Introduction to Public Health Notes

Introduction to Public Health, from the Centers for Disease Control YouTube channel

  • Definition of Public Health, by CEA Winslow
    • “The science and art of preventing dais, prolonging life, and promoting health through the organized efforts and informed choices of society organizations, public and private communities and individuals.”
  • More key terms:
    • 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 professionals; also known as health care.
    • Determinant: Factor that contributes to the generation of a trait. Examples of determinants include ethnicity and genetic makeup.
    • Epidemic / Outbreak: Occurrence in a community or region of cases of an illness, specific health related behavior, of other health related event clearly in excess of normal expectancy.
    • Health outcome: Result of a medical condition that directly affects the length or quality of a person’s life.
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  • Public health aims to provide groups of people with the right to be health and live in conditions that support health.
  • Key point: Public health focuses on groups as opposed to individuals.
  • In 500BCE, Greeks and Romans practiced community sanitation measure.
  • The Public Health act was passed in the UK in 1848. It established a central board of health.
  • In the 1970, President Nixon’s administration established the Environmental Protection Agency. It protects our health by maintaining the quality of the air, the water, and the land.
  • Notable pandemics:
    • Influenza has caused many pandemics over the course of history.
      • In 1918, the Spanish Flu infected 500 million people across the world.
      • It is estimated to have killed 20 to 50 million.
    • Polio is another notable disease that has had a massive impact on humanity.
      • A vaccine for polio was introduced in 1955. Eradication efforts have mostly eliminated polio, although it is still present in a few countries.
    • HIV emerged in the 1980s.
      • New infections of HIV have fallen significantly in recent years, largely due to public health interventions.
  • Public health plays a role in disaster response.
    • Pubic health workers respond to both human caused disasters (such as terrorist attacks) and natural disasters (such as hurricanes).
  • Key topic: Prevention Through Policy
    • Book of Leviticus, the third book of the Hebrew Bible, contains what is believed to be the first written public health code in the world. Includes guidance on bodily cleanliness and quarantine strategies.
    • Laws restricting tobacco use are a prime example of public health policies, as are increases in cigarette taxes.
    • Food labeling policies are instigated to promote public health. As are laws mandating minimum levels of physical activity for school children.
  • Sequence of a public heath approach:
    • Surveillance (Identification the problem)
    • Risk Factor Identification (Identification of the cause)
    • Intervention Evaluation (Identification of potential solutions)
    • Implementing (Implementing solutions)
  • Core Sciences for those practicing public health:
    • Surveillance: Monitoring for threats to public health.
    • Epidemiology: Where diseases originate, how/why they move through populations.
    • Laboratories: Performing tests to diagnose for disease, and performing research on diseases.
    • Informatics: Methods for collecting, compelling, and presenting health information.
    • Prevention effectiveness: Deals with the assessing relative effectiveness of different forms of intervention.
  • Example to Illustrate the Public Health Approach to Tackling a Disease: The Effort to Fight Cholera in London in the 1800s
    • Cholera is a potentially fatal intestinal disease, caused by bacteria. It killed thousands of people.
    • At this time, the cause of cholera was not conclusively known. Some thought that it was caused by bad air from rotting organic matter.
    • A British physician named John Snow, felt (correctly) that cholera was actually being caused due to the contamination of the city’s water sources. (At the time, untreated sewage was being dumped into the Thymes river).
    • John Snow is considered by many to be the father of modern epidemiology.
    • He conducted surveys to deduce where cholera cases were most concentrated. He then realized that clusters of cholera cases were more common around water sources, particularly a pump on broad street. Eventually, he convinced politicians that politicians that cholera was coming from contaminated water sources, and appropriate measures were taken.
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  • Three Core Functions of Public Health: 
    • Assessment: The collection and analysis of data.
    • Policy development: The creation of policies based on the data.
    • Assurance: The provision of public health services to those in need.
  • Ten Essential Public Health Services (Within the core functions)
    • Monitoring health
    • Diagnosing and investigating
    • Informing, education, and empowering
    • Mobilizing community partnerships
    • Developing policies
    • Enforcing laws
    • Providing care
    • Assuring a competent workforce
    • Evaluation
    • Research
  • Key point: The core functions of public health must be carried out at federal, state, and local levels, in order to be effective.
  • 32:00 – Useful chart describing how public health functions can be implemented at each of the three levels listed in the previous bullet.
  • Roles of different groups who have stake in public health
  • Players in the public health system:
    • Clinical Care Delivery System
    • Employers and Businesses
    • The Media
    • Academia
    • Government Public Health Infrastructure
    • Communities
  • NGOs also play key roles in public health
  • Key point: Public health focuses on populations, whereas healthcare focuses on individual patients.
  • Public health focuses on prevention, whereas healthcare focuses more on addressing health problems after the manifest.
  • Social media is now facilitating conversations concerning public health, for better or worse.
  • The inclusion of sidewalks and bike paths can improve public health.
  • Education departments can improve public health by providing students with healthy food options in cafeterias and vending machines.
  • 40:50 – Beginning of a discussion on what factors influence public health.
    • Health determinants:
      • Genes and biology
        • Sex
        • Age
        • Immunity levels
      • Health behavior
        • Smoking
        • Eating habits
        • Medication prescriptions
      • Social or societal characteristics
        • Can a person work
        • Where a person lives
        • Where a person goes to school
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      • Health services or medical
        • Insurance coverage
        • How close a person is to a health care provider
  • What determines the health of a population?
    • A pie chart showing the distribution of the relative importance of the four aforementioned factors is displayed at 42:11.
    • The most significant factor in determining public health is, according to the CDC, social and societal characteristics. Genes and biology supposedly have the least influence.
  • The relative effectiveness of varying public health interventions is discussed at 43:15.
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  • 44:42 – Description of several different forms of public health intervention, such as:
    • Tobacco warning labels
    • Treatment of heart disease
    • Vaccinations and cholesterol screening
    • Seatbelt laws and smoking restrictions
    • Poverty reduction and education
  • We should strive to make healthy decisions the default. A good way of doing so is by taking measures so that the best choices (from a public health standpoint) are the easiest choices to make.

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