Introduction to Population Health (Exam Pt.1)

Health Protection Era (antiquity - 1830s)

Focused on individual behaviors to prevent disease using religion and culture; included practices like quarantines and dietary restrictions.

Hygiene Movement (1840s-1870s)

Improved sanitary conditions in public health through community-wide environmental actions

• John Snow tackled cholera

• Semmelweis identified the importance of handwashing

• vital statistics became empirical foundation of epidemiology

Contagion Control Era (1880-1940)

Emphasized the germ theory of disease, outbreak investigations, and the use of vaccinations and environmental factors to control diseases.

• Ex: linkage of epidemiology, bacteriology, and immunology to form TB sanatoriums

Filling Holes in Medical Care System Era (1950s-mid 1980s)

 integrated control of communicable disease with modifying risk-factors and caring for high-risk populations; public system for control of specific communicable diseases, care for vulnerable populations, beginning of integrated healthcare systems with preventative services

• Ex: antibiotics, concept of risk factors, surgeon general report on cigarettes

Health Promotion/Disease Prevention Era (mid 1980s-2000s)

focused on individual behavior and disease detection; clinical and population-oriented prevention, focused on individual decision making

• Ex: AIDS epidemic and need for interventions, reductions in coronary heart disease

Population Health Era (2000s)

coordination of public health and healthcare delivery due to evidence-based thinking; focus on harms and costs as benefits of interventions, globalization

• Ex: evidence-based medicine and public health, new approaches to avoid medical errors, tobacco control, climate change

Population Approach

A public health strategy aimed at reducing risk for entire populations, although it may provide minimal individual benefit.

High Risk Approach

Targets individuals with a higher probability of disease, aiming to reduce their risk to normal population levels.

Behavior as a Health Determinant

Acts as a significant factor influencing disease susceptibility (e.g., smoking).

Infection as a Health Determinant

Can directly or indirectly cause diseases (e.g., being HIV positive).

Genetics as a Health Determinant

Often a less significant factor but can include history of conditions (e.g. addiction)

Geography as a Health Determinant

Influences disease frequency and presence (e.g. ebola in Africa)

Environment as a Health Determinant

Covers physical, built, or social factors (e.g. air quality or access to food)

Medical Care as a Health Determinant

Relates to access and quality of healthcare resources (e.g. hospital location)

Socio-economic-cultural Determinants

Includes available resources (e.g. finances and family support)

disadvantages of population approach

Minimal benefit to individual

Limited motivation

Hard to implement (too expensive)

advantages of population health approach

Large potential for societal impact

Can lead to substantial change

Can impact a range of health outcomes by targeting societal norms

disadvantages of high risk approach

Temporary, may not produce sustainable change

Limited potential for individual and population

May not address underlying issue

advantages of high risk approach

Strategy is tailored to individuals

Motivation from patient and provider

Cost-effective

health determinants

underlying factors that cause disease; go beyond the known