Transcript Mission of Public Health

“Public Health 101”
Nancy Alfred Persily, MPH
Assistant Provost, University at Albany
Associate Dean, School of Public Health
*Special thanks to Lia Snyder, MPH student
Mission of Public Health
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“the fulfillment of society’s interest in assuring
the conditions in which people can be healthy”1
Achieved through the application of health
promotion and disease prevention technologies
and interventions designed to improve and
enhance quality of life2
1Institute
of Medicine, The Future of Public Health, p.40
2Association of Schools of Public Health
Substance of Public Health
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Organized community efforts aimed at the
Prevention of Disease and the Promotion of
Health…and encompasses both activities
Undertaken through government and
associated efforts of private and voluntary
organizations and individuals
Institute of Medicine, The Future of Public Health, p.40
Public Health vs. Medical Care
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Medicine is concerned with individual patients where as
Public Health regards the “community” as its patient
“Public health has many disciplines (medicine, dentistry,
nursing, optometry, nutrition, social work, environmental
sciences, health education, health services administration,
behavioral sciences), its activities focus on entire
populations rather than on individual patients”
Association of Schools of Public Health
Public Health
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Prevents epidemics and the spread of disease
Protects against environmental hazards
Prevents injuries
Promotes and encourages healthy behaviors
Responds to disasters and assists community
recovery
Assures the quality and accessibility of health
services
http://www.health.gov/phfunctions/public.htm
Public Health
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During the 20th century, the average
lifespan of individuals lengthened by 30
years, 25 years of this gain is attributable to
advances in public health
CDC, Morbidity and Mortality Weekly Report
Ten Great Public Health Achievements
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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
CDC, Morbidity and Mortality Weekly Report
Ten Essential Public Health Services
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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
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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 population-based health services
Research for new insights and innovative
solutions to health problems
http://www.health.gov/phfunctions/public.htm
Public Health Functions
Adopted: Fall 1994, Source: Public Health Functions Steering Committee, Members (July 1995):
American Public Health Association·Association of Schools of Public Health·Association of State and Territorial Health Officials·Environmental Council of the
States·National Association of County and City Health Officials·National Association of State Alcohol and Drug Abuse Directors·National Association of State
Mental Health Program Directors·Public Health Foundation·U.S. Public Health Service --Agency for Health Care Policy and Research·Centers for Disease
Control and Prevention·Food and Drug Administration·Health Resources and Services Administration·Indian Health Service·National Institutes of Health·Office of
the Assistant Secretary for Health·Substance Abuse and Mental Health Services Administration
Current Issues in Public Health
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Bioterrorism
 Smallpox
Emerging Infectious Diseases
 West Nile Virus
Violence Prevention
 Firearms
Health Disparities
 Uninsured
Obesity
World Wide
 HIV/AIDS
Bioterrorism – Smallpox Model
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History of Smallpox
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An acute contagious disease caused by variola virus
Originated over 3,000 years ago
For centuries, repeated epidemics swept across continents, decimating
populations and changing course of history
In some ancient cultures, smallpox was such a major killer of infants
that custom forbade the naming of a newborn until the infant had
caught the disease and proved it would survive
Smallpox killed Queen Mary II of England, Emperor Joseph I of
Austria, King Luis I of Spain, Tsar Peter II of Russia, Queen Ulrika
Elenora of Sweden, and King Louis XV of France
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Killed as many as 30% of those infected; between 65-80% of survivors
were marked with deep pitted scars, most prominent on the face
No effective treatment ever developed
Edward Jenner’s demonstration, in 1798, that inoculation with cowpox
to protect against smallpox brought the first hope that the disease could
be controlled
In the early 1950’s – 150 years after the introduction of the vaccination
– an estimated 50 million cases of smallpox occurred in the world each
year, a figure which fell to around 10-15 million by 1967 because of
vaccination
In 1967, when WHO launched an intensified plan to eradicate
smallpox, the “ancient scourge” threatened 60% of the world’s
population, killed every fourth victim, scarred or blinded most
survivors, and eluded any form of treatment
WHO Fact Sheet on Smallpox, October 2001
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Eradication of Smallpox
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Declared globally eradicated in 1980; however, there are
concerns that smallpox virus could be used for bioterrorism
Bioterrorism Preparations
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In May, 2002, a joint working group consisting of members of
the Advisory Committee on Immunization Practice (ACIP) and
the National Vaccine Advisory Committee (NVAC) met
Draft Supplemental Recommendations of the ACIP on the USE
of Smallpox (Vaccinia) Vaccine were approved and now under
consideration by CDC and DHHS
Now conflict on whether to give vaccine on voluntary basis or
inoculate everyone
CDC’s Smallpox Preparation and Response Activities
Emerging Infectious Diseases – West
Nile Virus Model
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Introduction
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The spread of the West Nile virus in the United States is a major health
concern; since the first reported case in New York in 1999, the
mosquito-borne disease has spread across the country
History
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Encephalitis is an inflammation of the brain and can be caused by
viruses and bacteria, including viruses transmitted by mosquito bites
West Nile encephalitis is caused by the West Nile virus, a flavivirus
commonly found in Africa, West Asia, and the Middle East; it is
closely related to the St. Louis encephalitis virus found in the United
States
Discovered in Uganda in 1937; in 1999, it appeared in NYC and
caused largest outbreak in US history - 62 cases, seven deaths
Animals can also be infected - birds get it the most, but horses, cats,
bats, chipmunks, skunks, squirrels, and domestic rabbits
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Symptoms
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Symptoms vary depending on the severity of the infection
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Mild infections
 Flu-like symptoms, fever, headaches and body aches, skin rash,
swollen lymph glands
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Severe infections
 Higher fever, neck stiffness, disorientation, coma, paralysis,
convulsions and muscle weakness, death
Reducing Risks
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Stay indoors at dawn, dusk, and in the early evening
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Wear long-sleeved shirts and long pants when outdoors
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Spray clothing with repellents containing permethrin or DEET
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Apply insect repellent sparingly to exposed skin.
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Install or repair window and door screens so that mosquitoes cannot get
indoors
Centers for Disease Control and Prevention
Violence Prevention – Firearms Model
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Over 200 million guns are in civilian hands; 25 percent of
households have handguns
In 1998, firearm-related injuries the second leading cause
of injury death in US (31,000 deaths)
15,000 unintentional gunshot wounds are treated in US
hospital EDs each year
In 1994, treatment of gunshot injuries in US estimated at
$2.3 billion in lifetime medical costs, of which $1.1
billion was paid by federal government
CDC, Morbidity and Mortality Weekly
Guns in Schools
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Over 3,500 students expelled in 1998-99 for
bringing guns to school; 43% were in elementary
or junior high (US Department of Education)
4.9% of high school students reported having
carried a gun at least once in last 30 days (CDC,
1999)
Public Health Approach
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Collection and analysis of data that describes
scope and patterns of injury
Identification of risk factors and causes
Interventions are proposed, tested, and evaluated
Based on evaluations, successful interventions
are disseminated and monitored for ongoing
effectiveness
Handgun Epidemic Lowering Plan (HELP) Network
Role of Public Health Professionals
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Education
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Teach parents/guardians about risk associated with
keeping a gun in the home
Educate children regarding guns
Research
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Case find through Emergency rooms
Study populations at risk (eg. suicide,
socioeconomic)
Determine risk factors (eg. guns in home, gangs,
abuse)
Role of Public Health Professionals
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Policy
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Safe storage requirements
Close loopholes in secondary markets so that
acquiring a gun requires same scrutiny no matter
where purchased
Computerized data on serious mental health problems
so that background checks can be done quickly,
thoroughly
Harvard Public Health Review, Summer 2002
CDC Program - Prevent Firearm-Related Injuries
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Nationwide system to track firearm-related injuries (National
Electronic Injury Surveillance System [NEISS])
Development of surveillance system
Assess magnitude of firearm injury problem, evaluate programs and
policies designed to prevent injuries
Surveillance summary on firearm injury and mortality
Risk and protective factor research on firearm violence
Risk factors for gun use and injuries among young males living in
inner cities
CDC, National Center for Injury Prevention and Control
Ongoing Interventions
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Rise High Projects – Chicago, Il
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Gun Safety Program – Baltimore, MD
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Public awareness campaign that uses billboards, posters and bus
signs to “deglamorize” handguns and gun violence
Baltimore Co Police Dept uses detectives to teach students in
third, seventh and ninth grades about basic gun safety; included
in course is info from Center to Prevent Handgun Violence’s
Straight Talk About Risks curriculum
People Opening the World’s Eye to Reality (POWER) –
New York, NY
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Patients aged 21-53 paralyzed as result of gun violence or drug
abuse speak to youth about unforeseen consequences of
violence and gunplay
Lack of Integration
(local, state, government)
Economic Impact
Financing
Ethics
Confidentiality
Lack of Educated
Workforce
Barriers to Implementation of a
Public Health Initiative
Education of
Population
Lobbying Groups (eg. NRA; military)
“Our lives begin to end the day we
become silent about the things that
matter” Martin Luther King, Jr.
What Can You Do?
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Museum and Science Centers professionals are
skilled communicators and presenters
People are thirsty for reliable, trustworthy, and
unbiased sources of information regarding Public
Health issues
You can give the public the information they want
and need