should be congruent with that of the stimuli. It also means maintaining one’s own integrity in the presence of stressful situation such as tension, depression and anxiety. Spiritual Health - Some people relate health with religion; for others it has to do with personal values, beliefs, principles and ways of achieving mental satisfaction, in which all are related to their spiritual wellbeing.  Different perspectives on health Health is viewed as ✓ a right ✓consumption good and ✓ an investment Cont…. The WHO constitution sates that “... the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”. It involves ensuring access to health care The government is seen as having a responsibility to ensure this and issue of equity in health and health care. Cont… Others view health as an important individual objective of material aspect of life i.e. as consumption good. The third view considers health as an investment, indicates health as an important prerequisite for development because of its consequence on the overall production through its effect on the productive ability of the productive force.  Determinants of Health Determinants of health are: ✓factors that relate to peoples’ health status ✓requirements or risk factors that determine health status ✓determinants interact in a complex way Health or ill health is the result of a combination of different factors. There are different perspectives in expressing the determinants of health of an individual or a community.  The health field concept perspectives According to the health field concept there are four major determinants of health A. Human Biology Every Human being is made of genes. In addition, there are factors, which are genetically transmitted from parents to offspring. As a result, there is a chance of transferring defective trait.  Cont… B. Environment: is all that which is external to the individual human host. Those are factors outside the human body. Environmental factors that could influence health include: a. Life support, food, water, air etc b. Physical factors, climate, Rain fall c. Biological factors: microorganisms, toxins, Biological waste etc. Cont… C. Life style (Behavior): is an action that has a specific frequency, duration, and purpose, whether conscious or unconscious. It is associated with practice. It is what we do and how we act. Life style of individuals affects their health directly or indirectly. For example: ✓ Cigarette smoking ✓Unsafe sexual practice ✓ Eating contaminated food Cont… D. Health care organization:- in terms of their resource in human power, equipments, money and so on determine the health of people. It is concerned with a. Availability of health service people living in areas where there is no access to health service are affected by health problems and Cont… have lower health status than those with accessible health services. b. Scarcity of Health Services leads to inefficient health service and resulting in poor quality of health status of people. c. Acceptability of the service by the community d. Accessibility : in terms of physical distance, finance etc Cont… Barriers to accessing health services: ✓Lack of availability ✓High cost ✓Lack of insurance coverage → ↓preventive care, delayed treatment ✓Limited language access e. Quality of care that mainly focuses on the comprehensiveness, continuity and integration of the health care.  Cont… The other view of the determinants of health is from the ecological perspective. Accordingly, there are four different factors affecting health. They are: ✓ Socio-cultural determinants ✓ Physical determinants ✓Behavioral determinants and ✓Community organization Definition of public health Public health is defined as the science and art of ✓preventing diseases ✓ prolonging life ✓promoting health and efficiencies through organized community effort.  Cont… It is concerned with the health of the whole population and the prevention of disease from which it suffers. It 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 Public health focuses on the health of populations within a specific geographic area  Cont… Health promotion is a guiding concept involving activities intended to enhance individual and community health well-being. It seeks to increase involvement and control of the individual and the community in their own health. It acts to improve health and social welfare, and to reduce specific determinants of diseases and risk factors that adversely affect the health, well-being, and productive capacities of an individual or society Cont… It is a key element in public health and is applicable in the community, clinics or hospitals, and in all other service settings. Raising awareness and informing people about health and lifestyle factors that might put them at risk requires teaching  Cont… The Elements of Health promotion comprises of :- 1. Addressing the population as a whole in health related issues , in every day life as well as people at risk for specific diseases: 2. Directing action to risk factors or causes of illness or death; 3. Undertaking activities approach to seek out and remedy risk factors in the community that adversely affect health; 4. Promoting factors that contribute to a better condition of health of the population;  Cont… 5. Initiating actions against health hazards ,including communication ,education, legislation ,fiscal measures, organizational change ,community development , and spontaneous local activities ; 6. Involving public participation in defining problems deciding on action; 7. Advocating relevant environmental ,health , and social policy ; 8. Encouraging health professionals’ participation in health education and health policy. Prevention Prevention is activities designed to protect members of publics from actual or potential health threats and their harmful consequences. refers to the goals of medicine that are to promote, to preserve, and to restore health when it is impaired, and to minimize suffering and distress. There are four levels of prevention:  Cont… Primordial prevention is a prevention of development of risk factors in population It consists of actions to minimize future hazards to health It focuses on inhibiting the establishment factors (environmental, economic, social, behavioral and cultural) known to increase the risks of disease It addresses broad health determinants rather than preventing specific disease e.g. governmental policy: increasing taxes on cigarettes Physical activities  Cont… Primary Prevention refers to those activities that are undertaken to prevent the disease and injury from occurring or beginning. It works with both the individual and the community. Actions taken prior to the onset of disease It may be directed at the host, to increase resistance to the agent (such as immunization or cessation of smoking), or May be directed at environmental activities to reduce conditions favorable to the vector for a biological agent, such as mosquito vectors of malaria. Cont… Secondary Prevention is the early diagnosis and prompt treatment to prevent complications from a disease. It mainly focuses on individuals are experiencing health problems and who are at risk for developing complications or worsen conditions This should limit disability, impairment or dependency and prevent more severe health problems developing in the future. It includes steps to isolate cases and treat or immunize contacts to prevent further epidemic outbreaks. Examples include screening for high blood pressure breast self-examination etc.  Cont… Tertiary Prevention involves activities directed at the host but also at the environment in order to promote rehabilitation, restoration, and maintenance of maximum function after the disease and its complications have stabilized. those preventive measures aimed at rehabilitation following significant illness. At this level health services workers can work to retrain, re-educate and rehabilitate people who have already developed an impairment or disability. Providing a wheelchair, special toilet facilities, doors, ramps, and transportation services for paraplegics are often the most vital factors for rehabilitation.  Aims of public health Prevent epidemics and spread of disease Protects against environmental hazards Prevents injuries Promotes and encourages healthy behaviors Responds to disasters and assists communities in recoveries Assures the quality and accessibility of health services Major discipline in Public health Nutrition. Epidemiology Reproductive health: Health Economics Environmental Health Biostatistics Health Education Health Service Management Research International health Deals with health across regional or national boundaries Health personnel/organizations from one area or nation providing direct health care, or health sector development, in another area or nation Branch of public health focusing on developing nations & foreign aid efforts by industrialized countries  Global Health The health of populations in a global context “Global health is the area of study, research & practice that places a priority on improving health & achieving equity in health for all people worldwide” Problems that transcend national borders or have a global political & economic impact are often emphasized Cont… It is an interdisciplinary field that seeks to improve the health and well-being of people worldwide. Global health is concerned with health issues that transcend national boundaries and affect people worldwide. It also acknowledges that health problems in one part of the world can have far-reaching effects on other parts of the world, and that addressing global health challenges requires collaboration and cooperation across national borders. Cont… Public health and Medicine/clinicalcare Cont… One Health is defined as a collaborative, multisectoral, and trans-disciplinary approach working at the local, regional, national, and global levels with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment (CDC). Three Core Functions of Public Health The three core functions of public health include ✓Assessment ✓ Policy development, and ✓Assurance Cont… Assessment-systematically collect, analyze, and make available information on healthy communities. It involves collecting and evaluating data to identify the health needs of populations. Public health professionals monitor health trends, identify health disparities and injustices, and identify health problems requiring intervention and resource support Cont… Policy development-Promote the use of a scientific knowledge base in policy and decision making. Public health professionals also develop policies or work with lawmakers to ensure policies support public health. Cont… Assurance-Ensure provision of services to those in need. Assurance is a core function that facilitates justice. When the full depth and breadth of public health services, encompassing everything from ensuring clean air to providing vaccines and empowering clients to participate in the policy process, is available to all clients, the public health system is actively working to ensure health is attainable for all.  Ten Essential Public Health Services The CDC has identified 10 essential Public Health Services that all communities should use to protect and promote health. They include: Cont… 1. Assess and monitor population health status, factors that influence health, and community needs and assets 2. Investigate, diagnose, and address health problems and hazards affecting the population Cont… 3. Communicate effectively to inform and educate people about health, factors that influence it, and how to improve it 4. Strengthen, support, and mobilize communities and partnerships to improve health  Cont.. 5. Create, champion, and implement policies, plans, and laws that impact health 6. Utilize legal and regulatory actions designed to improve and protect the public’s health 7. Ensure an effective system that enables equitable access to the individual services and care needed to be healthy Cont… 8. Build and support a diverse and skilled public health workforce 9. Improve and innovate public health functions through ongoing evaluation, research, and continuous quality improvement 10. Build and maintain a strong organizational infrastructure for public health Cont… Public health professionals use these essential services to address health issues and ultimately improve population health outcomes The 10 essential public health services do not expressly focus on health inequities and disparities; however, applying these principles to public health activities can help facilitate health justice across the population. The essential services align with the three core functions of public health.