public health midterm 1

Rehabilitating persons with injury/disease to reduce complications (i.e diabetes management, HIV not progressing to AIDS)

Prevents injury/disease once exposure to risk factor occurs but still in early, "preclinical" stage

Targets risk factors leading to injury/disease (seatbelt laws, vaccinations, promote exercise)

Targets social and economic policies effecting health (i.e Laws restricting tobacco use)

•Antiquity -1830s

•authority-based control

•quarantine (epidemics)

•sexual prohibitions (disease transmission)

•dietary restriction (food-borne disease)

•1840s - 1870s

•sanitary conditions as a foundation for improved health

•cholera and water/sewage systems

•puerperal fever

•public health dept

•1880s -1940s

•Germ theory of disease

•Communicable disease control through environment (vaccination, sanatoriums)

•outbreak investigation

•epidemiology, bacteriology, immunology linkage tuberculosis

•1950s - mid 1980s

•integration of control of communicable diseases risk factor modification and care of high risk pops.

•antibiotics (1941)

•chronic disease epidemiology (Framingham of heart disease, psychiatric disorder trials)

•Polio vaccine (1955)

•Medicaid , Medicare (1965)

•Community health centers for low income and uninsured

•Mid 1980s - 2000

•Focus on individual behavior and disease detection in vulnerable populations

•clinical and population-oriented prevention

•AIDS epidemic and related risk reducing behavioral interventions

•coronary heart disease reductions

•screenings (mammography, Pap smears)

•Environmental movement (lead in gas/paint, air quality, radiation)

•2000s

•Public Health and Healthcare delivery coordination on evidence-based systems, holistic interdisciplinary thinking

•Evidence based recommendations and information management: harms, costs, benefits of interventions

•Evidence-based medicine & public health

•Climate change

•Antibiotic resistance

•Re-emergence of infectious disease

•Information technology

collaboration among health care systems, traditional public health, and social policy

Traditional Public Health, Health Care, Social Interventions

Group and community based interventions directed at health promotion and disease prevention (i.e communicable disease monitoring and control)

systems for delivering one-on-one individual health services (i.e disease screening, vaccinations)

Interventions primarily aimed at achieving other non-health goals (i.e housing, economic growth, education, social justice)

full range of strategies designed to protect health and prevent disease, disability, death

•Health issues

•Population(s)

•Society's shared health concerns

•Society's vulnerable groups

Focuses on those with the highest probability of developing disease and aim to bring their risk close to the levels experienced by the rest of the population

Focuses on the entire population and aim to reduce the risk for everyone

the causes of causes / upstream/ distal forces

immediate / proximal cause of disease

BIG GEMS

Behavior

Infection

Genetics

Geography

Environment

Medical Care

Socioeconomic-cultural

Assessment, Policy Development, Assurance

•Monitor health status

•Diagnose and investigate health problems & hazards

•Inform, educate, empower people about health issues

•Mobilize community partnerships

•Develop policies & plans that support individual & community health

•Enforce laws & regulations that protect health & ensure safety

•Link people to needed personal services

•ensure a competent public & personal healthcare workforce

•evaluate effectiveness, accessibility, quality or personal, population health services

•research for new insights and innovative solutions

Problem

Etiology

Recommendations

Implementation

Evaluation

1. Burden of disease (morbidity, mortality, prevalence, incidence)

2. Course of disease

3. Distribution of disease

# of cases with a specific condition/disease in a defined population at a specific time

the number of NEW cases that occur during a specified time in a population AT RISK FOR DEVELOPING THAT DISEASE

mortality rate/incidence rate

a variable that distorts the true relationship between an exposure and an outcome

an analysis using population-level data rather than individual-level data

an apparent result that occurs due to errors in data collection or measurement, not actual differences

cause precedes effect, cause and effect are associated, and altering the cause changes the effect

compares individuals with a disease to those without to identify risk factors

follows a group over time to see who develops disease based on exposure

participants are randomly assigned to intervention or control groups to test causality

assigning subjects to groups by chance to reduce bias

efficacy is how well an intervention works in ideal conditions; effectiveness is how well it works in real-world conditions

measured by the size or magnitude of the association between cause and effect

the ratio of disease risk among exposed individuals to those unexposed

as exposure increases, the risk or severity of disease also increases

the association is observed repeatedly in different studies and populations

the relationship between cause and effect makes sense based on biological knowledge

a factor that must be present for a disease to occur

a factor or combination of factors that inevitably produce disease

evidence-based actions suggested to address public health problems

prevents disease before it occurs

detects and treats disease early

reduces complications and improves quality of life for existing disease

the process of spreading knowledge or interventions to a wider audience

continuous collection and analysis of health data to monitor disease trends

official records of births, deaths, marriages, and other key population data

average number of years a person is expected to live

life expectancy adjusted for time spent in poor health

discusses the need for public health to return to community-based roots

explains the modern challenges and importance of public health

Includes federal, state, and local agencies plus private and community partnerships

The shift from undernutrition to overnutrition and diet-related diseases due to a higher increase of fats, sugars, and salt

As social and economic development occurs, different types of diseases become more prominent

The shift from high birth and death rates to low birth and death rates; extended life spans by size and age distributions