WHAT IS PUBLIC HEALTH? Allyson Hall, PhD Department of Health Services Research, Management, and...
-
date post
19-Dec-2015 -
Category
Documents
-
view
213 -
download
0
Transcript of WHAT IS PUBLIC HEALTH? Allyson Hall, PhD Department of Health Services Research, Management, and...
WHAT IS PUBLIC HEALTH?
Allyson Hall, PhD
Department of Health Services Research, Management, and Policy
College of Public Health and Health Professions
WHO’s Definition of Health
HEALTH IS A STATE OF COMPLETE
PHYSICAL, MENTAL AND SOCIAL
WELL-BEING, AND NOT MERELY
THE ABSENCE OF DISEASE OR
INFIRMITY
WHO, http://www.who.int/about/definition/en/print.html
An Ecological Model of Health
An Ecological Model: multiple determinants of health linkages and relationships among
determinants are emphasized
Source: Institute of Medicine, 2003
Determinants of Population Health: The Ecological Model
• Psychosocial factors
• Employment status and occupational factors
• Socioeconomic status
• Natural and built environments
• Public health and health care services
Assumptions about Public Health
Public health problems are multi-causal
Personal, group and population ‘behaviors’ are related to public health problems
Behaviors are influenced by a wide range of factors
Public Health September 10, 2007
Definition
Public health is what we, as a society, do collectively to assure the conditions in which people can be healthy.
Health Promotion and PreventionRecognized as a means to meet public
health objectives and improve public health interventions
Concerned with : Changing individuals and groups
behavior Improving their social environment
Health Promotion and Health Behavior Research and Practice Strives to:
Help people adopt new behaviors
Help people cease old behaviors
Reinforce healthy behavior Ensure a supportive and
healthy environment
Measles
TB
Pneumonia
Diphtheria
Scarlet Fever
Typhoid
Influenza
Whooping Cough
Polio
The Fall in the Standardized Death Rate (per 1,000) for Nine Common Infectious Diseases in Relation to Specific Medical Measures, US 1900-1973
Source: McKinlay and McKinlay, 1977
Source: Centers for Disease Control and Prevention MMWR, 1999
Motor-vehicle related deaths per 100,000 population and per 100 million vehicle miles traveled
Ten Great Public Health Achievements – United States, 1900-1999
Control of infectious disease
Vaccination Motor-vehicle
safety Safer workplaces Declines in death
from coronary heart disease and stroke
Safer and healthier food
Healthier mothers and babies
Family planning Fluoridation of
drinking water Recognition of
tobacco as health hazard
Centers for Disease Control and Prevention, MMWR, 1999
The Essential Public Health Services
1. Monitor health status to identify community health problems.2. Diagnose and investigate health problems and health hazards in the
community3. Inform, educate and empower people about health issues4. Mobilize community partnerships to identify and solve health
problems5. Develop policies and plans that support individual and community
health efforts6. Enforce laws and regulations that protect health and ensure safety7. Link people to needed personal health services and assure the
provision of health care when otherwise unavailable8. Assure a competent public health and personal health care
workforce9. Evaluate effectiveness, accessibility, and quality of personal and
population-based health services10. Research for new insights and innovative solution to health problems
Source: Public Health Function Steering Committee
In a nutshell….
Public Health Science
• Defines the problem (the who)
• Identifies risk factors for the disease (the why)
• Develops and implements interventions
• Measures effectiveness
Assessment
Policy Development
& Program Implementation
Assurance
Core Public Health Areas
• Epidemiology
• Biostatistics
• Environmental Health
• Health Services Administration/Health Policy
• Social and Behavioral Sciences
The Public Health System
CommunityHealth care
delivery system
Employers & Business
Governmental Public Health Infrastructure
Academics The Media
Assuring the Conditions for Population Health
Source: Institute of Medicine, 2002
The Government Public Health Infrastructure
• Local Health Departments
• State Health Departments
• Department of Health and Human Services
• Centers for Disease Control and Prevention
• National Institutes of Health
• Health Resources and Services Administration
• Food and Drug Administration
Jobs in Public Health
Health educatorEpidemiologistHealth policy analystCommunity organizer/activist/advocatePublic health department directorOccupational health and safety expertFood safety expertPublic health lawyer
Leading Causes of Death for Males by Race and Hispanic Origin, United States 2001
All Races White Black Hispanic
All Ages Diseases of the heart
Diseases of the heart
Diseases of the heart
Diseases of the heart
1-14 Accidents Accidents Accidents Accidents
15-19 Accidents Accidents Homicide Accidents
20-24 Accidents Accidents Homicide Accidents
25-34 Accidents Accidents Homicide Accidents
35-44 Accidents Accidents Diseases of the heart
Accidents
45-54 Diseases of the heart
Diseases of the heart
Diseases of the heart
Diseases of the heart
55-64 Cancer Cancer Cancer Cancer
65+ Diseases of the heart
Diseases of the heart
Diseases of the heart
Diseases of the heart
Source: National Center for Health Statistics, Health United States, 2003
Actual Causes of Death in the United States, 2000
Tobacco
Poor Diet/Physical InactivAity
Alcohol Consumption
Microbial agents
Toxic Agents
Motor Vehicles
Firearms
Sexual Behavior
Illicit Drug Use
0
5
10
15
20 1817
4 3 2 2 1 1 1
Source: Mokdad et al, 2004
Percent of all deaths
Percent Adult Current Smokers*, by selected characteristics: United States 1999-2001
18-24 25-44 45-64 65-74 75+ Below Poverty
>= to <2 times
poverty
>=2-<4 times
poverty
< 4 times poverty
0
5
10
15
20
25
30
35
27 2724
13
6
3229
26
18
Source: National Center for Health Statistics, Health United States, 2003
*Smoked at least 100 cigarettes in lifetime and currently smokes
Percent of Women Who Are Overweight*, by Selected Characteristics: United States 1999-2001
18-24 25-44 45-64 65-74 75+ Below Poverty
>= to <2 times
poverty
>=2-<4 times
poverty
< 4 times poverty
0
10
20
30
40
50
60
70
33
46
59 59
47
56 5551
43
Source: National Center for Health Statistics, Health United States, 2003
*BMI greater than or equal to 25