mph toolkit 1: public health as a framework

upstream vs downstream

pop level

• root causes & systemic factors (sdoh)

individ level

• symptoms, behaviors, and acute treatments

healthy people 2030

• science-based 10-year national objectives for improving health and well-being

  • emphasizes addressing SDOH, eliminating health disparities, and achieving equity

  • guides policies, programs, and research

5 components of SDOH

• healthcare access & quality

• neighborhood & built environment

• social & community context

• economic stability

• education access & quality

social ecological model

• intrapersonal

  • knowledge, attitudes, & skills

• interpersonal

  • families, friends, & social networks

• organizational

  • orgs & social institutions

• community

  • relationship b/w orgs

• public policy

  • state/local laws & regulations

health belief model

• perceived susceptibility

• perceived severity

• perceived benefits

• perceived barriers

• cues to action

• self-efficacy

transtheoretical model

• precontemplation

• contemplation

• preparation

• action

• maintenance

• termination

social cognitive theory

• main 3: personal/cognitive factors, behavioral factors, & environmental factors

• reciprocal determinism

• behavioral capacity

• observational learning

• reinforcements

public health approach goal & 5 components

define drivers that influence health outcomes and act

• surveillance

  • what is the problem?

• risk factor identification

  • what is the cause?

• intervention evaluation

  • what works?

• implementation

  • how do you do it?

surveillance system of attacks in healthcare (SSA)

• global standardized & systemic approach to collecting data of attacks on health care

• system utilizes the same methodology across countries to address the knowledge gap of the extent & nature of attacks on health care.

3 main components & goal of 10 essential public health services

• main components: assessment, policy development, & assurance

• goal: equity

epidemiological transition & stages

• Abdel created idea that social transformations humanity has transitioned from a predominated infectious disease world to predominated chronic diseases

• Stage 1: age of pestilence (deadly disease) and famine (scarcity of food → starvation & malnutrition)

• Stage 2: receding pandemics

• Stage 3: degenerative (worsening conditions) and man-made diseases

• Additional stage: delay of disease until advanced age

• Additional stage: social upheaval (change in social norms/structure) and war leading to resurgence

Global Burden of Disease - GBD led by the Institute of Health Metrics and Evaluation metrics (4)

• DALYs (Disability-adjusted life years): sum of years of life lost (YLLs) due to premature mortality and years lived with disability (YLDs)

• YLLS (Years of life lost): due to early death

• YLDs (Years lived with disability): due to health conditions causing disability

• HALE (Healthy life expectancy: number of years a person can expect to live in good health

6 levers of behavior change

• Social influences

• Information

• Emotional appeals

• Rules and regulations

• Choice architecture

• Material incentives

Great Man Theory (Thomas Carlyle, mid-1800s)

• Leaders are born, not made; leadership is innate. 

  • Criticized for ignoring situational context; assumes only certain individuals can lead.

Trait Theory (Ralph Stogdill, 1930s)

• Successful leadership depends on certain personality traits.

  • Traits can also be learned; context matters; expanded on Great Man Theory.

Behavioral Theories (1940s)

• Leadership defined by roles and tasks rather than innate traits.

  • Shifted focus to observable behaviors; distinguished leadership from management.

Contingency Theories (1960s)

• Leadership is situational; no single best way to lead. 

  • Emphasized adaptability; highlighted importance of context.

Theory X and Theory Y (Douglas McGregor)

• Theory X→ workers lack motivation, need direction, respond to rewards/punishments

• Theory Y → workers are self-motivated, seek challenges, and want participation.

  • Stressed how managers’ assumptions shape leadership style and worker engagement.

Transactional Leadership

• Uses rewards/punishments; focuses on maintaining systems and compliance.

  • Limited focus on innovation or long-term change; effective for stability.

Transformational Leadership

• Inspires and empowers others to bring positive change; emphasizes vision and relationships.

  • Encourages innovation, intrinsic motivation, and shared purpose.

McKinsey 7S Framework (Peters & Waterman)

• Leadership as alignment of 7 interconnected elements: shared values, strategy, structure, systems, skills, style, staff.

  • Balanced “hard” and “soft” factors; applied in organizations and communities.

Astin Social Change Model:

• Leadership driven by 7 “Cs”: consciousness of self, congruence, commitment, collaboration, common purpose, controversy with civility, citizenship—all connected around change.

  • Highlights values-based, inclusive