Public Health: Chapter 1 - the Population Health Approach

public health

The science and art of preventing disease, prolonging life, and promoting health through organized community effort

traditional healthcare

individual treatment and clinical care after disease occurs

factors contributing to disease & wellness

• genetics/biology

• behavior

• social environment

• physical environment

• healthcare access

• policies & cultural factors

population changes over time

• aging

• migration

• urbanization

• fertility changes

aging health impact

increases chronic diseases

migration health impact

brings new diseases

urbanization health impact

raises risks of pollution, crowding, and lifestyle diseases 

fertility changes health impact

affects workforce size, demand for health services

population health

the health outcomes of groups and the distribution of those outcomes and determinants; focuses on communities and prevention rather than treating individuals

health protection era

antiquity-1830s; focus on authority-based control of behaviors (quarantine, prohibitions)

hygiene movement

1840-1870s; focus on sanitation and vital statistics (e.g., John Snow, Semmelweis)

contagion control era

1880-1940s; germ theory, vaccines, outbreak investigation

filling holes in medical care system

1950s-1980s; integration of risk factor modification and healthcare access (medicare/medicaid)

health promotion/disease prevention era

1980s-200; focus on individual behavior, screenings, AIDS epidemic

population health era

2000-present; systems thinking, globalization, evidence based strategies

direct cause of disease

a factor that directly produces disease (e.g., HIV → AIDS)

contributory cause of disease

a factor that increases likelihood but is not sufficient alone (e.g., smoking → lung cancer)

epidemiological transition

a shift from infectious/acute diseases to chronic/noncommunicable diseases as societies develop

demographic transition

shift from high birth/death rates to low birth/death rates, leading to aging populations

nutritional transition

shift from nutrient-deficient diets to processed diets high in fat, sugar, and salt; one way population change over time

built environment

human-made surroundings such as housing, roads, parks, and transportation

natural environment

air, water, climate, ecosystems, and naturally occurring resources

high-risk approach

prevention strategy targeting individuals/groups with the greatest risk 

improving the average approach

prevention strategy aiming to reduce risk across the entire population

BIG GEMS

determinants of disease: behavior, infections, genetics, geography, environment, medical care, socioeconomic-cultural

public health in daily life

clean water, sanitation, safe food, vaccines, disease prevention, rod safety, environmental protections

personal health

focuses on treating individuals