Public Health

herd immunity

resistance of population based on immunity of high proportion of individuals

Shen Nung

drug therapy and acupuncture, theory of yin and yang

eye of horus

basis for Rx; represents instructions on how prescribed meds should be used

Imhotep

true father of medicine, wrote extensive medical texts and architect of pyramids

Hippocrates

father of medicine, took logical approach to medicine; hippocratic oath

da Vinci

anatomical drawings based on dissection

Fricastoro

diseases are caused by invisible seeds that penetrate and multiply in body

Galileo

invented telescope, used two lenses

medicare

payment of medical bills for elderly and disabled

medicaid

payment of medical bills for low income individuals

governmental health organizations

funded by tax dollars, managed by government officials, authority over geographical area

examples of government health organizations

WHO, Department of Health and Human Services, FDA, Medicare and Medicaid, WSCC model

quasi-governmental

operate independently of government supervision, some funding

Red cross

established by Clara Barton; provide relief during disasters, liaison between members of armed forces and families, blood drives

Babylon

Hammurabi code of law; prevent defrauding of helpless, medical fees spelled out, doctors penalized for complications

Egypt

water drainage, physicians keep records, papyrus ebers, mummifying, eye of horus

Greece

community sanitation, running water

Rome

incorporated Greek practices, hospitals for public, physicians do dissections and autopsies, public and private baths, healthcare for poor

middle ages

fall of Rome and loss of medical knowledge, spiritual era, movement of people

renaissance

diseases are environmental, greater understanding of signs and symptoms

Kircher

connected microorganisms in blood with disease

world health organization

largest world health related international agency in Geneva

Department of health and human services

primary organization in US responsible for health and welfare of citizens

Food and Drug Administration

protects public health by monitoring food and drug; safety, efficacy, security

quasi-governmental

operate independently of government supervision with some funding

nongovernmental

funded by private donations or memberships

Pasteur

demonstrated pathogenesis, developed vaccines, pasteurization in milk; germ theory

Koch

bacilli for anthrax, cholera, TB; germ theory

Centers for disease control and prevention

nation’s premiere health promotion, prevention, and preparedness agency; preparedness, promotion and prevention, healthy places

incidence rate

number of new cases divided by population at risk

attack rate

number of cases divided by number of cases + well times 100

prevalence rate

number of new and old cases at given time divided by population

John Snow

investigated cholera outbreak; germ theory

mortality

most reliable measure of population health status

life expectancy

average number of years a person is projected to live

years of potential life lost

life expectancy - age of death

disability adjusted life years

measures burden of disease, 1 = one year lost of healthy life

health adjusted life expectancy

number of years of healthy life expected on average

secondary data

data collected by someone else for a different purpose

descriptive studies

describe epidemics with respect to person, place, time

analytical studies

aimed at testing hypotheses

observational

observe natural course events, noting exposure and disease development

experimental

investigator allocates exposure and follows development of disease

secular curves

illustrate changes in disease over years

seasonal curves

illustrate cyclical changes in disease

single epidemic curves

used to calculate incubation period

point source epidemic curve

shows exposure at single point

continuous source epidemic curve

exposure is constant or intermittent

propagated epidemic curve

primary cases followed by secondary and tertiary cases

acute

disease in which peak severity occurs and subsides within 3 months

chronic

disease in which peak severity of symptoms continue past 3 months

communicable

illness that can be transmitted from an infected person or animal

non-communicable

disease cannot be transmitted

communicable disease model

host - environment - agent

chain of infection

pathogen → reservoir → portal of exit → transmission → portal of entry → establishment of infection

primary prevention

prevent onset of illness

active immunity

exposure prompts body to create antibodies

passive immunity

vaccine provides antibodies

secondary prevention

early diagnosis and prompt treatment

tertiary prevention

retrain, reeducate, rehabilitate

Environmental Protection Agency

regulates contaminants, sanitary surveys; water and air quality

thermal inversion

warm air holds down cold air near valley floor, causing accumulation of pollution

point source pollution

pollution traced to single source

nonpoint source

occurs through runoff, seepage, or falling of pollutants

coagulation

addition of chemicals that cause solids to clump

flocculation

water stands so solids fall to bottom

filtration

water passes through filters

disinfection

addition of chlorine or ozone to kill microbes

75% US households

municipal water treatment

primary water treatment

mechanical process - separation of fluids and solids

secondary water treatment

biological process - promote bacterial growth

tertiary water treatment

filtration, measurement, disinfection, discharge into surface water

clean water act

first comprehensive water quality law - water swimmable and fishable

Safe Drinking Water act

EPA sets max contaminant levels, MCLs categorized by risk level

resource conservation and recovery act

strict controls over treatment, storage, disposal

landfills

must have layer of clay or plastic to prevent leachates from entering ground water

CERCLA 80

superfund that cleans up contaminated sites