Transcript Public Health: What It Is and How It Works

Public Health:
What It Is and How It Works,
Fourth Edition
• Chapter-by-Chapter Power Point Slides
• Links to Internet-based resources
Chapter 7
Public Health Interventions
Chapter 7 Will Help You To:
• list general categories of public health programs and services
• describe the difference between community prevention and clinical
preventive services
• describe the major steps in the planning, implementation, and
evaluation of a public health program
• describe how and when planning and evaluation occur during the
life of a program
• define and develop outcome, impact, and process objectives
• describe the relationships among activities, process measures,
impact measures, and outcome measures in the evaluation of a
program
• Explain the difference between doing things right and doing the right
things within the context of a public health intervention
Interventions, Programs,
and Services
• Are programs different from services?
• Levels of prevention
• Clinical preventive services vs. community
preventive services
• Evidence based community preventive
services
– Task Force on Community Preventive
Services
Who Does What in the Community?
Organizations Providing Surveillance and Epidemiology Services
Environmental health
Communciable/infectious disease
Chronic disease
Syndromic
Behavioral risk factors
Injury
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Percentage of Jurisdictions
LHD only
both LHD and State
other local gov't agency only
State agency only
Non-gov't organization only
Who Does What in the Community?
Government Agencies Providing Treatment for Communicable Diseases
Tuberculosis
Other STDs
HIV/AIDS
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Percentage of Jurisdictions
LHD Direct
LHD Contract
LHD Direct & Contract
Other local gov't agency
State agency
100%
Who Does What in the Community?
Government Organizations Providing Screening for Disease and Conditions
Tuberculosis
High blood pressure
Blood lead
Other STDs
HIV/AIDs
Cancer
Cardiovascular disease
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Percentage of Jurisdictions
LHD Direct
LHD Contract
LHD Direct & Contract
Other local gov't agency
State agency
Who Does What in the Community?
Government Agencies Providing Maternal and Child Health Services
WIC
Family Planning
EPSDT
Prenatal care
Obstetrical care
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Percentage of Jurisdictions
LHD Direct
LHD Contract
LHD Direct & Contract
Other local gov't agency
State agency
100%
Who Does What in the Community?
Organizations engaged in regulation, inspection and/or licensing activities
Food service establishments
School/daycare
Hotels/motels
Campgrounds & RVs
Mobile homes
Health-related facilities
Housing (inspections)
Tobacco retailers
Cosmetology businesses
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Percentage of Jurisdictions
LHD only
Other local gov't only
state gov't agency only
multiple gov't agencies
non-gov't agency only
Who Does What in the Community?
Organizations engaged in regulation, inspection and/or licensing activities
Swimming pools (public)
Septic tank installation
Private drinking water
Lead inspection
Smoke-free ordinances
Solid waste haulers
Solid waste disposal sites
Food processing
Public drinking water
Milk processing
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Percentage of Jurisdictions
LHD only
Other local gov't only
state gov't agency only
multiple gov't agencies
non-gov't agency only
100%
Who Does What in the Community?
Organizations providing environmental health services
Food safety education
Vector control
Groundwater protection
Indoor air quality
Surface water protection
Pollution prevention
Hazardous waste disposal
Noise pollution
Land use planning
Hazmat response
Radiation control
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Percentage of Jurisdictions
LHD only
other local gov't agency only
state agency only
multiple gov't agencies
non-gov't organization only
Who Does What in the Community?
Organizations providing environmental health services
Food safety education
Vector control
Groundwater protection
Indoor air quality
Surface water protection
Pollution prevention
Hazardous waste disposal
Noise pollution
Land use planning
Hazmat response
Radiation control
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Percentage of Jurisdictions
LHD only
other local gov't agency only
state agency only
multiple gov't agencies
non-gov't organization only
100%
Who Does What in the Community?
Organizations Providing Other Public Health Services
School health
School-based clinics
Outreach and enrollment for
medical insurance
Animal control
Veterinarian public health activities
Correctional health
Laboratory services
Occupational safety and health
Emergency medical services
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Percentage of Jurisdictions
LHD only
other local gov't agency only
state agency only
multiple gov't agencies
non-gov't organization only
100%
Who Does What in the Community?
Government Agencies Providing Other Health Services
Oral health
Home health care
LHD Direct
LHD Contract
LHD Direct & Contract
Comprehensive primary care
Other local gov't agency
State agency
Behavioral/mental health services
Substance abuse services
0%
10%
20%
30%
40%
50%
60%
Percentage of Jurisdictions
70%
80%
90%
100%
Who Does What in the Community?
Organizations Providing Population-based Primary Prevention Services
Tobacco
Obesity
Unintended pregnancy
Injury
Violence
Substance abuse
Mental illness
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Percentage of Jurisdictions
LHD only
LHD & non-gov't
State agency only
Multiple gov't agencies
Non-gov't organization only
100%
Program Management
in Public Health
•
•
•
•
•
Where are we?
Where do we want to be?
Should we do something?
What should we do?
How do we know we are making progress?
–
–
–
–
Outcome objectives
Impact objectives
Process objectives
Activity measures
Discussion
• A public hearing is being held in your community to
determine how to spend money that can be used to
address an important environmental health problem
facing the community. You are asked to testify at this
public hearing.
• The county health department and the county medical
association have provided data demonstrating high levels
of lead in the blood of children that have been screened
to date and rates of lead poisoning higher than state and
national averages. Several civil and community
organizations in the community believe that the funds
should be used for a campaign to eliminate leaf burning
in the community, although they provide no data on
illnesses or death from that cause.
• What would you say in your testimony? Be sure to
include arguments, evidence and rationale to support
your conclusions.
Additional Resources
•
•
•
•
•
•
An Ounce of Prevention...What Are the Returns? (PDF
format) CDC; 1999
Effectiveness of Disease and Injury Prevention. MMWR
1996;46:No4
Framework for Program Evaluation in Public Health.
MMWR 1999;48:RR-11
Guide to Community Preventive Services
National Guideline Clearinghouse. AHRQ-AMA-AAHP.
Evidence-based clinical practice guidelines
Public Health Innovation Exchange (descriptions of
innovative projects). American Public Health Association