Transcript Epidemiology - UNC Center for Public Health Preparedness

Session 1, Part 1
Epidemiology:
A Basic Public Health Science
E is for Epi Series Overview
• Designed for non-epidemiologists
• Provides introduction to:
– History of epidemiology
– Epidemiology specialties
– Key terminology, measures, and resources
• Describes examples of epidemiology in
public health practice
Learning Objectives
Session 1, Part 1
• Define the 10 Essential Public Health
Services
• Explain the science of epidemiology in the
broader context of the ten Essential Public
Health Services
Overview
Session 1, Part 1
• “Quiz”
• The 10 Public Health Essential Services
Quiz
Scenario
As you read the front page of the local paper,
you notice an alarming article about an outbreak
of “disease X” in your community. You read on
to learn about the scientifically established
cause of “disease X,” and precautionary
measures for avoiding exposure.
Question 1
This valuable information was published as a frontpage story because:
a. The local football team lost its game last night
b. The front-page columnist is on vacation
c. State and local health officials and their staff
have worked for weeks to gather data, conduct
laboratory and statistical tests, generate
hypotheses, and collaborate with the media to
alert and educate the public about “disease X”
as effectively as possible
Question 1
This valuable information was published as a frontpage story because:
a. The local football team lost its game last night
b. The front-page columnist is on vacation
c. State and local health officials and their staff
have worked for weeks to gather data, conduct
laboratory and statistical tests, generate
hypotheses, and collaborate with the media to
alert and educate the public about “disease X”
as effectively as possible
Scenario 2
On your way into the local grocery store,
you notice a flyer advertising a toll-free
hotline number for enrolling uninsured
children in a federally funded health
insurance program.
Question 2
This insurance program is being offered because:
a. The federal government has a budget surplus
and is looking for a way to spend it
b. A telephone company offered the state health
department a great deal on 1-800 numbers
c. Public health professionals have documented the
numbers of uninsured children in their states, and
worked with federal and state policy makers to
institute outreach and “wrap around services” that
assure the universal provision of health care
Question 2
This insurance program is being offered because:
a. The federal government has a budget surplus
and is looking for a way to spend it
b. A telephone company offered the state health
department a great deal on 1-800 numbers
c. Public health professionals have documented the
numbers of uninsured children in their states, and
worked with federal and state policy makers to
institute outreach and “wrap around services” that
assure the universal provision of health care
Scenario 3
You and your sweetheart share a romantic
dinner at your favorite restaurant. Not only
is the meal delicious – you do not get food
poisoning!
Question 3
This enjoyable experience has been brought
to you by:
a. The restaurant management
b. Your local health department
c. A joint effort of the restaurant
management and your local health
department
Quiz #3: Question
This enjoyable experience has been brought
to you by:
a. The restaurant management
b. Your local health department
c. A joint effort of the restaurant
management and your local health
department
10 Essential Public Health
Services
Comparison of Services
Public Health Model
Primary focus on population
Medical Model
Primary focus on the individual
Public service ethic, tempered by Personal service ethic,
concerns for the individual
conditioned by awareness of
social responsibilities
Emphasis on community
prevention and health promotion
Emphasis on patient diagnosis,
treatment, and care
Interventions for the
environment, human behavior
and lifestyles, and medical care
Interventions are medical care
Public Health Mission:
“To promote physical and mental
health, and prevent disease,
injury, and disability”
Origin and Purpose
Consensus statement
defines a detailed
model of core public
health functions
“Core Functions” of Public Health
• Assessment
• Policy development
• Assurance
1988
1989
1990
1991
1992
1993
1994
Federal health care
system reform
Core Public Health Functions and
Essential Services
CDC, 2010
#1: Monitor health status to identify and
solve community health problems
• Identification of health risks and
determination of health service needs
• Utilization of technology to interpret and
communicate health information to
diverse audiences
• Attention to the vital statistics and health
status of specific groups that are at
higher risk
• Collaboration in integrating and
managing public health information
systems
#2: Diagnose and investigate
health problems and health
hazards in the community
• Epidemiological identification of outbreaks, patterns of
infectious and chronic diseases and injuries
• Public health laboratory capability using modern
technology to conduct rapid screening and high volume
testing
• Infectious disease epidemiology programs
• Technical capacity for investigation of disease outbreaks
and assessing patterns of chronic disease and injury
#3: Inform, educate, and empower people
about health issues
• Health information, health education, and
health promotion activities
• Health communication plans and
activities such as media advocacy and
social marketing
• Accessible health information and
educational resources
• Health education and promotion program
partnerships
#4: Mobilize community partnerships and
action to identify and solve health
problems
• Partnerships among community groups and
associations to undertake preventive,
screening, rehabilitation, and support
programs
• Coalitions to draw upon the full range of
potential human and material resources in the
cause of community health
#5: Develop policies and plans that support
individual and community health efforts
• Systematic community-level and state-level planning
• Development and tracking of measurable health objectives
• Establishing strategies and actions to guide community
health improvement
• Development of legislation, codes, regulations,
ordinances, and other policies to enable performance of
the Essential Public Health Services
#6: Enforce laws and regulations that protect
health and ensure safety
• Enforcement activities in areas of public health
concern
– Protection of drinking water and enforcement of clean air
standards
– Re-inspection of workplaces following safety violations
– Enforcement of laws governing the sale
of alcohol and tobacco to minors
– Seat belt and child safety seat usage
– Childhood immunizations
#7: Link people to needed personal health
services and assure the provision of
health care when otherwise unavailable
• Identifying populations with
barriers to personal health
services
• Identifying personal health
service needs of populations
with limited access
• Assuring the linkage of people to appropriate
personal health services through
– Coordination of provider services
– Development of interventions that address barriers to
care (e.g. language)
#8: Assure a competent public and personal
health care workforce
• Education and training
• Credentialing technical and professional
health personnel
• Adoption of continuous quality
improvement and life-long learning
programs
• Partnerships with professional workplace development
programs
• Continuing education in management, cultural
competence, and leadership development programs
#9: Evaluate effectiveness, accessibility, and
quality of personal and population-based
health services
• Evaluation and critical review of health
programs
– based on analyses of health status and
service utilization data
– to determine program effectiveness
– to provide information for allocating resources
and reshaping programs
#10: Research for new insights and
innovative solutions to health problems
• Link with institutions of higher
learning and research
• Mount timely epidemiological and
economic analyses
• Conduct needed health services
research
– Survey design; conducting interviews and facilitating
focus groups
– Conducting clinical trials
– Accessing and using public records
Corresponding Services
Quiz Scenario
Essential Service
Informing the public of an
outbreak investigation in the
community
#2: Diagnose and
investigate health problems
and hazards in the
community
Promoting enrollment in a
federally subsidized health
insurance program
#7: Link people to needed
personal health services and
assure the provision of
health care when otherwise
unavailable
Maintenance of a sanitary
#6: Enforce laws and
restaurant environmental for regulations that protect
public well-being
health and ensure safety
Summary
• Core Functions of public health are assessment,
policy development, and assurance
• The 10 Essential Public Health Services create a
“common ground” and a comprehensive
infrastructure that provides a supportive context
for any public health priority in a community
• Epidemiology is a quantitative tool that can be
used to implement Essential Public Health
services
References and Resources
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Gordis L. Epidemiology. 2nd ed. Philadelphia, Pa: WB Saunders Company;
2000.
Hearne SA, Segal LM, Earls MJ, Unruh PJ. Ready or Not? Protecting the
Public’s Health in the Age of Bioterrorism. Washington, DC: Trust for
America’s Health; December 2004. Issue Report. Available at:
http://healthyamericans.org/reports/bioterror04/BioTerror04Report.pdf.
Accessed March 1, 2012.
Office for State, Tribal, Local and Territorial Support, Centers for Disease
Control and Prevention 10 Essential Public Health Services [National Public
Health Performance Standards Program Web site]. December 9, 2010.
Available at: http://www.cdc.gov/nphpsp/essentialservices.html. Accessed
March 1, 2012.
Kipp A. Overview of Epidemiology in Public Health [online training]. North
Carolina Center for Public Health Preparedness, University of North Carolina
at Chapel Hill School of Public Health; 2004. NCCPHP Training Web Site.