Transcript Component 1: Introduction to Health Care and Public Health in the

Component 1: Introduction to
Health Care and Public Health
in the U.S.
Unit 1: Introduction to modern healthcare in the US
Introduction to Public health
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"the science and art of preventing disease,
prolonging life and promoting health through the
organized efforts and informed choices of
society, organizations, public and private,
communities and individuals."
Public Health
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Vaccination
Motor-vehicle safety
Safer workplaces
Control of infectious diseases
Decline in deaths from coronary heart
disease and stroke
Safer and healthier foods
Healthier mothers and babies
Family planning
Fluoridation of drinking water
Recognition of tobacco use as a health hazard
10 Great Public Health
Achievements – US, 1900-1999
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Control of infectious diseases
◦ Example: Typhoid
 spread by ingesting contaminated food or water
 In 1891 the typhoid death rate in Chicago alone was
174 per 100,000 people.
 Now, thanks to public health measures only about
400 cases are seen in the US each year, most of
whom originate when patients travel in developing
countries
Public Health Successes
(continued)
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
Control of infectious diseases
◦ Example: Smallpox
 Epidemic viral illness, possibly responsible for
hundreds of millions of deaths in the 20th century
alone
 In the early 1950s there were about 50 million cases
of smallpox each year worldwide
 By 1977, smallpox was eradicated, thanks to an
aggressive public health program and the use of an
effective vaccine
Public Health Successes
(continued)
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Control of nutritional deficiencies
◦ Example: Goiter
 Lack of iodine in diet leads to impaired thyroid
hormone synthesis and an enlargement of the
thyroid gland in the neck (a goiter)
 Fortification of salt with iodine virtually eradicated
nutritional goiter in the US
Public Health Successes
(continued)
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
Control of nutritional deficiencies
◦ Example: Tooth Decay
 Adding fluoride to drinking water substantially
reduces the incidence of dental caries (tooth decay)
in populations
 In 1945 fluoride was added to water in Grand
Rapids, Michigan, which resulted in a reduction in
cavities.
 Now over 10,000 US communities fluoridate their
water
Public Health Successes
(continued)
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Improvements in understanding disease
◦ Epidemiology is considered the basic science of public
health and is
 a quantitative basic science
 a method of causal reasoning based on developing
and testing hypotheses pertaining to occurrence and
prevention of morbidity and mortality
 a tool for public health action to promote and protect
the public’s health
How has public health improved
healthcare?
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Improvements in understanding disease
◦ An example of epidemiology at work:
 In 1854 -- epidemic of cholera in London, England.
 Cholera is a bacterial disease spread by
contamination of food or water
 Lack of sanitation and overcrowding -- important
factors that led to the spread of disease
 Spread of disease linked to a contaminated public
water pump by Dr John Snow
 Snow’s hypothesis: cholera was spread by
contaminated water
How has public health improved
healthcare?
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Improvements in data collection
◦ Original methods of data collection were crude
◦ progressive improvement in methodology led to the
use of sophisticated scientific methods to collect data
 cohort studies
 randomized control trials
How has public health improved
healthcare? (continued)
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Improvements in data collection
• Example: the Framingham Heart Study
• The study followed patients for a number of years to
identify factors that contribute to the development of
cardiovascular disease (CVD)
• Over the years, three generations of participants have
helped identify major CVD risk factors
How has public health improved
healthcare? (continued)
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Improvements in data analysis (use of tools
such as multivariate analysis and metaanalysis)
 Improvement in disease surveillance
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◦ Example: the Real-Time Outbreak and Disease
Surveillance (RODS) Laboratory at the University of
Pittsburgh, Department of Biomedical Informatics
How has public health improved
healthcare? (continued)
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Health IT Workforce Curriculum
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Improvement in training
◦ Establishment of many schools of public health in the
early 20th century
◦ Professional degrees such as Master of Public Health
(M.P.H.)
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Improvements in infrastructure
◦ Federal
◦ State
◦ Local health departments
How has public health improved
healthcare? (continued)
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