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CEA Winslow
science and art of preventing disease, prolonging life, and promoting health through the organized efforts of society
Sir Vickers
The landmarks of political, economic, and social history are the moments when some condition passed through category of the intolerable aka things where we initially didn't understand the impact. Examples: drinking while pregnant, smoking, vaping, etc.
institute of medicine
"Fulfilling society's interest in assuring conditions in which people can be healthy."
World Health Organization
Public health aims to provide max benefit for the largest number of people
major achievements from 1990-1999 and examples
1. vaccinations- smallpox vaccine, tetanus
2. motor vehicle safety. Ex: Young drivers and passengers, alcohol impaired drivers, safety belts, child safety and booster seats
3. safer workplaces. Ex: OSHA, electrocutions, etc
4. control of infectious diseases
5. coronary heart disease and stroke ex: healthier diet, exercise,
6. safer and healthier foods. Decreases microbial contamination, increased nutritional content, ability to preserve perishable foods, pasteurization, identification of food borne pathogens
7. healthier mothers and babies. Ex: infant mortality rate decrease, average family size decrease
8. Family planning. average family size decrease
9. recognition of tobacco use as a health hazard
Ten Great Public Health Achievements --- United States, 2001--2010
• Vaccine-Preventable Diseases
• Prevention and Control of Infectious Diseases
• Tobacco Control
• Maternal and Infant Health
• Motor Vehicle Safety
• Cardiovascular Disease Prevention
• Occupational Safety• Cancer Prevention
• Childhood Lead Poisoning Prevention
• Public Health Preparedness and Response
Life expectancy has ___________________ to an additional _________ years since 1990. ________________ of those years were due to __________________
improved;30
25; public health
Sections of public health
-biostatistics
-environmental health
-occupational health
-epidemiology
-health policy and management
-health promotion and community health sciences
Unique features of public health
- social justice
- political nature
- dynamic agenda
- link with government
- science
- prevention
- culture
Core Functions of Public Health
assessment, policy development, assurance
essential services of public health
-assess and monitor public health
- investigate, diagnose, and address health hazards and root causes
- communicate effectively to inform and educate
- strengthen, support, and mobilize communities and partnerships
- create champions, and implement policies, laws, and plans
- utilize legal and regulatory actions
- enable equitable access
-build a diverse and skilled workforce
- improve and innovate through evaluation, research, and quality improvement
- build and maintain a strong organizational infrastructure for public health
What essential services are under the core function of assessment?
-Asses and monitor population health
-investigate, diagnose, and address health hazards and root causes
What essential services are under the core function of policy development?
-communicate effectively to inform and educate
-strengthen, support, and mobilize communities and partnerships
-create, champion, and implement policies, plans, and laws
-utilize legal and regulatory actions
what essential services are under the core functions of assurance?
-enable equitable access
-build a diverse and skilled workforce
-improve and innovate through evaluation, research, and quality improvement
-build and maintain a strong organizational infrastructure for public health
What is an example of assess and monitor population health?
a report on influenza activity levels
what is an example of diagnose, investigate, and address, health problems?
covid test
What is an example of communicating effectively to inform and educate?
Hand washing infographics or things you can do to fight the flu
what is an example of strengthen, support, and mobilize community partnerships?
drive through flu vaccine clinic
what is an example of create, champion, and implement policies, plans, and laws?
Mandatory flu vaccination
What is an example of utilize and regulatory actions?
if you don't flu vaccine, you could be placed on suspension
What is an example of enable equitable access?
Free vaccine clinic
what is an example of build a diverse and skilled workforce?
having people from different backgrounds who are all qualified and trained for the job
what is an example of improve and innovate through ongoing evaluation, research, and continuous quality improvement?
Primary-aged children are given nasal spray vaccine instead of shot vaccine
what is an example of building and maintaining a strong organizational infrastructure?
specified divisions of Brazos County Health District that focus on a certain population or topic
leading causes of death in 1900
pneumonia, influenza, bronchitis, tuberculosis, diarrhea
leading causes of death in 1930
1. heart disease
2. pneumonia, influenza, bronchitis
3. cancer
4. Nephritis
leading causes of death in 1970
1. heart disease
2. malignant neoplasm
3. cerebrovascular diseases
4. influenza/pneumonia/bronchitis
5. accidents (not motor vehicle) and suicide
leading causes of death in 2007
1. heart disease
2. malignant neoplasm
3. cerebrovascular disease
4. chronic lower respiratory infections
5. accidents/unintentional injuries
leading causes of death in in 2015
1. Heart disease
2. malignant neoplasm
3. chronic lower respiratory disease
4. accidents/unintentional injuries
5. cerebrovascular diseases
trends in leading causes of death over history
-heart disease became prevalent in 1930 to current
-went from primarily infectious disease to non communicable diseases
what are the stages of the epidemiological transistion?
Pre: pestilence and famine
Early: receding pandemics
late: degenerative and man-made diseases
post: delayed degenerative disease and emerging infections
What stage of the epidemiological transition is the US in right now?
the fourth stage: delayed degenerative diseases and emerging infections
leading cause of death for ages 1-44
unintentional injuries
leading cause of death for ages 45-64
malignant neoplasms
leading cause of death for 65+
heart disease
Are males or females more likely to have heart disease and malignant neoplasms?
males
leading cause of death in Asian people
malignant neoplasms
leading cause of death in Native Americans
diseases of the heart
leading cause of death in Black and African American people
malignant neoplasms
leaidng cause of death in white and non hispanic people
diseases of the heart
Heart disease is more common in the ____________________
south
Cancer is more common in the _____________________
south
ecological fallacy
Occurs when inferences or conclusions are made at the individual level based on relationships observed at the group level
aggregation fallacy
Occurs when inferences or conclusions are made at the group level based on relationships observed at the individual level
What are the tow largest population health drivers?
social and economic factors and health behaviors
________ _______________ has a greater impact on your health than ______________ ____________
zip code; genetic code
Determinants of population health from inside to outside
1. biology of disease
2. individual behavior
3. social, family, and community networks
4. living and working conditions
5. social, economic, cultural, health, and environmental conditions
reasons for epidemiolocal transition
-improved living conditions
-changes in socioeconomics, culture, and politics
-changes in the relationship between the agent, host, and environment
-advances in medicine?
Stage 1 of Epidemiological Transition example
infectious and parasitic diseases
black plague
accidents and animal attacks
Stage 2 of Epidemiological Transition example
More medicine, sanitation, nutrition, etc.
Stage 3 of Epidemiological Transition example
heart disease, cancer, diabetes
Stage 4 of Epidemiological Transition example
people still get cancer, heart disease, etc., but they occur later on in life
What are the determinants of health?
biological
environmental
behavioral
socioeconomic
What re biological determinants of health?
age
sex- longevity, hormones, reproduction, and susceptibility or protective factors related to certain diseases
genetics
What are the behavioral determinants of health?
· Tobacco
· Alcohol consumption
· Use of illicit drugs
· Physical activity
· Dietary behavior
· Sexual practices
Socioeconomic Determinants of Health
· education
· income and wealth
· Employment
· Housing and neighborhood
What are the environmental determinants of health?
Physcial
built
What is involved with physical environmental determinants of health?
- Outdoor air quality
- Water quality
- Toxic substances
- Hazardous waste
- Climate
- Water shortage
- Extreme weather events
- Natural disasters
-Natural pollution
- Seepage
- Fires
-Vog (volcanic fog)
- Anthropogenic pollution
-Energy production and use
- Cars
-Effluent
What is involved with built environmental determinants of health?
-Homes
- Indoor air pollution
-Structural soundness
- Lead based paints
- Community and infrastructure
- Sanitation
- Transportation
- Green spaces
- Food access
Sociological framework (SEF) from inside circle to outside
individual
interpersonal
institutional/organizational
community
social structure, policies, and systems
Step in and stand up against sexual violence is what type of SEF and why
- organizational bc it Is implemented at an organizational level
VEO rides is what type of SEF and why?
- Individual - one person can ride at a time and you are not required to do it, it is your choice
Walk across texas is an example of what kind of SEF and why
- Community- involved with counties and purpose is to get communities moving
- institutional/organizational
How is "cross or loop the lone star state" linked to SEF and determinants of health
· individual or interpersonal- person can decide to do it with themselves or with group
· Organizational- organization put thing in place
· Physical Environmental- weather could cause people to not go cycle
· Built environment- if city has safe bike environment
· Biological- some cant ride long distances, asthma
· Socioeconomic- cost to pay for bike
How is a sound playing when someone throws their trash away linked to SEF and determinants of health?
· Community- keep community clean which relates to environmental
· You cant just go put trashcan in community- has to be implemented
Interpersonal- people were in groups
Who does responsibility for health go to?
the state who has the responsibility to ensure health and a lot of the work happens in the government. A lot of services are given on a local level because states can vary in needs in different areas. State is responsible and local areas deliver.
What is a part of the federal government infrastructure?
-policy making
-financing
-public health promotion and collection and dissemination of information
-capacity building
-direct management of services
-Health and Human services
what are examples of health and human services that are a part of the government>
CDC and FDA
What is a part of state governmental infrastructure?
-mental health
-substance abuse
-Medicaid
-long term care
-environmental protection
-public assistance
-mental health with and without substance abuse
What is included in local governmental infrastructure?
· Immunizations
· Obesity prevention
· Maternal and child health
· Diabetes screening
· Blood lead screening
· Epidemiology and surveillance
· Emergency preparedness
· High blood pressure screening
· Communicable disease screening, including food safety
What are the different types of agencies?
-county
-city
-city county
-townships
-multicounty
The type of agency is decided based on _____________________________________
the needs of that area
What are the different governance types?
-centralized
-decentralized
-mixed/shared
What type of governance is texas?
decentralized
centralized governance
controlled at state level; state
decentralized governance
controlled at local level
Texas is ____________ decentralized. What does this mean?
largely; this means that not every county in Texas has a health department and that health departments are concentrated in more populated areas.
How many counties are in Texas?
254 but notes say 250
Big populations have more __________________ in positions in health departments
diversity
Do larger populations have specialized or standard positions and why?
specialized because they have a larger population and more people to serve
Smaller populations have more ___________________ positions in health departments
standardized
What happens when people retire?
We lose institutional knowledge
What is something that this generation has a better understanding of than older generations?
technology
informational resources
How we work with information and the current level of activity in technology information systems
True/ false: Informational resources are getting more and more efficient.
true
communication channels
how we get information out
what are examples of communication channels?
Print media, broadcast news, fax, facebook, email, etc are highest for how we get out info during emergency response
Most fiscal resources fall under ____________________ funds
federal
What are some expenditures that fall under fiscal reosurces?
-WIC
-Consumer health
-infectious disease
Oregon and New York spend over _______________________ per capital
$70
A cyclist commits to a virtual charity ride across Texas to improve physical activity. What is the primary level of the Social Ecological Framework involved in this example?
individual
To improve worker health, a CEO implements standing-biased desk for all employees. What is the primary level of the Social Ecological Framework involved in this example?
institutional/organizational
to ensure proper disposal of hazardous waste a neighborhood board hosts collection events two times per year. What level of the Social Ecological Framework is involved with managing this intervention?
community
which of these clauses best aligns or is associated with the federal government's role in health?
A. Establish justice
B. Ensure domestic tranquility
C. Provide for common defense
D. Promote the general welfare
E. secure the blessing of liberty
C. Provide for common defense
and D. Promote the general welfare
The majority of leading causes of death in the US are ______________________________
non-communicable diseases/ conditions
During this stage of the epidemiologic transition infectious disease outbreaks would still occur, but usually not widespread, and the overall crude death rate began to drop.
Age of declining pandemics
Which phase of the epidemiologic transition is characterized by people living longer with chronic conditions due to improved environmental, behavioral and medical conditions and the appearance of diseases such as Zika?
age of delayed degenerative disease and emerging infectious disease
The leading cause of death for young adults, including college aged students is
unintentional injuries
The essential service of "build and maintain infrastructure" falls under which core function?
assurance
Which of the following are major public health achievements from the last century (1900-1999)? select all that apply
options:
- fluoridation of drinking water
-cancer prevention
-public health preparedness and responses
-safer workplaces
Fluoridation of drinking water and safer workplaces