Transcript What is Public Health? - University of Florida

WHAT IS PUBLIC HEALTH?
Allyson Hall, PhD
Department of Health Services Research,
Management, and Policy
College of Public Health and Health Professions
WHO’s Definition of Health
HEALTH IS A STATE OF COMPLETE
PHYSICAL, MENTAL AND SOCIAL
WELL-BEING, AND NOT MERELY
THE ABSENCE OF DISEASE OR
INFIRMITY
WHO, http://www.who.int/about/definition/en/print.html
An Ecological Model of Health

An Ecological Model:
 multiple
determinants of health
 linkages and relationships among determinants are
emphasized
Determinants of Population Health: The Ecological
Model
• Psychosocial factors
• Employment status and
occupational factors
• Socioeconomic status
• Natural and built
environments
• Public health and
health care services
Source: Institute of Medicine, 2003
Assumptions about Public Health
Public health problems are multi-causal
 Personal, group and population
‘behaviors’ are related to public health
problems
 Behaviors are influenced by a wide
range of factors

Definition
Public health is what we, as a society, do collectively
to assure the conditions in which people can be
healthy.
Public Health
September 10, 2007
Public Health’s Mission
Protecting health on a population level
Social justice emphasis
Health Promotion and Prevention
Recognized as a means to meet public health
objectives and improve public health interventions
Concerned with :
 Changing individuals and groups behavior
 Improving their social environment
Health Promotion and Health Behavior
Research and Practice Strives to:
Help people adopt new behaviors
 Help people cease old behaviors
 Reinforce healthy behavior
 Ensure a supportive and healthy
environment

The Fall in the
Standardized Death Rate
(per 1,000) for Nine
Common Infectious
Diseases in Relation to
Specific Medical Measures,
US 1900-1973
Scarlet Fever
Measles
Typhoid
TB
Influenza
Pneumonia
Whooping
Cough
Polio
Diphtheria
Source: McKinlay and McKinlay, 1977
Motor-vehicle related
deaths per 100,000
population and per 100
million vehicle miles
traveled
Source: Centers for Disease Control and Prevention MMWR, 1999
Ten Great Public Health Achievements
– United States, 1900-1999





Control of infectious
disease
Vaccination
Motor-vehicle safety
Safer workplaces
Declines in death from
coronary heart
disease and stroke





Safer and healthier food
Healthier mothers and
babies
Family planning
Fluoridation of drinking
water
Recognition of tobacco
as health hazard
Centers for Disease Control and Prevention, MMWR, 1999
The Essential Public
Health Services
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Monitor health status to identify community health problems.
Diagnose and investigate health problems and health hazards in the
community
Inform, educate and empower people about health issues
Mobilize community partnerships to identify and solve health problems
Develop policies and plans that support individual and community health
efforts
Enforce laws and regulations that protect health and ensure safety
Link people to needed personal health services and assure the provision of
health care when otherwise unavailable
Assure a competent public health and personal health care workforce
Evaluate effectiveness, accessibility, and quality of personal and populationbased health services
Research for new insights and innovative solution to health problems
Source: Public Health Function Steering Committee
In a nutshell….
Public Health Science
• Defines the problem (the who)
• Identifies risk factors for the disease (the why)
• Develops and implements interventions
• Measures effectiveness
Assessment
Policy
Development
& Program
Implementation
Assurance
Core Public Health Areas
• Epidemiology
• Biostatistics
• Environmental Health
• Health Services Administration/Health Policy
• Social and Behavioral Sciences
The Public Health System
Community
Health care
delivery system
Governmental Public Assuring the Conditions
Health Infrastructure for Population Health
Academics
Source: Institute of Medicine, 2002
Employers &
Business
The Media
The Government Public Health
Infrastructure
•Local Health Departments
• State Health Departments
• Department of Health and Human Services
• Centers for Disease Control and Prevention
• National Institutes of Health
• Health Resources and Services Administration
• Food and Drug Administration
Jobs in Public Health
Health educator
Epidemiologist
Health policy analyst
Community organizer/activist/advocate
Public health department director
Occupational health and safety expert
Food safety expert
Public health lawyer
In conclusion…
There is much work to be
done……
Leading Causes of Death for Males by Race and
Hispanic Origin, United States 2001
All Races
White
Black
Hispanic
All Ages
Diseases of the
heart
Diseases of the
heart
Diseases of the
heart
Diseases of the
heart
1-14
Accidents
Accidents
Accidents
Accidents
15-19
Accidents
Accidents
Homicide
Accidents
20-24
Accidents
Accidents
Homicide
Accidents
25-34
Accidents
Accidents
Homicide
Accidents
35-44
Accidents
Accidents
Diseases of the
heart
Accidents
45-54
Diseases of the
heart
Diseases of the
heart
Diseases of the
heart
Diseases of the
heart
55-64
Cancer
Cancer
Cancer
Cancer
65+
Diseases of the
heart
Diseases of the
heart
Diseases of the
heart
Diseases of the
heart
Source: National Center for Health Statistics, Health United States, 2003
Actual Causes of Death in the
United States, 2000
Percent of all deaths
20
18
17
15
10
5
0
Source: Mokdad et al, 2004
4
3
2
2
1
1
1
Percent Adult Current Smokers*, by selected
characteristics: United States 1999-2001
35
30
32
27
29
27
26
24
25
18
20
13
15
10
6
5
0
18-24
25-44
45-64
65-74
75+
Below
Poverty
*Smoked at least 100 cigarettes in lifetime and currently smokes
Source: National Center for Health Statistics, Health United States, 2003
>= to <2
times
poverty
>=2-<4
times
poverty
< 4 times
poverty
Percent of Women Who Are Overweight*, by
Selected Characteristics: United States 19992001
70
59
60
50
40
59
56
55
51
47
46
43
33
30
20
10
0
18-24
25-44
45-64
65-74
75+
Below
Poverty
*BMI greater than or equal to 25
Source: National Center for Health Statistics, Health United States, 2003
>= to <2
times
poverty
>=2-<4
times
poverty
< 4 times
poverty
Want to work in public health?
Public Health at the University of
Florida
http://www.mph.ufl.edu/