Lesson 1.1 Public Health Concepts

Health

state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity

successful defense

Health is the ________________________ of the host against forces tending to disturb body equilibrium.

Public Health

science and art of preventing disease, prolonging life, and promoting physical and mental health and efficiency through organized community efforts

overall health of a community

Public Health is concerned with threats to the ________________________ based on population health analysis.

Disease

failure of the body defense mechanism to cope with forces tending to disturb body equilibrium

Etiology

science of theory of the causes or origins of disease

Epidemiology

study of the distribution of disease and the factors that influence the occurrence of disease in groups of people

Pharmacoepidemiology

study of how drugs interact with human populations

drugs and their effects

Pharmacoepidemiology combines principles from both pharmacology (the study of a.____________________) and epidemiology (the study of the b.______________________________ in specified populations)

a = ?

distribution and determinants of health-related states or events

Pharmacoepidemiology combines principles from both pharmacology (the study of a.____________________) and epidemiology (the study of the b.______________________________ in specified populations)

b = ?

prevent

Objectives of Public Health:

• Focuses of a public health intervention is to a.__________ rather than treat a disease through b.________________ of cases and the c.___ of healthy behaviors.

a = ?

surveillance

Objectives of Public Health:

• Focuses of a public health intervention is to a.__________ rather than treat a disease through b.________________ of cases and the c.___ of healthy behaviors.

b = ?

promotion

Objectives of Public Health:

• Focuses of a public health intervention is to a.__________ rather than treat a disease through b.________________ of cases and the c.___ of healthy behaviors.

c = ?

Health Education according to Green et al. 1980

Any combination of learning experiences designed to facilitate voluntary adaptations of behavior conducive to health.

Health Education according to Green & Kreuter, 2005

Any planned combination of learning experiences designed to predispose, enable and reinforce voluntary behavior conducive to health in individuals, groups or communities.

Facipulation

application of facilitation techniques used in an attempt to manipulate a group towards a pre-determined outcome

Health Behavior according to WHO, 1998

Any activity undertaken by an individual regardless of actual or perceived health status, for the purpose of promoting, protecting or maintaining health, whether or not such behavior is objectively effective toward that end.

Participation

Health Education Strategies include:

a. ________________ of target population

b. capacity, resources, priorities, needs

c. ________________ learning activities

d. ________________ of programs

e. ________________ of information

f. _________________ of program staff

a = ?

Community needs assessment

Health Education Strategies include:

a. ________________ of target population

b. capacity, resources, priorities, needs

c. ________________ learning activities

d. ________________ of programs

e. ________________ of information

f. _________________ of program staff

b = ?

Planned

Health Education Strategies include:

a. ________________ of target population

b. capacity, resources, priorities, needs

c. ________________ learning activities

d. ________________ of programs

e. ________________ of information

f. _________________ of program staff

c = ?

Implementation

Health Education Strategies include:

a. ________________ of target population

b. capacity, resources, priorities, needs

c. ________________ learning activities

d. ________________ of programs

e. ________________ of information

f. _________________ of program staff

d = ?

Presentation

Health Education Strategies include:

a. ________________ of target population

b. capacity, resources, priorities, needs

c. ________________ learning activities

d. ________________ of programs

e. ________________ of information

f. _________________ of program staff

e = ?

Training

Health Education Strategies include:

a. ________________ of target population

b. capacity, resources, priorities, needs

c. ________________ learning activities

d. ________________ of programs

e. ________________ of information

f. _________________ of program staff

f = ?

Health Promotion

process of enabling people to increase control over, and to improve, their health (WHO, 1986)

Advocate

Health Promotion Strategies

• push for policies

Mediate

Health Promotion Strategies

• connect to different sectors

Enable

Health Promotion Strategies

• empower people

polluted water and lack of proper waste disposal

History of Public Health

• Early human civilization, it was recognized that ________________________ may spread vector-borne diseases.

attempted to regulate behavior

History of Public Health

• Early religions _____________________ that specifically related to health, from types of food eaten to the extent to which certain behaviors could be indulged, such as drinking alcohol or s exual relations.

public health policies and programs

History of Public Health

• The establishment of governments placed responsibility on leaders to develop __________________________ to gain some understanding of the causes of disease to ensure stability and prosperity.

Roman times

Early Public Health Interventions:

• By _____________________, it was well understood that proper diversion of human waste was a necessary tenet of public health in urban areas.

variolation

Early Public Health Interventions:

• Chinese developed the practice of _______ following a smallpox epidemic around 1000 BC

dried Crusts

Early Public Health Interventions:

• Variolation was done by inhaling the ________ that formed around the lesions of infected individuals

scratch

Early Public Health Interventions:

• children were protected by inoculating a a.________ on their forearms with the b.____ from a lesion.

• this practice was not documented in the West until the early c.____ and was used on a very limited basis.

a = ?

pus

Early Public Health Interventions:

• children were protected by inoculating a a.________ on their forearms with the b.____ from a lesion.

• this practice was not documented in the West until the early c.____ and was used on a very limited basis.

b = ?

1700s

Early Public Health Interventions:

• children were protected by inoculating a a.________ on their forearms with the b.____ from a lesion.

• this practice was not documented in the West until the early c.____ and was used on a very limited basis.

c = ?

vaccination

Early Public Health Interventions:

• The practice of a._________ did not become prevalent until the 1820s, following the work of b.____________ to treat smallpox

a = ?

Edward Jenner

Early Public Health Interventions:

• The practice of a._________ did not become prevalent until the 1820s, following the work of b.____________ to treat smallpox

b = ?

Black Death (Bubonic Plague)

Early Public Health Interventions

During the 14th century a.________________________ in Europe, it was believed that b._________________________________ would further prevent the spread of bacterial infection.

This did little to stem the plague, however, which was spread by rodent-borne fleas infected by the bacteria c._________________.

d._______________________ resulted in much greater benefits since it removed the rodent infestations.

The development of e.________ in the medieval period helped mitigate the effects of other infectious diseases

a = ?

removing the bodies of the dead

Early Public Health Interventions

• During the 14th century a.________________________ in Europe, it was believed that b._________________________________ would further prevent the spread of bacterial infection.

• This did little to stem the plague, however, which was spread by rodent-borne fleas infected by the bacteria c._________________.

• d._______________________ resulted in much greater benefits since it removed the rodent infestations.

• The development of e.________ in the medieval period helped mitigate the effects of other infectious diseases

b = ?

Yersinia pestis

Early Public Health Interventions

• During the 14th century a.________________________ in Europe, it was believed that b._________________________________ would further prevent the spread of bacterial infection.

• This did little to stem the plague, however, which was spread by rodent-borne fleas infected by the bacteria c._________________.

• d._______________________ resulted in much greater benefits since it removed the rodent infestations.

• The development of e.________ in the medieval period helped mitigate the effects of other infectious diseases

c = ?

Burning the areas of cities

Early Public Health Interventions

• During the 14th century a.________________________ in Europe, it was believed that b._________________________________ would further prevent the spread of bacterial infection.

• This did little to stem the plague, however, which was spread by rodent-borne fleas infected by the bacteria c._________________.

• d._______________________ resulted in much greater benefits since it removed the rodent infestations.

• The development of e.________ in the medieval period helped mitigate the effects of other infectious diseases

d = ?

quarantine

Early Public Health Interventions

• During the 14th century a.________________________ in Europe, it was believed that b._________________________________ would further prevent the spread of bacterial infection.

• This did little to stem the plague, however, which was spread by rodent-borne fleas infected by the bacteria c._________________.

• d._______________________ resulted in much greater benefits since it removed the rodent infestations.

• The development of e.________ in the medieval period helped mitigate the effects of other infectious diseases

e = ?

John Snow

Early Public Health Interventions

• Science of epidemiology was founded by a.____________’s identification of a b.__________________ as the cause of an c.________________ in London.

• Dr. Snow believed in the d.___________________ as opposed to the prevailing miasma theory

a = ?

polluted public water

Early Public Health Interventions

• Science of epidemiology was founded by a.____________’s identification of a b.__________________ as the cause of an c.________________ in London.

• Dr. Snow believed in the d.___________________ as opposed to the prevailing miasma theory

b = ?

1854 cholera outbreak

Early Public Health Interventions

• Science of epidemiology was founded by a.____________’s identification of a b.__________________ as the cause of an c.________________ in London.

• Dr. Snow believed in the d.___________________ as opposed to the prevailing miasma theory

c = ?

germ theory of disease

Early Public Health Interventions

• Science of epidemiology was founded by a.____________’s identification of a b.__________________ as the cause of an c.________________ in London.

• Dr. Snow believed in the d.___________________ as opposed to the prevailing miasma theory

d = ?

Miasma theory

Early Public Health Interventions:

• a.______________ taught correctly that disease is a result of b.__________, it was based only upon the prevailing theory of c.___________________.

a = ?

poor sanitation

Early Public Health Interventions:

• a.______________ taught correctly that disease is a result of b.__________, it was based only upon the prevailing theory of c.___________________.

b = ?

spontaneous generation

Early Public Health Interventions:

• a.______________ taught correctly that disease is a result of b.__________, it was based only upon the prevailing theory of c.___________________.

c = ?

1880s

Early Public Health Interventions:

• But the modern era of public health did not begin until the a.______, when the culmination of b.________________________________________________ revolutionized the study of infectious disease

a = ?

Robert Kock’s germ theory and Louis Pasteur’s production of artificial vaccines

Early Public Health Interventions:

• But the modern era of public health did not begin until the a.______, when the culmination of b.________________________________________________ revolutionized the study of infectious disease

b = ?

Michel Foucault

Early Public Health Interventions

• the plague model of governmentality (biopolitics) was opposed to the later cholera model

• Examining how governments exert control over population

cholera epidemic

Early Public Health Interventions

• Historical accounts of the a._________________ (2nd worst pandemic that devastated Europe between 1829 and 1851), was first fought by the use of what Foucault called “b._______________,” which focused on flux, circulation of air, location of cemeteries, etc.

• All those concerns, born of the miasma theory of disease, were thus mixed with c.______________ of the management of populations, which Foucault designed by the concepts of d.________.

a = ?

social medicine

Early Public Health Interventions

• Historical accounts of the a._________________ (2nd worst pandemic that devastated Europe between 1829 and 1851), was first fought by the use of what Foucault called “b._______________,” which focused on flux, circulation of air, location of cemeteries, etc.

• All those concerns, born of the miasma theory of disease, were thus mixed with c.______________ of the management of populations, which Foucault designed by the concepts of d.________.

b = ?

urbanistic concerns

Early Public Health Interventions

• Historical accounts of the a._________________ (2nd worst pandemic that devastated Europe between 1829 and 1851), was first fought by the use of what Foucault called “b._______________,” which focused on flux, circulation of air, location of cemeteries, etc.

• All those concerns, born of the miasma theory of disease, were thus mixed with c.______________ of the management of populations, which Foucault designed by the concepts of d.________.

c = ?

biopower

Early Public Health Interventions

• Historical accounts of the a._________________ (2nd worst pandemic that devastated Europe between 1829 and 1851), was first fought by the use of what Foucault called “b._______________,” which focused on flux, circulation of air, location of cemeteries, etc.

• All those concerns, born of the miasma theory of disease, were thus mixed with c.______________ of the management of populations, which Foucault designed by the concepts of d.________.

d = ?

chronic diseases such as cancer and heart disease

Modern Public Health:

• As the rate of infectious diseases in the developed world decreased through the 20th century, public health began to put more focus on ________________________.

average life span

Modern Public Health:

• During the 20th century, the dramatic increase in a.____________ is widely credited to b._______________________, such as vaccination programs and control of infectious diseases, better safety policies such as motor-vehicle and worker safety, improved family planning, fluoridation of drinking water, and programs designed to decrease chronic diseases such as heart disease and stroke

a = ?

public health achievements

Modern Public Health:

• During the 20th century, the dramatic increase in a.____________ is widely credited to b._______________________, such as vaccination programs and control of infectious diseases, better safety policies such as motor-vehicle and worker safety, improved family planning, fluoridation of drinking water, and programs designed to decrease chronic diseases such as heart disease and stroke

b = ?

malnutrition and poverty

Modern Public Health

a. Developing world remained plagued by largely preventable infectious diseases, exacerbated by _______________________

b. Front page headlines continue to present society with ________________ on daily basis.

c. Increase of childhood obesity and the concomitant increase in type II diabetes among children; impact of adolescent pregnancy; and the on-going social, economic and health disasters related to the 2005 tsunami and hurricane Katrina in 2006. These are all ________________________.

a = ?

public health issues

Modern Public Health

a. Developing world remained plagued by largely preventable infectious diseases, exacerbated by _______________________

b. Front page headlines continue to present society with ________________ on daily basis.

c. Increase of childhood obesity and the concomitant increase in type II diabetes among children; impact of adolescent pregnancy; and the on-going social, economic and health disasters related to the 2005 tsunami and hurricane Katrina in 2006. These are all ________________________.

b = ?

public health challenges

Modern Public Health

a. Developing world remained plagued by largely preventable infectious diseases, exacerbated by _______________________

b. Front page headlines continue to present society with ________________ on daily basis.

c. Increase of childhood obesity and the concomitant increase in type II diabetes among children; impact of adolescent pregnancy; and the on-going social, economic and health disasters related to the 2005 tsunami and hurricane Katrina in 2006. These are all ________________________.

c = ?

inequality, poverty and education

Modern Public Health:

a. Since the 1980s, the growing of population health has broadened the focus of public health from individual behaviors and risk factors to population-level issues such as _______________________________.

b. Concerned with addressing determinants of health across a population, rather than advocating for _________________________.

c. There is a recognition that our health is affected by many factors including where we live, genetics, our income, our educational status, and our social relationships – these are known as “_______________________”

a = ?

individual behavior change

Modern Public Health:

a. Since the 1980s, the growing of population health has broadened the focus of public health from individual behaviors and risk factors to population-level issues such as _______________________________.

b. Concerned with addressing determinants of health across a population, rather than advocating for _________________________.

c. There is a recognition that our health is affected by many factors including where we live, genetics, our income, our educational status, and our social relationships – these are known as “_______________________”

b = ?

social determinants of health

Modern Public Health:

a. Since the 1980s, the growing of population health has broadened the focus of public health from individual behaviors and risk factors to population-level issues such as _______________________________.

b. Concerned with addressing determinants of health across a population, rather than advocating for _________________________.

c. There is a recognition that our health is affected by many factors including where we live, genetics, our income, our educational status, and our social relationships – these are known as “_______________________”

c = ?

public health programs

Modern Public Health

a. Most government recognize the importance of __________________ in reducing the incidence of disease, disability and the effects of aging, although public health generally receives significantly less government funding compared with medicine

b. In recent years, public health programs providing ______________ have made incredible strides in promoting health, including the eradication of smallpox

c. Important public health issues: ?

a = ?

vaccinations

Modern Public Health

a. Most government recognize the importance of __________________ in reducing the incidence of disease, disability and the effects of aging, although public health generally receives significantly less government funding compared with medicine

b. In recent years, public health programs providing ______________ have made incredible strides in promoting health, including the eradication of smallpox

c. Important public health issues: ?

b = ?

HIV-AIDS, diabetes, smoking, infectious disease, etc.

Modern Public Health

a. Most government recognize the importance of __________________ in reducing the incidence of disease, disability and the effects of aging, although public health generally receives significantly less government funding compared with medicine

b. In recent years, public health programs providing ______________ have made incredible strides in promoting health, including the eradication of smallpox

c. Important public health issues: ?

c = ?

epidemics

Core Principles of Public Health:

a. Prevent _____________ and the spread of disease

b. Protect against ___________________

c. Prevent ___________

d. Promote and encourage __________________

e. Respond to ______________ and assist communities in recovery

f. Assure the quality and accessibility of ________________

a = ?

environmental hazard

Core Principles of Public Health:

a. Prevent _____________ and the spread of disease

b. Protect against ___________________

c. Prevent ___________

d. Promote and encourage __________________

e. Respond to ______________ and assist communities in recovery

f. Assure the quality and accessibility of ________________

b = ?

injuries

Core Principles of Public Health:

a. Prevent _____________ and the spread of disease

b. Protect against ___________________

c. Prevent ___________

d. Promote and encourage __________________

e. Respond to ______________ and assist communities in recovery

f. Assure the quality and accessibility of ________________

c = ?

healthy behaviors

Core Principles of Public Health:

a. Prevent _____________ and the spread of disease

b. Protect against ___________________

c. Prevent ___________

d. Promote and encourage __________________

e. Respond to ______________ and assist communities in recovery

f. Assure the quality and accessibility of ________________

d = ?

disasters

Core Principles of Public Health:

a. Prevent _____________ and the spread of disease

b. Protect against ___________________

c. Prevent ___________

d. Promote and encourage __________________

e. Respond to ______________ and assist communities in recovery

f. Assure the quality and accessibility of ________________

e = ?

health services

Core Principles of Public Health:

a. Prevent _____________ and the spread of disease

b. Protect against ___________________

c. Prevent ___________

d. Promote and encourage __________________

e. Respond to ______________ and assist communities in recovery

f. Assure the quality and accessibility of ________________

f = ?

population

Primary focus of Public Health

individual

primary focus of medicine

prevention, health promotion, and the whole community

Emphasis of public health

diagnosis, treatment, and the whole patient

Emphasis of Medicine

Intervention aimed at environment, human behavior & lifestyle, Medical care

Paradigm of Public Health

Medical Care

Paradigm of Medicine

Organizational lines of specialization of Public Health

Analytical (epidemiology), Setting & populations (occupational health), Substantive health program, Skills in assessment, policy, development and assurance

Organs, Patient Group, Etiology, Pathophysiology, and Technical Skills

Organizational lines of specialization of Medicine

Excellent > Fairly well > Those feeling under par > Those definitely ill

Spectrum of Health