assignment
Reem F.
assignment.pptLearning Objectives
- Describe two historic pandemics
- Explain the Chain of Infection model
- Describe how U.S. public health is organized
- Explain how primary prevention reduces the spread of Covid-19
About me
- Major changes to my role due to Covid-19
- Teaching
- Research
- Service
About Public Health
- Public health as a movement
- Public health as a profession
- Public health as prevention
What is Public Health?
Chart1
| Protecting the public from disease |
| Government-provided healthcare system for the poor |
| Policies and programs that maintain healthy living conditions |
| Not sure |
Sheet1
| Column1 | |
| Protecting the public from disease | 16% |
| Government-provided healthcare system for the poor | 47% |
| Policies and programs that maintain healthy living conditions | 27% |
| Not sure | 10% |
| To resize chart data range, drag lower right corner of range. |
About Public Health
- “Public health is about what makes us sick, what keeps us healthy, and what we can do TOGETHER about it.”
- Richard Riegelman
- Successive re-definings of the unacceptable (Vickers, 1958)
About Public Health
- Fulfilling society’s interest in assuring conditions in which people can be healthy (Institute of Medicine, 1988)
What is Public Health?
- Ecological perspective of health
- Determinants of health: biologic, behavioral, social, cultural, environmental and their inter-relationships
- Public Health in America document
- Core functions and essential public health services
Federal vs. State
- U.S. Constitution: To promote the general welfare
- Reserve clause
- Interstate commerce clause
- Power to tax and spend
Federal Agencies
- Department of Health and Human Services (HHS)(www.hhs.gov)
- Alex Azar
Centers for Disease Control and Prevention
- Main epidemiologic and assessment agency for the nation
- Publishes Morbidity and Mortality Weekly Report (MMWR)
- Center for Health Statistics
President
- State of the Union
- Appointing justices
- First Lady/Man
- Appoints heads of agencies
- Defense, Energy, HHS, etc
- Executive orders
USDA
- Abe Lincoln
- Dietary Guidelines for Americans
- SNAP
- WIC
- National School Breakfast & Lunch Programs
- Regulates safety of meat, poultry
FDA
- Food labeling
- Safety of processed foods and beverages (milk and eggs)
- Vaccinations
State Health Departments
- Coordinate activities of local health agencies and provide funding
- Collect and analyze data
- Laboratory services
- License and certify medical personnel, facilities, and services
Local Public Health Agencies
- County and city health departments
- Day-to-day responsibility
- Medical care for the poor
- 10 Core public health functions
Who is Public Health?
- Public Health Workforce Interests and Needs Survey (PH WINS)
- 23,000 state and local public health workers
- First nationally representative sample
Who is Public Health?
- 72% female
- 48% over age 50 (average age 48)
- 70% White, 13% AA, 7% Hispanic, 5% Asian
- Average salary $55,000-$65,000
- 54% have over 10 years experience
- 38% plan to leave governmental PH by 2020
- 41% Enviro and Epi; 28% Admin; 15% Clinical
Surgeon General
- “Nation’s physician”
- Influential reports
About Public Health
Rome 150 BC
Aqueducts and sewers
About Public Health
The Middle Ages (450 AD – 1492 AD)
Public health declined to low levels
Disease and lack of sanitation were hallmarks
Community and personal hygiene were virtually nonexistent
About Public Health
- Bubonic plague swept through Europe in 1349-1354, killing 30% of the population (Black Death)
- People that fled the cities or lived in rural areas survived
- Quarantines were developed at the end of the first bubonic plague
- Quaranta giorni
About Public Health
Historic pandemics
Hong Kong Flu – 1968 (1 million)
H1N1 Swine Flu – 2009 (500,000)
HIV/AIDS – 1981 to present (32 million)
Chain of Infection
Courtesy of Henry Schneider.
Mosquitoes?
Sewage treatment?
Collect garbage?
Vaccinations?
Antibiotics?
Safe food?
Quarantine?
Isolation?
Fleas?
Condoms?
Boil water?
Question:
- How do we prevent Covid-19?
Levels of Prevention
- Primary – avoid the development of disease
- Secondary – early disease detection
- Tertiary – reduce morbidity
- Cost typically increases with level
Public Health Measures
About Public Health
About Public Health
History of Public Health
History of Public Health
- John Snow – cholera outbreaks in London, England 1854
Epidemiology
- Epidemiology is the study of the distribution and determinants of disease in human populations
Top 10 causes of death 1900
Pneumonia
Tuberculosis
Diarrhea
Heart disease
Stroke
Nephritis
Accidents
Cancer
Senility
Diphteria
Source: CDC - http://www.cdc.gov/nchs/data/dvs/lead1900_98.pdf
Top 10 causes of death (2017)
Heart disease (647,000)
Cancer (599,000)
Accidents (170,000)
Chronic lower respiratory disease (160,000)
Stroke (146,000)
Alzheimer’s (121,000)
Diabetes (83,000)
Influenza and Pneumonia (55,000)
Kidney disease (50,000)
Suicide (47,000)
Source: CDC
Top causes of death (2020)
Heart disease (?)
Cancer (?)
Covid-19 (~240,000)
Accidents (?)
Chronic lower respiratory disease (?)
Stroke (?)
Alzheimer’s (?)
Diabetes (?)
Influenza and Pneumonia (?)
Kidney disease (?)
Suicide (?)
About Public Health
- Public Health 1.0
- Late 19th century until 1950
- Sanitation
- Food/water safety
- Understanding infectious disease
About Public Health
- Public Health 2.0
- 1950 until 2012
- Shift to chronic disease
- Safety net care
- IOM report in 1988
About the Future
- Public Health 3.0
- The future of Public Health
- Focus on social determinants of health
- Chief health strategists
- Engage public and private stakeholders
- Accreditation
- Data sharing
- Funding
www.healthypeople.gov/2020/tools-resources/public-health-3
About the Future
- Single payer health care to improve access/quality
About the Future
- Constitutional amendment
- 13th
- 19th
- 27th
- Congress proposes; States ratify
- https://www.archives.gov/federal-register/constitution
About the Future
- 28th Amendment for Pandemic Response
- Who is in charge?
- How are resources deployed?
- Who is responsible?
- Limits of power
- Foreign policy
Learning Objectives
- Describe two historic pandemics
- Explain the Chain of Infection model
- Describe how U.S. public health is organized
- Explain how primary, secondary, and tertiary prevention works with Covid-19
Questions
- How has Covid-19 impacted you?
Opportunity
- What: APA webinar on Covid and alcohol use
- When: Tomorrow 1pm-3pm
- Where: Virtual https://register.gotowebinar.com/register/5368065765283714320
Opportunity
- What: MCACHE student article for newsletter
- When: Oct 16 from 11am-12:30pm
- Where: Virtual
- MCACHE also needs a student-at-large member
Thought experiment (if time permits)
- Mary’s Room
- Frank Jackson
