Key Concepts in Public Health and Epidemiology

Health

Complete well-being, not just absence of disease.

Public Health

Science and art of preventing disease and promoting health.

Mission of Public Health

Assuring conditions for people to be healthy.

U.S. Healthcare System

Focuses on individual health rather than population health.

Public Health System Goals

Prevent disease, disability, and death in populations.

Federal Power in Public Health

Based on interstate commerce and tax provisions.

State Public Health Role

Coordinates local health agencies and manages Medicaid.

Local Public Health

Handles day-to-day public health tasks.

Core Function: Assessment

Collect and analyze health information systematically.

Core Function: Policy Development

Use scientific knowledge for policy and decision-making.

Core Function: Assurance

Ensure services are provided to those in need.

John Snow

Father of Epidemiology, traced cholera outbreak source.

Primary Prevention

Health promotion for well populations, addressing risk factors.

Secondary Prevention

Screening and early intervention for at-risk individuals.

Tertiary Prevention

Rehabilitation and quality of life improvement for patients.

Upstream Approach

Prevent problems at their source, not just consequences.

Market Justice

Individual responsibility for health outcomes and resources.

Social Justice

Common good; equal rights and opportunities for all.

Libertarian Views

Individual rights restricted only to prevent harm.

Paternalism

Restricting freedom to protect health and safety.

Tragedy of the Commons

Overuse of shared resources due to self-interest.

Leading Causes of Death Shift

From infectious to chronic diseases over time.

Actual Causes of Death

Underlying causes leading to diseases that kill.

Behavioral Theory Utility

Predicts behavior and identifies determinants for action.

Health Belief Model

Predicts health behavior based on perceived risks.

Transtheoretical Model

Stages of change: precontemplation to maintenance.

Social Ecological Model

Five levels influencing health behavior: individual to policy.

Socioeconomic Status and Health

Lower status correlates with poorer health outcomes.

Social Determinants of Health

Environmental conditions affecting health and quality of life.

Statistics

Methods to understand data and extract information.

Probabilities

Predict future outcomes based on past data.

P-value

Probability of result occurring by chance; <0.05 significant.

Statistical Power

Probability of detecting an effect if present.

False Positives

Identifying a non-existent effect or disease.

False Negatives

Failing to detect an existing effect or disease.

Specificity

Test's ability to avoid false positives.

Sensitivity

Test's ability to avoid false negatives.

Rate Components

Frequency, population size, and time period.

Adjusted Rates Purpose

Control for confounding variables in health data.

Statistical calculation

Use a statistical calculation to make the populations being examined equivalent.

Risk Assessment

Identifies events and exposure that may be harmful to humans, estimates the probabilities of their occurrence, estimates the extent of harm they may cause.

Risk perception

Involves psychological factors, is the result of the apparent irrationality of the public in response to risks that experts estimate to be small. Classified on dread and knowability.

Cost-Benefit analysis

Weighs the estimated cost of implementing a policy against the estimated benefit (usually in monetary terms). Costs are easier to calculate than benefits.

Confidence interval

Range of values within which the true result probably falls.

Epidemiology

The study of the determinants, distribution, and frequency of disease in human populations (who and why gets the disease).

Determinants of health

Attributes that contribute to good and bad health, including environmental, community, and societal interactions with genetic disposition.

Incidence

New cases of disease followed over a period of time; some may become sick.

Prevalence

Total existing cases of the disease, calculated as (Incidence Rate) x (Average duration of the disease).

Experimental study design

Randomized control trial that starts with two random groups (experimental and control), watches over time, and compares; considered the gold standard.

Evidence based public health

Process of integrating science-based interventions with community preferences to improve the health of populations.

Type I evidence

Demonstrates potential risk to disease relationship; e.g., smoking causes lung cancer.

Type II evidence

Describes relative impact of various interventions; e.g., price increases with a targeted media campaign reduces smoking rates.

Type III evidence

Information on the adaptation and translation of an effective intervention; dissemination and implementation research; e.g., moving from clinical trials to populations brings new challenges and unknowns.

Systematic review

Synthesizes the results of different studies to summarize the best available evidence on a specific question.

Carrying capacity

The number of organisms that can be supported without degrading the environment.

Consequences of urbanization

Excess population leads to increased homelessness and struggles providing clean water, sewage service, and management of diseases.

Population growth rates

Lower fertility rates in developed nations due to factors like increased access to education, healthcare, and family planning options, while developing countries often experience higher birth rates.

Global threat of population growth

Pollution and reaching our carrying capacity.

US healthcare spending

US spends a lot more money on healthcare compared to other countries but has a relatively low health status; ranks low on OECD's analysis for infant mortality and life expectancy.

Factors contributing to rising healthcare costs

Aging population, continual development of new technology, malpractice suits and insurance, and administrative costs.

Administrative complexity in healthcare

Many different insurers pay for medical care, each with unique requirements and processes, making it more time-consuming and expensive.

Nationalized healthcare pros

Greater accessibility, lower costs, reduced administrative complexity.

Privatized healthcare pros

Less regulation, greater freedom for physicians, more innovation.

Single payer healthcare systems

No market competition, lower costs, standardized benefits, no concern for profit, simpler to navigate.

FDA role

Assures foods not regulated by USDA are safe, wholesome, sanitary, and properly labeled; ensures drugs and medical devices are safe and effective.

USDA role

Regulates 20% of federally regulated foods, including meat from livestock, poultry, and egg products; conducts daily inspections.

Irradiating food

Use of radiation to kill microbial contaminants of food; FDA approved but not allowed for organic foods.

Drug approval process

Companies file a new drug application (NDA) and demonstrate evidence of the drug's desired effect in animals and safety; includes three phases of clinical trials.

One Health

The idea that the health of people is connected to the health of animals and our shared environment.

EPA

Agency ensuring a cleaner, healthier environment in the US.

Mercury

Toxic element causing neurological damage and paralysis.

Minamata Bay Incident

1950s mercury pollution affecting fish and humans.

Lead

Neurotoxin damaging brain, especially in children.

Flint Water Crisis

Lead contamination in Flint, Michigan's water supply.

Asbestos

Fibrous mineral linked to lung diseases and cancer.

PCBs

Industrial chemicals contaminating water and fish.

BPA

Chemical in plastics affecting hormone function.

CAFOS

Concentrated animal feeding operations causing pollution.

Public Health Achievements

CDC highlights significant 20th-century health improvements.

Healthy People 2030

Goals for health and well-being across lifespan.

Type I Evidence

Demonstrates preventable risk-disease relationship.

Type II Evidence

Describes impact of interventions on health outcomes.

Type III Evidence

Real-world application of effective health interventions.

Chronic Disease

Long-lasting conditions requiring ongoing medical attention.

Leading Causes of Death

Heart disease, cancer, chronic lung disease, stroke.

Cardiovascular Disease

Number one cause of preventable deaths in the US.

Demographic Shift

Increasing average age and retiring baby boomers.

Medicare Challenges

Rising costs and unsustainable enrollment growth.

Health Disparities

Persistent inequalities in health outcomes among groups.

Environmental Health Risks

Health threats from pollutants like lead and mercury.

Health Promotion

Strategies to enhance overall community health.

Behavioral Risk Factors

Tobacco use, poor nutrition, physical inactivity.

2-fold

Dual approach to improve older health.

Dementia care costs

Nearly $300 billion annually in the U.S.

Risk factors

Genetic and nongenetic influences on health.

Physical exercise benefits

Protective against various chronic diseases.

Context in behavior

Influences actions based on environment and situation.

System 1 thinking

Fast, intuitive, emotional decision-making process.

System 2 thinking

Slow, deliberate, logical decision-making process.

Dietary recommendations

75% of U.S. population fails to meet them.