Transcript comp1_unit8c_lecture_slides

Component 1: Introduction to Health
Care and Public Health in the U.S.
1.8: Public Health Part II
1.8c: Public Health and Chronic
Diseases and Environmental
Health
Chronic Diseases
• The success of public health in combating
infectious diseases has led to our current
situation, where chronic diseases have taken
the stage as the leading causes of death in
the US
• 7 of the 10 leading causes of mortality are
chronic diseases, led by the top 4: Heart
disease, Cancer, Stroke, and Chronic lower
respiratory diseases
Component 1/Unit 8c
Health IT Workforce Curriculum
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Leading Causes of Mortality in
US, 2007 Data
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Heart disease: 616,067
Cancer: 562,875
Stroke (cerebrovascular diseases): 135,952
Chronic lower respiratory diseases: 127,924
Accidents (unintentional injuries): 123,706
Alzheimer's disease: 74,632
Diabetes: 71,382
Influenza and Pneumonia: 52,717
Nephritis, nephrotic syndrome, and nephrosis: 46,448
Septicemia: 34,828
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Chronic Disease Topics
Chronic disease topics include:
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Arthritis
Asthma & Allergies
Cancer
Chronic Fatigue Syndrome
Diabetes
Epilepsy
Heart Disease
Hemochromatosis
Hepatitis B
Hepatitis C
Iron Overload
Osteoporosis
Overweight and Obesity
Stroke
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Chronic Disease: Prevention
• CDC estimates that 70% of deaths in the US are now
caused by chronic diseases
• Public health focus on behaviour modification
• Chronic diseases mainly due to four modifiable health
risk behaviors
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lack of physical activity
poor nutrition
tobacco use
excessive alcohol consumption
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Chronic Disease - Education
• Since behaviour modification is the main public
health goal, the tools to effect that are –
– Education and informational materials
• For the public
• For health care practitioners
• For policymakers
– Funding opportunities
– Recommendations, best practices, guidelines
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World Health Organization
(WHO) and Chronic Diseases
• The WHO has developed the “Stepwise
Framework”
• PLANNING
– STEP 1: Estimate population need and advocate for
action
– STEP 2: Formulate and adopt policy
– STEP 3: Identify policy implementation steps
• IMPLEMENTATION
– Table of 3 steps
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WHO Stepwise Framework
Policy implementation
steps
Population-wide interventions
National Level
Interventions for
individuals
Sub-National Level
Implementation step 1
CORE
Interventions that are feasible to implement with existing
resources in the short term.
Implementation step 2
EXPANDED
Interventions that are possible to implement with a
realistically projected increase in or reallocation of resources
in the medium term.
Implementation step 3
DESIRABLE
Evidence-based interventions which are beyond the reach of
existing resources.
www.who.int/chp
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Environmental Public Health
• Environmental public health is vital to population
health
• Removal of lead from gasoline and from house
paint are two of the numerous triumphs of this
field
• Other critical functions include air and water
quality monitoring and education, and hazardous
waste management
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Environmental Topics
• One way of categorizing environmental topics is by their means of
contact with the population, such as –
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air quality
food protection
radiation protection
solid waste management
hazardous waste management
water quality
noise control
environmental control of recreational areas
housing quality
vector control
• Another categorization method is to organize topics by public health
program
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Environmental Programs and
Topics
Public Health environmental programs and topics
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Air Quality
Bioterrorism Agents/Diseases
Chemical Agents
Environmental Hazards and
Exposure
Food Safety
Hazardous Substances
Hazardous Waste Sites
Health Disorders and the
Environment
Herbicides
Component 1/Unit 8c
– Hydrocarbons
– Laboratory Measurements in
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– Lead
– Natural Disasters
– Pesticides
– Smoking and Tobacco Use
– Urban Planning for Healthy
Places
– Vessel Sanitation and Health
– Water Quality
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Chronic Diseases and
Environmental Public Health
• There is some overlap between chronic diseases and environmental
topics. Some examples –
– Smoking, asthma, air quality
– Cancer, environmental hazards and exposure, chemical agents
• Similarly, there are overlaps between communicable diseases and
environmental topics, such as
– Bioterrorism
– Water quality and water-related diseases
• Divisions between different facets of public health can be artificial,
created for efficiency of organization. In actuality, relationships
between facets of public health are often complex rather than simple
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