Public Health 101 Series Introduction To Public Health

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Public Health 101 SeriesIntroduction to PublicHealthInstructor nameTitleOrganizationNote: This slide set is in the public domain and may be customized as needed bythe user for informational or educational purposes. Permission from the Centers forDisease Control and Prevention is not required, but citation of the source isappreciated.

Course TopicsIntroduction to Public Health1. Public Health Definition and Key Terms2. History of Public Health3. A Public Health Approach4. Core Functions and Essential Services of Public Health5. Stakeholder Roles in Public Health6. Determining and Influencing the Public’s Health2

Learning ObjectivesAfter this course, you will be able to describe the purpose of public healthdefine key terms used in public healthidentify prominent events in the history of public healthrecognize the core public health functions and servicesdescribe the role of different stakeholders in the field ofpublic healthlist some determinants of healthrecognize how individual determinants of health affectpopulation health3

Topic 1Public Health Definitionand Key Terms4

Public Health Defined“The science and art of preventingdisease, prolonging life, and promotinghealth through the organized effortsand informed choices of society,organizations, public and privatecommunities, and individuals.”—CEA WinslowPhoto: IF Fisher and EL FiskWinslow CEA. The untilled field of public health. Mod Med 1920;2:183–91.5

The Mission of Public Health“Fulfilling society’s interestin assuring conditions inwhich people can behealthy.”—Institute of Medicine“Public health aims toprovide maximum benefit forthe largest number ofpeople.”—World Health Organization6

Public Health Key Termsclinical care: prevention, treatment, and management of illness andthe preservation of mental and physical well-being through the servicesoffered by medical and allied health professions; also known as healthcare.determinant: factor that contributes to the generation of a trait.epidemic or outbreak: occurrence in a community or region of casesof an illness, specific health-related behavior, or other health-relatedevent clearly in excess of normal expectancy. Both terms are usedinterchangeably; however, epidemic usually refers to a largergeographic distribution of illness or health-related events.health outcome: result of a medical condition that directlyaffects the length or quality of a person’s life.Stedman TL, ed. Stedman’s medical dictionary. 28th ed. Baltimore, MD: Lippincott, Williams, and Wilkins; 2006.Farlex, Inc. The free dictionary. Huntingdon Valley, PA: Farlex, Inc.; 2014. Available at: http://www.thefreedictionary.com/.7

Knowledge CheckFill in the blank with the correct answer.A. groups of peopleB. individualsgroups of peoplePublic health aims to providewith the right to be healthy and live in conditionsthat support health.8

Knowledge CheckFill in the blank with the correct answer.A. pandemicB. interventionC. epidemic or outbreakD. preventionepidemic or outbreak is a diseaseA(n)occurrence among a population that is inexcess of what is expected for a given timeand place.9

Topic 2The History of Public Health10

Sanitation and Environmental Health500 BCE1840s1970Greeks and Romanspractice communitysanitation measuresThe Public HealthAct of 1848 wasestablished in theUnited KingdomThe EnvironmentalProtection Agencywas founded11

PandemicsInfluenzaPolioHIV500 million infectedworldwide in 1918Vaccine introducedin 1955; eradicationinitiative launched in198834 million living withHIV worldwide; 20%decline in newinfections since 200112

Preparedness for Disaster naPlague used as aweapon of war duringthe Siege of KaffaPublic healthsurveillanceconducted afterthe 9/11 attacksEmergency services,public healthsurveillance, anddisease treatmentprovided13

Prevention Through PolicyBookof LeviticusTobaccoLawsThe world’sfirst writtenhealth codeLaws banning smokingin public placesObesityFood labeling andpromotion of physicalactivity14

Knowledge CheckWhich of the following events in public health historyhave been pandemics? (Select all that apply)A. Siege of KaffaB. InfluenzaC. PolioD. Hurricane Katrina15

Topic 3A Public Health Approach16

A Public Health ApproachSurveillanceRisk tation17

Public Health Core Sciences18

Cholera — A Public Health ApproachCholera, a fatal intestinaldisease, was rampant duringthe early 1800s in London,causing death to tens ofthousands of people in thearea. Cholera wascommonly thought to becaused by bad air fromrotting organic matter.Photo: TJ Kirn, MJ Lafferty, CMP Sandoe, and R Taylor,Dartmouth Medical School19

John Snow, PhysicianJohn Snow is best known forhis work tracing the source ofthe cholera outbreak and isconsidered the father ofmodern epidemiology.Photo: London School of Hygieneand Tropical Medicine20

Epidemiology — What is the Problem?Cluster of Cholera Cases, London — 1854Image: The Geographical Journal21

Risk Factor Identification — What Is the Cause?Cluster of Cholera Cases and Pump Site LocationsImage: The Geographical Journal22

Intervention Evaluation — What Works?Through continuous research, Snow understood whatinterventions were required to stop exposure to the contaminated watersupply on a larger scale, andstop exposure to the entire supply ofcontaminated water in the area23

Implementation — How Do You Do It?John Snow’s research convincedthe British government that thesource of cholera was watercontaminated with sewagePhoto: Justin Cormack24

Knowledge CheckFill in the blanks with the correct answers.Each public health core science helps us toprotect andpromote the public’s health byproviding public health practitioners with theanswers they need.25

Knowledge CheckMatch each component of the public health approachwith the questions they answer.A. Risk Factor IdentificationB. SurveillanceC. ImplementationD. Intervention EvaluationB. Surveillance1. What is the problem?A. Risk Factor Identification2. What is the cause?D. Intervention Evaluation3. What works?C. Implementation4. How do you do it?26

Topic 4Core Functionsand Essential Servicesof Public Health27

Three Core Functions of Public HealthAssessmentSystematically collect, analyze,and make available informationon healthy communitiesPolicyDevelopmentPromote the use of a scientificknowledge base in policy anddecision makingAssuranceEnsure provision of services tothose in needInstitute of Medicine. The future of public health. Washington, DC: National Academies Press; 1988.28

Ten Essential Public Health Services1.2.3.4.5.6.7.8.9.10.Monitor HealthDiagnose and InvestigateInform, Educate, EmpowerMobilize Community PartnershipDevelop PoliciesEnforce LawsLink to/Provide CareAssure a Competent WorkforceEvaluateResearch29

Core Functions at Government LevelsPolicyDevelopmentAssuranceNational tobaccopublic healthsurveillanceSmoking banon commercialflightsFederal grantsfor antismokingresearchMonitor statetobacco useIncreasetobacco taxReport on localtobacco useCounty lawsprohibitingsmoking in barsAssessmentFederalStateLocalFundingfor campaignthroughProposition 99Resources to helpsmokers quitin multiplelanguages30

Knowledge CheckWhich of the following is NOT a core function of publichealth?A. AssuranceB. AssessmentC. AuthorityD. Policy development31

Knowledge CheckThe essential health services of monitoring health anddiagnosing and investigating disease relate to whichcore public health function?A. AssuranceB. AssessmentC. Policy Development32

Topic 5Stakeholder Rolesin Public Health33

Partners in the Public Health SystemCommunityGovernmentPublic HealthInfrastructureClinical CareDelivery SystemEnsuring the Conditionsfor Population HealthAcademiaEmployersand BusinessesThe MediaInstitute of Medicine. The future of the public's health in the 21st century. Washington, DC: The National Academies Press; 2002.34

Nongovernmental Organization ExamplesOrganization TypeExampleProfessional membershiporganizationsAmerican Public HealthAssociationAssociations related to aspecific health concernAmerican Cancer SocietyOrganizations of citizensfocused on health concernsAmericans for NonsmokersRightsFoundations that supporthealth projects and influencepublic policy developmentBill and Melinda GatesFoundationInstitute of Medicine. Who will keep the public healthy? Workshop summary. Washington, DC: The National Academies Press; 2003.35

Health Care as a Partner in Public HealthPublic HealthHealth CarePopulation focusIndividual patient focusPublic health ethicPersonal service ethicPrevention or publichealth emphasisDiagnosis and treatmentemphasisJoint laboratoryand field involvementJoint laboratoryand patient involvementClinical sciences peripheralto professional trainingClinical sciences essential toprofessional trainingPublic sector basisPrivate sector basis36

Other Partners in Public Health Vehicle for public discourseHealth education and promotionHealth communicationSocial media as catalystEmployersand Businesses Employer-sponsored health insuranceprogramsWellness initiatives and benefitsHealthy workplaces and communitiesGovernmentAgencies City planningEducationHealth in all policiesAcademia EducationTrainingResearchPublic ServiceMedia37

Knowledge CheckMatch each stakeholder to its role in public health.A. AcademiaC. GovernmentD. MediaC. GovernmentB. Employers and businessesD. Media1. Vehicle for public discourse2. Health in all policiesA. Academia3. Education and trainingB. Employers and businesses4. Wellness initiatives and benefits38

Topic 6Determining and Influencingthe Public’s Health39

Health Determinants Genes and biologyHealth behaviorsSocial or societalcharacteristicsHealth services or medicalcareCenters for Disease Control and Prevention. Social determinants of health. http://www.cdc.gov/socialdeterminants/FAQ.html.40

What Determines the Health of a Population?Genes and BiologySocial/SocietalCharacteristics;Total EcologyHealth BehaviorsMedical CareCenters for Disease Control and Prevention. Social determinants of health. http://www.cdc.gov/socialdeterminants/FAQ.html.41

Health Impact PyramidFrieden TR. Framework for public health action: the health impact pyramid. Am J Public Health 2010;100:590–5.42

Health Impact PyramidFrieden TR. Framework for public health action: the health impact pyramid. Am J Public Health 2010;100:590–5.43

Knowledge CheckList the four determinants of health.1.Genes and biology2.Health behaviors3.Social/societal characteristics4.Health services or medical care44

Knowledge CheckFill in the blanks using the followingchoices.A. downB. up1. As we move down the health impactpyramid, the public health impact growsgreater.2. As we move up the health impactpyramid, the amount of individual effortincreases.45

Public Health Core Sciences46

Course SummaryDuring this course, you learned to describe the purpose of public healthdefine key terms used in public healthidentify prominent events in the history of public healthrecognize the core public health functions and servicesdescribe the role of different stakeholders in the field ofpublic healthlist some determinants of healthrecognize how individual determinants of health affectpopulation health47

QUESTIONS?48

Resources and Additional Reading American public health Association (APHA). The Prevention and public health Fund: a criticalinvestment in our nation’s physical and fiscal health. APHA Center for Health Policy Issue Brief.Washington, DC: APHA; 2012. 2-838B1B0757D111C6/0/APHA PrevFundBrief June2012.pdf.California Department of public health. TabaccoFreeCA. http://www.Tobaccofreeca.org.Centers for Disease Control and Prevention. Key facts about seasonal flu m.Centers for Disease Control and Prevention. Overweight and ers for Disease Control and Prevention. Social determinants of tml.Centers for Medicare and Medicaid Services. National health expenditure projections: 2008–2018. xpendData/downloads/proj2008.pdf.Dean H. Introduction to public health, epidemiology, and surveillance. Presented at the CDCScience Ambassador Program, July 16, 2012.Frieden, TR. Framework for public health action: the health impact pyramid. Am J public health2010;100:590–5.Kindig D, Stoddart G. What is population health? Am J public health. 2003;93:380–3.Institute of Medicine. For the public’s health: investing in a healthier future. Washington, DC:National Academies Press; 2012.Institute of Medicine. Primary care and public health: exploring integration to improvepopulation health. Washington, DC: The National Academies Press; 2012.49

Resources and Additional Reading Institute of Medicine. The future of public health. Washington, DC: The National AcademiesPress; 1988.Institute of Medicine. The future of the public's health in the 21st century. Washington, DC: TheNational Academies Press; 2002.Institute of Medicine. Who will keep the public healthy? Workshop summary. Washington, DC:The National Academies Press; 2003.Pearl R. Tobacco smoking and longevity. Science 1938;87:216–7.Preamble to the Constitution of the World Health Organization as adopted by the InternationalHealth Conference, New York, June19–July 22, 1946.Federal Communications Commission. Texting while driving. IDS. UNAIDS World AIDS Day Report, assets/documents/epidemiology/2012/gr2012/JC2434 WorldAIDSday results en.pdf.Skelton A. Introduction to public health science and practice.” Presented at the CDC Steven M.Teutsch Prevention Effectiveness Fellowship Orientation, August 15, 2012.US Department of Health, Education, and Welfare. Smoking and health. Washington, DC: publichealth Service; 1964. inslow CEA. The untilled field of public health. Mod Med 1920;2:183–91.World Health Organization (WHO). World report on violence and health. Geneva: WHO; 2002.http://www.who.int/violence injury prevention/violence/world report/en/.50

DisclaimersLinks provided in this course to nonfederal organizations are provided solely as aservice to our users. These links do not constitute an endorsement of theseorganizations nor their programs by the Centers for Disease Control andPrevention (CDC) or the federal government, and none should be inferred. CDCis not responsible for the content contained at these sites.Use of trade names and commercial sources is for identification only and doesnot imply endorsement by the Division of Scientific Education and ProfessionalDevelopment, Center for Surveillance, Epidemiology, and Laboratory Services,Centers for Disease Control and Prevention, the Public Health Service, or the U.S.Department of Health and Human Services.The findings and conclusions in this course are those of the authors and do notnecessarily represent the official position of the Centers for Disease Control andPrevention.51

For more information, please contact the Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348Visit: http://www.cdc.gov Contact CDC at: 1-800-CDC-INFO or http://www.cdc.gov/infoThe findings and conclusions in this course are those of the authors and do not necessarily represent the official position of theCenters for Disease Control and Prevention.Center for Surveillance, Epidemiology, and Laboratory ServicesDivision of Scientific Education and Professional Development

The Mission of Public Health . 6 . SAY:\爀屲The Institute of Medicine states that the mission of public health is fulfilling society's interest in assuring conditi\൯ns in which people can be healthy.\爀屲Similarly, the World Health Organization stresses that public health aims to provide maxim對um benefit for the largest number of .

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