Community and Public Health: Key Concepts, Organizations, and Disease Prevention Strategies ( exam 1 )

Health

A dynamic state or condition of the human organism that is multidimensional in nature, a resource for living and results from a person's interactions and adaptations to his or her environment.

Community

A group of people who have common characteristics, defined by location, race ethnicity, age, occupation, interest in particular problem or outcomes, or common bonds.

Public health

Actions that society takes collectively to ensure that the conditions in which people can be healthy can occur; the most inclusive term.

Community health

Health status of a defined group of people and the actions and conditions to promote, protect, and preserve their health.

Population health

Health outcomes of a group of individuals, including the distribution of such outcomes within the group.

Global health

Health problems, issues, and concerns that transcend national boundaries, best addressed by cooperative actions and solutions.

Personal health activities

Individual actions and decision-making that affect the health of an individual or his or her immediate family members or friends.

Community/public health activities

Activities aimed at protecting or improving the health of a population or community.

Factors affecting community health

Physical: Geography, Environment, Community size, Industrial development.

Social cultural factors

Beliefs, traditions and prejudices, economy, politics, religion, social norms, socioeconomic status.

Community organizing

Process by which communities are helped to identify common problems or goals, mobilize resources and develop and implement strategies for reaching goals they have collectively set.

Individual behavior

Takes the concerted effort of many individuals to make a program work.

Herd immunity

The resistance of a population to the spread of an infectious agent based on the immunity of a high proportion of individuals.

History of community and public health

Almost as long as the history of civilization; knowledge of the past helps us better prepare for future community health challenges.

Earliest Civilizations

Many community health practices went unrecorded; practices involved taboos, rites, and spiritual belief.

The Eighteenth Century

Characterized by industrial growth; cities overcrowded, water supplies inadequate and unsanitary, problems with trash, workplaces unsafe.

Health resources development period (1900-1960)

Growth of healthcare facilities and providers, further divided into Reform phase (1900-1920).

Period of social engineering (1960-1973)

Federal government became active in health matters; 1965: Medicare and Medicaid established.

Period of Health Promotion (1974-present)

Identification that premature death is traceable to lifestyle and health behaviors; Healthy People publication established.

Twenty-first century global achievements

Reductions in child mortality, vaccine-preventable deaths, access to safe water and sanitation, malaria prevention and control.

Governmental Health agencies

Part of governmental structure; funded primarily by tax dollars and managed by government officials.

International health agencies

World Health Organization (WHO) - most widely recognized international governmental health organization.

Purpose and Work of WHO

Mission: attainment of highest possible level of health by all peoples; work financed by member nations.

National Health Agencies

Each nation has a department or agency within its government responsible for protection of health and welfare of its citizens.

Department of Health and Human Services (HHS)

U.S. primary national health agency; organized into 11 operating agencies, 10 regional offices.

State health agencies

All 50 states have their own state health departments; purpose: to promote, protect, and maintain the health and welfare of their citizens.

Local Health departments

Responsibility of city or county governments; jurisdiction often depends on size of population.

Whole School, Whole Community, Whole Child (WSCC) Model

Student-centered model; emphasizes role of community in supporting school, connection between health and academic achievement.

Quasi-Governmental Health Organizations

Some official health responsibilities; operate more like voluntary health organizations.

Nongovernmental Health agencies

Funded by private donations or membership dues; operate free from governmental interference.

Voluntary Health agencies

Created by one or more concerned citizens that felt a specific health need was not being met by governmental agencies.

Professional Health Organizations

Made up of health professionals who have completed specialized training and have met standards of registration/certification.

Philanthropic Foundations

Endowed institutions that donate money for the good of humankind; fund programs and research on prevention, control, and treatment of many diseases.

Corporate involvement in community health

Biggest role is provision of healthcare benefits; worksite health promotion programs aimed at lowering healthcare costs.

Epidemiology

Population medicine; concerned with the course of disease in a population.

American Red Cross

Official duties include providing relief to victims of natural disasters and serving as liaison between members of armed forces and their families during emergencies.

Epidemiologist

Collect information about disease status of a community.

Factors that affect the health of a community

Physical: Geography, Environment, Community size, Industrial development.

History of WHO

Established in 1948, with a mission for the attainment of the highest possible level of health by all peoples.

Operating Agencies of the DHHS

Includes CDC, FDA, NIH, and others focused on various health-related functions.

20th century achievements in public health

Vaccination, Motor vehicle safety, Control of infectious diseases, Decline of deaths from CHD and stroke, Healthier mothers and babies, Safer and healthier foods, Safer workplaces, Family planning, Fluoridation of drinking water, Recognition of tobacco use as a health hazard.

The twenty-first century

U.S. community/public health in early 2000s includes healthcare delivery, environmental problems, lifestyle diseases, communicable diseases, alcohol and other drug abuse, health disparities, disasters, public health preparedness.

World community and public health in the twenty-first century

Includes communicable diseases, poor sanitation and unsafe drinking water, hunger, migration and health.

Service, Social, and Religious organizations

Make significant health-related contributions, often without health as their primary mission.

Epidemic

Unexpectedly large number of cases of an illness, specific health related behavior, or event in a particular population.

Outbreak

Similar to an epidemic except that it is used for more limited geographical areas.

Endemic

Disease that occurs at an expected level in a population or in a certain location.

Pandemic

Outbreak over a wide geographical area.

Rates

Allow for comparison of outbreaks at different times or in different places.

Cases

People afflicted (those who are sick).

Natality rate

Rate of births in a population.

Morbidity rate

Rate of sickness in a population.

Mortality rate

Rate of death in a population.

Population at risk

Those susceptible to a particular disease or condition.

Incidence rate

Number of new health-related events or cases of a disease, divided by population at risk.

Attack rate

Incidence rate calculated for a particular population for a single disease outbreak; expressed as a percentage.

Prevalence rate

Number of new and old cases in a given period of time, divided by total number in that population.

Crude rates

A rate in which the denominator includes the total population.

Age-adjusted rates

Used to make comparisons of relative risks across groups and over time when groups differ in age structure.

Reportable diseases

Diseases of local public health concern; designated by states.

Notifiable diseases

Conditions that warrant monitoring; designated by the CDC and Council of State and Territorial Epidemiologists (CSTE).

Mortality statistics

Most reliable measure of population health status.

Life expectancy

Average number of years a person from a specific cohort is projected to live from a given point in time.

Years of potential life lost

Number of years lost when death occurs before one's life expectancy.

Disability-adjusted life years (DALYs)

Measures burden of disease; one DALY = one lost year of healthy life.

Health-adjusted life expectancy (HALE)

Number of years of healthy life expected, on average, in a given population or region of the world.

Secondary data

Data collected by someone else, possibly for another purpose.

National Health Survey Act of 1956

Authorized continuing survey of amount, distribution, and effects of illness and disability in the U.S.

National Health Interview Survey (NHIS)

Conducted by NCHS; questions respondents about their health.

National Health and Nutrition Examination Survey (NHANES)

Assesses health and nutrition status through mobile examination center.

Behavioral Risk Factor Surveillance System (BRFSS)

Surveys on health-related risk behaviors.

Descriptive study

Study that describes epidemics with respect to person, place, and time.

Analytic study

Study that investigates the causes and effects of health-related states or events.

Mortality or fatality rate

death rate

U.S. Census

Enumeration of the population taken every 10 years, gathers data on race, age, income, employment, education, dwelling type, other

Vital Statistics Report

Summaries of records of major life events: birth, death, marriage, divorce, infant deaths

Epidemic curves

Graphic display of the cases of disease according to the time or date of onset of symptoms

Single epidemic curves

Can be used to calculate incubation period—period of time between exposure to an infectious agent and onset of symptoms

Common source epidemic curve

A type of epidemic curve that represents cases arising from a single source of infection.

Point source epidemic curve

A type of common source epidemic curve where all cases occur within one incubation period.

Continuous source epidemic curve

A type of common source epidemic curve where cases occur over a prolonged period.

Propagated epidemic curve

A type of epidemic curve that represents cases that spread from person to person.

Analytics studies

Test hypotheses about relationships between health problems and possible risk factors.

Observational studies

Investigator observes natural course of events, noting exposed vs. unexposed.

Experimental studies

Investigator allocates exposure and follows development of disease.

Placebo

Treatment of no therapeutic effect; usually given to group within an experimental group to serve as comparison to another group receiving intervention.

Causation

Association does not imply causation; researchers evaluate causal relationship between risk factor and effect.

Criteria for causation

Strength, Dose-response, Consistency, Specificity, Temporality, Biological plausibility.

Acute diseases

Diseases in which peak severity of symptoms occurs and subsides within 3 months.

Chronic diseases

Diseases or conditions in which symptoms continue longer than 3 months.

Communicable diseases

Diseases for which biological agents or their products are the cause and that are transmissible from one individual to another.

Noncommunicable diseases

Illnesses that cannot be transmitted from one person to another.

Infectivity

Ability of a biological agent to enter and grow in the host.

Agent

Cause of disease or health problem.

Host

Susceptible person or organism invaded by an infectious agent.

Environment

Factors that inhibit or promote disease transmission.

Pathogenicity

Capability of a communicable agent to cause disease in a susceptible host.

Chain of infection

Pathogen -> reservoir → portal of exit → transmission → portal of entry → establishment of infection in new host.

Pathogen

Disease-causing agent (virus, bacterium, etc.).

Reservoir

Favorable environment for infectious agents to live and grow (human, animal, etc.).