Public Health

Weekly Overview

Overview

Public health professionals promote healthy lifestyles by focusing on preventing disease and injury and prolonging life within their communities. Many of the tactics used to keep populations safe have been in place for centuries while new tactics have evolved due to numerous influencing factors. These unfluences have driven change in public health practices over the years at the national, state, and local levels. Public health careers are plentiful and fall into over ten major areas. All of these areas work dutifully to support millions globally.

What you will cover

1. Foundation of Public and Community Health

a. Define public health.

1) Personal perspective

a) Daily activities and behaviors taken for granted, yet have significant effects on limiting spread of disease

(1) Brushing teeth with chlorinated water

(2) Hand washing to prevent transfer of germs

(3) Plumbing and bathroom fixtures eliminating transmission of common bacterial diseases

(4) Prevention for dental disease, cleaning, flossing, and fluoridation of water

(5) Prevention for heart disease

(a) Diet

(b) Exercise

(c) Cholesterol lowering medications

(6) Food safety, including refrigeration

(7) Radiation safety: microwaves

(8) Highway safety: headlights, seatbelts, and drunk driving laws

b) Physical environment made safer from efforts of public health and available resources to support public health

(1) Air quality

(2) Smoke detectors

(3) Removal of asbestos

(4) Public safety roles: Centers for Disease Control and Prevention (CDC), public health department, and the Department of Homeland Security

2) Community perspective

a) Local focus: community health

(1) Economic perspective

(2) Risks: environmental, such as mining and industry

b) Geographical community: schools, churches, health care facilities, community centers, and economic perspective

c) Social and cultural effect

d) Genetics

3) Global perspective: effect of technology, communication, travel, and diverse communities, including the CDC as a resource for tracking

a) National

b) State

c) International

4) Society perspective

a) Vulnerable populations

(1) Disease: risk factors, including heredity, exercise, and eating habits

(2) Disability

(3) Special needs of elderly and children

b) Needs of society as a whole

(1) Health issues

(2) Shared concerns: violence and safety

5) Defining population health

b. Explain the historical development of public health.

1) Definition of community and public health over time: broader and more data- and evidence- based

a) Early definition

(1) Parents might state that public health is for the poor.

(2) Grandparents might state that public health is washing hands to prevent disease.

b) 20th-century definition: the science and art of preventing disease, prolonging life, and promoting health through organized effort

c) 21st-century definition: the totality of evidence-based public and private efforts that preserve and promote health and prevent disease, disability, and death

2) Influencing factors

a) Technology and science advances: computers, new treatment approaches, new medications, less invasive procedures, and new diagnostic tools

b) Sanitation: waste management, food processing, regulation, and prohibition

(1) Health protection: authority-based

(2) Hygiene movement: 1840-1870s

(3) Contagion control: Germ theory of 1880-1940s

c) Education: effect of media about disease, such as cigarettes and heart disease, and sexual practices

(1) Health promotion and disease prevention: 1980-2000

(2) Focus on behaviors

d) Evidence: research and data tracking

(1) Institute of Medicine (IOM) report

(2) Core public health functions: assessment, policy development, and assurance

(3) Surveillance: CDC

e) Disease management: vaccines and treatment options

(1) Discuss a disease treatment has changed over time: diabetes, heart disease, tuberculosis, and HIV

(a) Example: Case studies, research, surveys, and data collection have lead to such developments as angioplasty, stents, and open heart surgery. These developments increase survival rates for those suffering from heart disease. Patients suffering from heart disease before these developments often suffer from massive heart attacks and die suddenly.

(b) Diabetes is managed with diet and medications; new insulin pumps manage blood sugars better, limiting the damage done to a person’s vascular system from uncontrolled blood sugars.

(2) Some diseases have disappeared: polio

f) Focus on disease prevention

g) Care providers: physicians, hospitals, nurses, advanced practitioners, clinics, and emergency medicine

h) Population health: 21st century

(1) Coordination of public health and health care delivery

(2) Evidence-based systems thinking

3) Approaches to protect and promote health

4) Health care: systems for delivering care

a) One-on-one individual health services

b) Prevention, cure, palliation, and rehabilitation

5) Public health

a) Group- and community-based interventions

b) Health promotion and disease prevention

6) Social

a) Interventions with a non-health-related purpose

(a) Secondary effects on health

c. Describe the structure and function of public health at national, state, and local levels.

1) Health law, policy, and ethics

a) Health policies affect ways in which public health and health care are conducted. Health policy is a subset of public policy. This includes who makes the decision and what decision is made.

b) Three components

(1) Health care: access, quality, and cost

(2) Public health: population health and safety

(3) Bioethics: application of group and individual values and morals to controversial areas, such as end-of-life care and stem cell research

(a) Respect for persons

(b) Beneficence

(c) Justice

(d) Institutional review boards

c) Types of law

(1) Constitutional law

(2) Legislative statutes

(3) Administrative regulation

(4) Judicial law

d) Philosophies toward government

(1) Effect on health policies

(2) One fundamental difference in our society is the attitude or philosophy about the roles government and the economic market should play in advancing health.

e) Social justice: characteristics and implications

(1) Views health care as a social resource

(2) Requires active government involvement in health services delivery

(3) Assumes that the government is more efficient in allocating health resources

(4) Medical resource allocation determined by central planning

(5) Ability to pay inconsequential for receiving medical care

(6) Equal access to medical services viewed as a basic right

f) Market justice: characteristics and implications

(1) Views health care as an economic good

(2) Assumes free market conditions for health services delivery

(3) Assumes that markets are more efficient in allocating resources

(4) Production and distribution of health care determined by the market

(5) Medical care distribution based on people’s ability to pay

(6) Access to medical care viewed as economic reward for personal effort and achievement

g) Right to health care

(1) In 1948, a right to health care was incorporated into the Universal Declaration of Human Rights and the World Health Organization Constitution. Everyone has a right to a standard of living including health care.

(2) Limited rights to health care have been established by legislative action.

(a) Federal law includes the Emergency Medical Treatment and Active Labor Act; emergency care through emergency departments

(b) Limited to emergency conditions

(c) Balance between individual’s rights and society needs

2) Structure

a) National

(1) Governmental

(a) Department of Health and Human Services

(b) CDC

(c) National Institute of Health

(d) Food and Drug Administration

(e) Health Resources and Services Administration

(f) Agency for Health Research and Quality

(g) Substance Abuse and Mental Health Services Administration

(h) Indian Health Services

(2) Nongovernmental

(a) American Cancer Society

(b) American Red Cross

(3) Professional organizations

(a) Public health association

(b) Center for Public Health Systems & Services Research

b) State

(1) Public health departments or departments of health

(2) State chapters of nongovernmental health agencies, such as the American Heart Association

(3) State public health associations

c) Local

(1) City: county public health departments

(2) Community health centers

(3) Local chapters: nongovernmental agencies and professional organizations

d) Global

(1) World Health Organization: created in 1948

(a) United Nations International Children's Emergency Fund

(b) United Nations Joint Programme on HIV and AIDS

(c) U.S. Agency for International Development

(2) United Nations

(3) World Bank

3) Function

a) 10 essential public health services

(1) Assess.

(2) Diagnose and investigate health problems.

(3) Policy development: Inform, educate, and empower people about health issues.

(4) Mobilize community partnerships to identify and solve health problems.

(5) Develop policies and plans that support health efforts.

(6) Assurance: Enforce laws and regulations to protect health and ensure safety.

(7) Link people to health services.

(8) Ensure the provision of competent public and personal health workers.

(9) Evaluate the effectiveness, accessibility, and quality of personnel and population health-based services.

(10) IOM: Research new insights and innovative solutions for health problems.

b) How do government agencies work together?

(1) Collaboration

(2) Coordination

(3) Mobilization of efforts

c) National

(1) Governmental health needs

(2) Regulation

d) Nongovernmental

(1) Education

(2) Advocacy

(3) Health services

e) State

(1) Public health

(2) Safety

(3) Sets rules and regulations: immunization requirement for school entry

(4) Services: personal health, environmental health, health resources, and laboratories

f) Local

(1) Public health

(2) Prevention: safety

(3) Services: immunizations, sexually transmitted disease prevention, treatment and control, inspections, and testing

4) Funding

a) Taxes

b) Federal funding

c) Grants

d) Private donations

e) Licensing fees

5) Roles and responsibilities of national, state, and local agencies

a) National

(1) Repository of public health data: National Center for Health Statistics

(2) National initiatives: Healthy People

(3) Technical expertise and support: research

b) State

(1) Data collection

(2) Regulate public and community health

(3) Technical expertise and support

c) Local

(1) Treatment

(2) Education

(3) Investigation

(4) Safety net for the underserved

d. Identify careers within public health.

1) Public health systems are complex and require coordination of multiple organizations

a) Systems should strive to provide the ten essential services outlined by CDC

b) Diverse career options under the public health umbrella

2) Ten common areas of study

a) Biostatistics

b) Community Health

c) Epidemiology

d) Environmental Health

e) Global Health

f) Health Policy and Management

g) Health Communication and Promotion

h) Maternal and Child Health

i) Minority Health

j) Behavioral Health

3) Many career points

a) Public

(1) CDC

(2) State and local health departments

b) Non-profit

(1) American Cancer Society

(2) Consumer advocacy organizations

c) Academic

(1) Public health programs within universities/colleges

(2) Scientist, researchers

d) Private

(1) Medical facilities

(2) Social work

(3) Managed care organizations