Public Health Key Concepts
Health Definitions
WHO: Health is a state of complete physical, mental, and social well-being.
McKenzie et al. (2016): Health is a dynamic, multidimensional state resulting from interactions and adaptations to the environment.
Community and Public Health
Community: A group sharing common characteristics like geography or values.
Community Health: The health status of a defined group and actions to promote and protect their health.
Public Health (CEA Winslow): The science and art of preventing disease, prolonging life, and promoting health through organized efforts.
Public Health (CDC): The science of protecting and improving the health of people and their communities.
Mission of Public Health: To fulfill society’s interest in assuring conditions in which people can be healthy.
Determinants of Health
Gestational endowments
Social circumstances
Environmental conditions
Behavioral choices
Availability of quality medical care
Factors Affecting Community Health
Physical Factors: Geography, environment, community size, industrial development.
Social & Cultural Factors: Social factors, cultural factors, beliefs, traditions, prejudices, economy, politics, religion, social norms, socioeconomic status.
Community Organization: Process for identifying problems, mobilizing resources, and implementing strategies.
Behavioral Factors: Individual behaviors contributing to community health.
History of Public Health
Early tribes near water sources.
Communicable diseases linked to spiritual forces.
Renaissance & exploration period.
Industrial growth.
Modern era of public health (1850-today).
Health resources development period (1900-1960).
Reform phase of public health (1900-1920).
Declaration of Alma Ata (1978).
Bacteriological period of public health (1975-1900).
20th century - Health resource development period.
Key Events
Sanitation and Environmental Health: Greeks and Romans practiced community sanitation; The Public Health Act of 1848 (UK); EPA founded in 1970.
Pandemics: Influenza (1918), Polio, HIV.
Preparedness for Disaster Response: Biologic warfare, September 2001, Hurricane Katrina.
Prevention Through Policy: Tobacco laws, Book of Leviticus, obesity measures.
Public Health Approach
Surveillance: What is the problem?
Risk Factor Identification: What is the cause?
Intervention Evaluation: What works?
Implementation: How do you do it?
Public Health Core Sciences
Epidemiology
Laboratory
Informatics
Surveillance
Prevention Effectiveness
Three Core Functions of Public Health
Assessment: Collect and analyze information.
Policy Development: Promote scientific knowledge in policy.
Assurance: Ensure service provision.
Ten Essential Public Health Services
Monitor Health
Diagnose and Investigate
Inform, Educate, Empower
Mobilize Community Partnership
Develop Policies
Enforce Laws
Link to/Provide Care
Assure a Competent Workforce
Evaluate
Research
Partners in Public Health
Community
Clinical Care Delivery System
Government
Academia
The Media
Employers and Businesses
Contrasting Public Health and Health Care
Public Health: Population focus, prevention emphasis.
Health Care: Individual patient focus, treatment emphasis.
Health Impact Pyramid
Increasing public health impact from counseling and education to socioeconomic factors.
Healthcare Delivery System
Organization to deliver health care services.
Classifications: Governmental, Quasi-Governmental, Nongovernmental.
World Health Organization (WHO)
Objective: Attainment of the highest possible level of health for all peoples.
Core Functions: Leadership, research, standards, policy, technical support, monitoring.
Sustainable Development Goals
17 goals addressing poverty, climate change, and economic growth (established in 2015).
UNICEF
Mandate: Help children at risk.
GOBI Strategy: Growth monitoring, oral rehydration therapy, breastfeeding, immunization.
CDC
Founded in 1946, focusing on infectious diseases.
National Health Agencies
Primary Role: Protect the health and welfare of its citizens
Department of Health (DOH)
Authority on health in the Philippines.
FDA of the Philippines
Regulation of cosmetics, drugs, foods, etc.
National Institutes of Health (NIH) in the Philippines
Health research center.
Philippine Red Cross
Humanitarian services and disaster-related activities.
Non-Governmental Health Organizations
Voluntary Health Agencies
Professional Health Organizations/Associations
Philanthropic Foundations
Epidemiology
The study of the distribution and determinants of health-related states or events in specified populations.
Demography
The study of statistics such as births, death, income, or the incidence of disease.
History of Epidemiology
Hippocrates, Dr. Benjamin Rush, John Snow.
Levels of Disease Occurrence
Sporadic: Infrequent and irregular.
Endemic: Constantly present.
Hyperendemic: Persistent, high levels.
Outbreak: Increase in cases.
Epidemic: Increase above normal expectations.
Pandemic: Epidemic over several countries/continents.
Importance of Rates
Cases: People afflicted with a disease.
Rate: Number of events in a population over time.
General Categories of Rates
Natality (Birth) Rate: Number of live births / total population.
Morbidity (Sickness) Rate: Number of sick people / total population at risk.
Mortality (Death) Rate: Number of deaths / total population.
Incidence Rate: Number of new cases / population at risk.
Prevalence Rate: Number of new and old cases / total population.
Sources of Data
Primary Data: Original information collected first hand.
Secondary Data: Data collected by someone else.
Epidemiological Studies
Experimental
Observational
Observational Studies
Descriptive: Describe extent of disease (who, when, where).
Analytical: Test hypotheses about relationships between health problems and risk factors.