PHS final

core public health functions

Defined by national academy of medicine

• assessment

• policy development

• assurance

  
  

Assessment

a core public health function; obtaining data that defines the health of the overall population, including defining the nature of new and persisting health problems

policy development

a core public health function; developing evidence-based recommendations and other analyses of options, such as health policy analysis. to guide implementation, including efforts to educate and mobilize community partnerships

assurance

a core public health function; governmental public health’s oversight responsible for ensuring that key computes of an effective health system, including health care and public health, are in place even through the implementation will often be performed by others

essential public health service

defined by the national academy of medicine core function, guide day-to-day responsibilities

assessment

• monitor health status to identify and solve community health

• dignose and investigate health problems and health hazards in the community

policy development

• inform educate and empower people about health issues

• mobilize community partnership and action to identify and solve health problems

• develop policies and plans that support individual and community health efforts

  assurance

• enforce laws and regulations that protect health and ensure safety

• link people to needed personal health services and ensure the provision of health care when otherwise unavailable

• ensure that provision of a competent public and personal healthcare workforce

• evaluate effectiveness, accessibility, and quality of personal and population based health services

  all three national academy of medicine

• research for new insights and innovative solutions to health problems

assessment

essential public health service:

• monitor health status to identify and solve community health

• dignose and investigate health problems and health hazards in the community

policy development

essential public health service:

• enforce educate and empower people about health issues

• mobilize community partnership and action to identify and solve health problems

• develop policies and plans that support individual and community health efforts

assurance

essential public health service:

• enforce laws and regulations that protect health and ensure safety

• link people to needed personal health services and ensure the provision of health care when otherwise unavailable

• ensure that provision of a competent public and personal healthcare workforce

• evaluate effectiveness, accessibility, and quality of personal and population based health services

all three national academy of medicine

essential public health service: research for new insights and innovative solutions to health problems

home rule

authority is delegates from the state to the local health department allowing them to set their own structure and function and rasie their own funding

local public health authiory/responsibilities

• immunizations for those not covered by the private system

• communicable disease surveillance and investigation of outbreaks

• communicable disease control, often including at a minimum tuberculosis and syphilis case finding and treatment

• inspection and i]licensing of restaurants

• environmental health surveillance

• coordinating public health screening programs, including newborn and lead screening

• tobacco control programs

• public health preparedness and response disasters

healthcare safety net

when public health in the usa provides healthcare provider for those without as source of healthcare

foundational public health services

skills, programs, and activites that must be avalible in state and local health departments system-wide put forth by the public health leadership forum of the instute of medicine

foundational capabilities

cross-cutting skills that need to be present in state and local health departments everywhere for the health system to work anywhere

foundational areas

the substantive areas of expertise or program-specific activities in all state and local health departments also essential to protect the community’s health

CDC and the agency for toxic substances and disease registry

the lead agency for prevention, health data, epidemic investigation, and public health measures aimed at disease control and prevention. the other one works with the environmental protection agency to provide guidance in health hazards of toxic exposure; work with state and local departments except of EIS which is domestically and internally

NIA (National Institute on Aging)

lead research agency: also funds traing programs and communication of health information to the professional community and public; recourses for everyone

FDA federal drug administration

consumer protection agency with authority for safety of foods and efficacy of drugs, vaccines, and other medical and public health interventions

HRSA Health Resources and Services Administration

seeks to ensure equitable access to comprehensive quality healthcare

AHRQ (Agency for Healthcare Research and Quality)

research agenda to improve the outcomes and quality of healthcare including patient safety and access to service

SAMHSA (Substance Abuse and Mental Health Services Administration)

works to improve quality and availability if prevention, treatment, and rehabilitation for substance abuse and mental illness

IHS Indian Health Service

provides direct healthcare and public health services to federally recognized tribes

community-oriented primary care

the formalization of the aspiration of the USA government to connect clinical care with public health

community-based participatory research

community members are involved in all phases of the research process contributing their expertise while sharing ownership and responsibility over the research and assassinating to build trust, knowledge and skill to facilitate the research and development and implimention of interventions

community-oriented public health

healthcare efforts are expanded to take on additional public health roles in collaboration with health institutions

how food can affect our health

• too little food

• too much food

• deficiencies of vitamins and minerals

• contaminate

• individual suscepities

• food-borne communicable diseases

1 in 6

the amount of americans that get sick from foodborne illness every year

3,000

the amount of people that die from foodborne illness every year

CDC’s outbreak investigation

1. decting a possible outbreak

2. defining and finding cases

3. generating hypothhesis

4. testing the hypothesis

5. finding a point of contamination and the source of the outbreak

6. controlling the outbreak

7. deciding that an outbreak is over

cluster

when ill persons in a _____ are found to have something in common to explain why they have the same illness

outbreak

a cluster of illness caused by one contaminate

case definition

spells out what person will be defined as having the disease as part of an outbreak

source traceback

finding where the contamination

food safety modernization

• famers and food prossors to maintain distribution records so that the FDA can more quickly trace an outbreak to it sourse

• foreign food suppliers to meet the same safety standards as domestic suppliers

• regular inspection of all food processing facilities, with more free

Phase 1,2,3 and 4

the FDA’s traditionally divide the testing and approval process for drugs into preclinical research

Phase 1

a study that focuses on the pharmacology and excretion to establish the dosage range and route of absorption, metabolism and excretion. aims to establish the dosage range and route of administation to be used in subsequent studies.

Phase 2

small sometimes uncontrolled trials designed to determine whether there is a suggestion of efficacy. they serve as a precondition for moving ahead with the expense, time and potential harm of conducting large randomized controlled trials (proof of concept)

phase 3

randomized controlled studies to establish efficacy

phase 4

assessment of safety based on the use of the drug in clinical practice. spontaneous reporting system traditionally the basis of this. Databases from clinical practice and formal studies of safety increasing used to asses safety in clinical practice

key limitations of randomized

• too small

• too short

• too simple

off-label prescribing

the use of FDA-approved drugs for indications not approved by FDA

spontaneous reporting system

in this system, those who prescribe the drug, and increasingly patients themselves are encouraged to report side effects to the FDA

surrogate endpoints

may not be a direct measurement of how a pacient feels, functions or survives

breakthrough drugs

is intended to treat serious condition are preliminary clinical evidence indicates that the drugs may demonstrate substantial improvement on a clinically significant endpoints over available therapy

N-of-1 trials

may be conducted on one or a small group of patients who are observed off the treatment, on the reagent, and subsequently off the treatment again to determine wheater they clearly benefit from the drug

the new authority given to the FDA in 2007

• authority to require more representative patients be included in randomized controlled studies to more closely reflect the population

• authority to develop large database system to require follow up studies for drugs to monitor their performance in clinical practice

• authority to develop a large database systems that track pharmacy records and electronic medical records to assess side effects

• authority to place increased restriction in who can prescribe and what conditions are needed to prescription

• authority to approve/ monitor drug advertising

• authority to withdraw drugs from the market when serious issues of safety are raised

dietary supplements

unconventional drug product are vitamins and minerals and herbal treatments not fda approved