Week 1: Intro to Public Health & US Medical System

Public Health Definition

“The science and the art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community efforts…” - Winslow (1920)

“The art and science of preventing disease, prolonging life and promoting health through the organized efforts of society" - Acheson (1988)

Goal of Public Health

Make changes that can benefit the health of the population as a whole

3 Core Functions of Public Health

1. Assessment: public health agencies regularly collect data on population health, thru surveillance and epidemiological studies

2. Policy Development: public health agencies assist in public health policy; the plan/approach to preventing and reducing risk

3. Assurance: public health agencies ensure that services are available and accessible to all

6 Public Health Goals

1. Prevent epidemics and the spread of disease

2. Protect against environmental hazards (ex. storms, access to fresh food and water)

3. Prevent injuries (ex. helmets, seatbelts)

4. Promote and encourage healthy behaviors

5. Respond to disasters and assist communities in recovery

6. Assure the quality and accessibility of health services

10 Essential Public Health Services

1. Monitor health status to identify and solve community health problems

2. Diagnose and investigate health problems and health hazards in the community

3. Inform, educate, and empower people about health issues

4. Mobilize community partnerships and action to identify and solve health problems

5. Develop policies and plans that support individual and community health efforts

6. Enforce laws and regulations that protect health and ensure safety

7. Link people to needed personal health services and assure the provision of healthcare when otherwise unavailable

8. Assure competent and personal healthcare workforces

9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services

10. Research for new insights and innovative solution to health problems

6 Public Health Disciplines

1. Prevent epidemics and the spread of disease

2. Protect against environmental hazards

3. Prevent injuries

4. Promote and encourage healthy behaviors

5. Respond to disasters and assist communities in recovery

6. Assure the quality and accessibility of health services

Public Health vs. Medical Practice

Public Health

• Patient = Community

• Diagnosis w/ public health sciences

• Treatment Goal = Prevent disease and disability

Medical Practice

• Patient = Individual

• Diagnosis w/ medical testing

• Treatment Goal = Cure

4 Leading Factors that Drive People’s health

1. Social and Economic Environment (40%)

2. Health Behavior (30%)

3. Clinical Care (20%)

4. Physical Environment (10%)

• Living and Working Conditions:

  • Psychosocial factors

  • Employment status

  • Socioeconomic status

  • Natural and built environments

  • Public health services

  • Healthcare services

3 Levels of Prevention

1. Primary: prevent injury/illness; remove threat before disease occurs

2. Secondary: minimize the severity once it has occurred; find and treat

3. Tertiary: mitigate effects; minimize disability by providing care/rehab services; lessen the impact of big trauma, getting the patient back to baseline (normal)

Examples of Primary Prevention

• Vaccination

• Education

• Seatbelt

• Exercise

Examples of Secondary Prevention

• Anti-hypertensive medication

• Diabetes management

Examples of Tertiary Prevention

• Dialysis

• Surgery

• Rehab

Science vs. Politics

Science: How we understand threats to health, determine what interventions might work, and evaluate whether the interventions worked

• Assessment function

Politics is how we as a society make decisions about what policies to implement

• Part of both the policy development and assurance functions of public health

• Communities pay for public health initiatives/interventions with taxes

Downstream Approach to patient care

Focuses on immediate needs and consequences, dealing with the symptoms of a problem after it has occurred, like providing individual assistance or healthcare to those already affected

Upstream Approach to patient care

Focuses on root causes and prevention, aiming to prevent problems from occurring in the first place by addressing systemic issues, like policies or inequalities

6 Public Health Disciplines

1. Epidemiology

1. Statistics

2. Biomedical Sciences

1. Environmental Health Science

2. Social and Behavioral Science

3. Health Policy and Management

Epidemiology

• Focuses on identifying causes of diseases and health outcomes in populations rather than individuals

• Aims to control infectious disease spread and identify causes of chronic disease

Statistics

• Provides essential tools for analyzing population health data collected by government agencies

• Data serve as diagnostic indicators of community health and are crucial for calculating risks/benefits in both epidemiological research and clinical trials.

Biomedical Sciences

• Addresses disease mechanisms, particularly infectious diseases caused by pathogens

• Infectious disease control dominated early public health efforts (19th-20th centuries)

  • Biomedical research now also focuses on control of new diseases and noninfectious diseases (ex. chronic diseases, genetics)

Environmental Health Science

Examines how environmental factors impact health

• Air quality

• Water quality

• Solid and hazardous wastes

• Safe food and drugs

• Global environmental change

Social & Behavioral Sciences

• Recognizes behavior as a leading factor that affect people’s health, examining how social environments influence health behaviors

• Major health threats:

  • Tobacco

  • Poor diet

  • Physical inactivity

  • Injuries

Health Policy and Management

Evaluates the healthcare system's role in public health, addressing critical concerns

• Cost

• Efficiency

• Quality

• Equitable access to care

What of the following is considered the most impactful on a person’s health

Patient behavior

Which of the following is secondary prevention?

Antihypertensive medication