Class 1, 2, 3

P

Clinical Care 

prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by medical and allied health professions; also known as health care

Determinant

factor that contributes to a condition, usually beyond an individual’s control is when it is a social determinant

Disparities

Unequal rates of disease, risks, exposures

Health Outcome

a medical condition that directly affects the length or quality of a person’s life

Ecological Systems Theory*

• Explains how a person’s development is influenced by different types of environmental systems that interact with each other. Individual’s behavior and development are shaped by their relationships, surroundings, and broader society

• 5 levels/systems of this theory: microsystem, mesosystem, exosystem, microsystem, chronosystem

Microsystem

the immediate environment where direct interaction occurs - such as family, school, friends, teachers, & neighbors. These relationships have the most direct impact on the person’s daily life

Mesosystem

The connections between Microsystems - for example, how a child’s home life interacts with their school life. Positive communication between parents and teachers is an example of a strong mesosystem

Exosystem

External settings that don’t involve the person directly but still affect them. For instance, a parent’s workplace stress might influence the home environment

Macrosystem

The larger cultural and societal context, including laws, values, traditions, and social norms. These shape how all other systems operate and influence development. 

Individual SDOH Examples

Income, Education, Race/Ethnicity, Age, Gender, Literacy, Employment, Healthy Child Development, Personal health practices

Environmental SDOH Characteristics

Housing conditions, working conditions, physical environment (safety, availability of healthy options), food safety, water quality, Income inequality, Social norms, Transportation

Immediate Social Contexts SDOH

• Child abuse and neglect

• exposure to violence e

• early life conditions

• parental characteristics

• living in poverty

• racism/sexism/homophobia

• food insecurity

Political/Cultural SDOH

• Public policies

• laws/regulations

• cultural practices

• racism/sexism/homophobia

• wars, displacement

Institutionalized racism

unfair access to opportunities, housing, education or healthcare 

Personally mediated racism

prejudice and discrimination between individuals

Internalized racism

when people accept negative beliefs about their own racial group. these levels reinforce one another, sustaining inequality

3 types of racism

Institutionalized racism, personally mediated racism, internalized racism

5 Steps to Addressing a Public Health Issue in a Community

1. define health problem

2. identify risk factors

3. develop and test interventions to address the problem

4. implement the interventions

5. monitor interventions to assess their effectiveness

3 Core Functions of Public Health

Assurance, Assessment, Policy Development

10 Essential Public Health Services*

1. Assess and monitor population health 

2. Investigate, diagnose, and address health hazards and root causes

(1 & 2 are assessment) 

3. Communicate effectively to inform and educate

4. Strengthen, support, and mobilize communities and partnerships

5. Create, champion, and implement policies, plans, and laws

6. Utilize legal and regulatory actions 

(3,4,5 are policy development)

7. Enable equitable access

8. Build a diverse and skilled workforce

9. Improve and innovate through evaluation, research, and quality improvement

10. Build and maintain a strong organizational infrastructure for public health

(7,8,9,10 are assurance)

Equity is in the center for all functions

Controversies of Public Health

• Political Interference with Science (CDC for example)

• Vaccine Controversy, Mask mandates

• Public health challenges the status quo

• Potential for negative economic impact

• Potential for the restriction of individual freedom

• moral and religious controversies

• Political pressures impact public health process

Non-Governmental Organizations (NGOs)

Any non-profit, voluntary citizens’ group which is organized on a local, national, or international level

• works independent of the government to address social, health, environmental, or humanitarian issues

Frameworks of prevention

structured way of thinking about how, when, and for whom to take action to prevent disease or promote health

Levels of Prevention

Primary, Secondary, Tertiary

Primary Prevention

prevents disease before it happens (vaccinations, healthy diet campaigns, sanitation)

Secondary prevention

Detects and treats disease early to stop progression (screenings, blood pressure checks)

• implemented after a disease has begun, but before it is symptomatic

• early identification through screening and treatment

Tertiary prevention

Reduces complication or disability from existing disease (rehabilitation, chronic disease management)

Levels of Prevention by Risk

Universal prevention, selective prevention, indicated prevention

Universal Prevention

targets everyone in a population, regardless of individual risk

• goal is to reduce overall incidence of disease and promote general health 

Selective Prevention

targets subgroups of the population who are at higher-than-average risk of developing a disease

• goal is to prevent disease in those more likely to be affected

• example: providing extra counseling for teenagers in low-income neighborhoods to prevent smoking 

Indicated Prevention

targets individuals showing early signs or symptom of a disease but who do not yet meet full diagnostic criteria

• goal is to stop or delay progression of disease

• example: screening for prediabetes and offering lifestyle programs to prevent type 2 diabetes