PUBLIC HEALTH

• Public Health


  The science and art of: Preventing disease, Prolonging life, Promoting health through: Organized efforts, Informed choices of society, organizations, public and private communities, and individuals

  
• WHO, 1948: Health is a state of complete physical, mental and social well-being and is not merely the absence of disease or infirmity
• WHO, 1984: Health


  The extent to which an individual or group is able to realize aspirations, satisfy needs and to change or cope with the environment
• Alma-Ata Declaration of 1978: Identified primary health care as the key to the attainment of the goal of Health for All
• Alma-Ata Declaration of 1978: Health is a fundamental human right
• Alma-Ata Declaration of 1978: Attainment of the highest possible level of health requires social and economic sectors
• Alma-Ata Declaration of 1978: Gross inequality is politically, socially and economically unacceptable
• Alma-Ata Declaration of 1978: The people have a right and duty to participate in planning and implementation of their health care
• Alma-Ata Declaration of 1978: Primary health care is made universally accessible at cost that the community and country can afford, an integral part of the country's health system and the overall social and economic development
• Alma-Ata Declaration of 1978: An acceptable level of Health for All by the year 2000 can be attained through a fuller and better use of resources for social and economic development, of which, primary health care should be allotted its proper share
• Clinical Care


  Prevention, treatment, and management of illness and preservation of mental and physical well-being through the services offered by medical and allied health professions
• Determinant


  Factor that contributes to the generation of a trait
• Outbreak


  An illness happens in unexpected high numbers, may stay in one area or extend more widely, can last days or years, sometimes a single case of a contagious disease can be an outbreak
• Epidemic


  Occurrence in a community or region of cases of an illness, specific health-related behavior, or other health-related event clearly in excess of normal expectancy, usually affects a larger area than an outbreak
• Pandemic


  A disease outbreak that spreads across countries or continents, affects more people and takes more lives than an epidemic
• Health Outcome


  Result of a medical condition that directly affects the length or quality of a person's life
• Changing Concepts in Public Health

  • Disease Control Phase
  • Health Promotion Phase
  • Social Engineering Phase
  • Health for All Phase

  
• Disease Control Phase: Sanitary legislation and sanitary forms, technical knowledge were less available, primarily aimed at the control of man's environment, improvement in health of the people due to disease and death control

  
• Health Promotion Phase: One more goal was added to public health - Health promotion of individuals, initiated as personal health services: mother and child health, school health, industrial health, mental health, rehabilitation services
• Social Engineering Phase: Change in patterns of disease, social and behavioral aspects of disease and health were prioritized to lessen the burden of chronic diseases, concept of Risk Factors came to existence
• Health for All Phase: Health gap between rich & poor, within & between countries was recognized, aims to provide health care to all by reducing inequalities within & between the population so that an individual will lead a socially & economically productive life
• 20th century: Dramatic increase in average life span is credited to public health achievements - vaccination, infection control, better safety policies, improved family planning, emphasis on safe drinking water, now the focus is shifting towards chronic diseases
• Public Health Problems


  • Infectious diseases
  • Chronic diseases
  • Emergencies
  • Injuries
  • Environmental health problems
  • Other health threats
• Public Health Approach


  • Surveillance
  • Risk Factor Identification
  • Intervention
  • Evaluation
  • Implementation
• Surveillance


  Problems are identified by using surveillance systems to monitor health events and behaviors occurring among a population
• Risk Factor Identification


  Determination of factors that might make certain populations more susceptible to disease
• Intervention Evaluation


  Evaluation of what has worked in the past in addressing the same problem or if a proposed intervention makes sense with the affected population
• Implementation


  Available resources and knowledge about the affected population are considered
• Public Health Core Sciences

  • Public Health Surveillance
  • Epidemiology
  • Public Health Laboratories
  • Public Health Informatics
  • Prevention Effectiveness
• Public Health Surveillance


  Monitors a public health situation
• Epidemiology


  Determines where diseases originate, how or why they move through populations, and how can they be prevented
• Public Health Laboratories


  Support public health by performing tests to confirm disease diagnoses, conducting research and training
• Public Health Informatics


  Deals with the methods for collecting, compiling, and presenting health information, allows for utilization of electronic data effectively when addressing a public health situation
• Prevention Effectiveness


  Closely linked to public health policy, provides important economic information for decision makers to help choose the best option available

  
• Influenza: Public health surveillance monitors when and where cases occur each year, epidemiology enables understanding of why different populations choose to get vaccinated, public health laboratories determine if persons have influenza or a different infection, informatics utilized to receive and analyze electronic information from health care institutions to determine outcomes, prevention effectiveness campaigns for influenza vaccination that might cost high but can prevent costs
• Cholera in London in the early 1800s was a fatal intestinal disease that caused death to tens of thousands, was commonly thought to be caused by bad air from rotting organic matter
• John Snow


  Best known for his work tracing the source of the cholera outbreak and is considered the father of modern epidemiology
• John Snow's research convinced the British government that the source of cholera was water contaminated with sewage
• Core Functions of Public Health

  • Assessment
  • Policy Development
  • Assurance
• Ten Essential Public Health Services


  • Systematically collect, analyze, and make available information on healthy communities
  • Promote the use of a scientific knowledge base in policy and decision making
  • Ensure provision of services to those in need