Transcript document

PUBH 8002. A SYNTHESIZED PUBLIC HEALTH STUDIES. 1QTR.WK1-11
FINAL PROJECT: NWABUIBE, Collins.doc
PRESENTATION
November 11, 2013
What Is Public Health?
Public Health has been described as the science and art of
Protecting and improving the health of community through
education, promotion of healthy lifestyle, and research for
disease and injury prevention. Public Health helps improve
the and well-being of people in local communities and
around the globe. PH works to prevent health problems
before they occur
Definitions’ of Public Health
Winslow (1920),describes it as “ the science and art of
preventing life, and promoting physical health and
efficiency through organized community efforts for the
sanitation of the environment, the control of community
infections, the education of the individual in principles of
personal hygiene, the organization of medical and nursing
services for the early diagnosis and preventive treatment of
disease, and the development of the social machinery
which will ensure to every individual in the community a
standard of living adequate for the maintenance of health”
Turnock (2001), later described public health as the “
collective effort to identify and address the unacceptable
and realities that result in preventable and avoidable health
outcomes, and it is the composite of efforts and activities
carried out by people committed to these ends”
Institute of Medicine (1988), offered a condensed definition
of public health as “ fulfilling society’s interest in assuring
conditions in which people can be healthy, “,
WHO , Public Health refers to all organized measures (
whether public or private) to prevent disease, promote
health and prolong life among the population as a whole.
Its activities aim to provide conditions in which people can
Core Functions of public health
The three main functions of public health are
oThe assessment and monitoring the health of communities and
populations at risk to identify health problems and priorities
oThe formation of public policies designed to solve identified local
and national health problems and priorities
oTo ensure that all populations have access to appropriate and
cost-effective care, including health promotion and disease
prevention services.
Applications of ph core functions
oAssessment
oPolicy development
oAssurance
( e.g. , guidelines and strategies in preventing
HIV/AIDS)
Brief history of Public Health
•
During the past 150 years two factors have shaped the modern public health system: first, the growth of
scientific knowledge, second, the growth of public acceptance of disease control as their responsibility,
•
In earlier centuries, little was known about the causes of disease, society tended to regard illness with a
degree of resignation and few public action was taken
•
Public organizations, and agencies were formed to employ newly discovered interventions against health
threats
•
Scientific knowledge grew, public authorities expanded to take on new task i.e. sanitation, immunization,
regulation, health education, and personal health care
•
In 18th century, outbreak of epidemic such as the plaque, cholera, and smallpox evoked sporadic public
health effort to protect citizens in the face of dread disease
•
Isolation and quarantine of the ill became common measures for containing specified contagious disease (
e.g., several American ports cities adopted rules for trade quarantine and isolation of the sick)
•
In 1601, the practice of public health became official in England following the adoption of Poor Law which
continued in American colonies (Grob,1996;Starr, 1982)
•
The 19th century marked The Great Sanitation Awakening and advance in Public Health and the
identification of filth as both a cause and a vehicle for transmission of disease (Winslow, 1923)
In the US,
o Shattuck (1850), documented vital statistics on Massachusetts population finding differences in morbidity
and mortality rates in different localities
o Dorothea Dix ( n.d), and others led the movement in the establishment of some 32 public institutions to
care for individuals who mentally ill
o
In the 19th century social reform movement established the principles of state
responsibility for
Impact of public health
In brief,
achievements of public health in the 20th century have
improved our quality of life: an increase in life expectancy, worldwide
reduction in infant and child mortality, and the elimination or reduction of
many communicable diseases
• Today, and into the 21st century, PH leaders have strengthened their roles
as advocates for improved population-based health in an International
and local community
• In 1999, the Centers for Disease Control and Prevention named the top
ten greatest public health achievement of the 21st century- advances have
been made largely responsible for increasing the lifespan of populations;
over twenty-five or twenty years can be accredited to public health
initiatives, while medical advances account for less than four years.
In sum, the average life expectancy for Americans has increased by about 30
years since 1900.
•
The dramatic
Why is public health controversial
Introduction-Public health services (interventions) have propensity to be
embroiled in controversies, very engrossing and can hardly be settled once
and for all to everybody’s satisfaction.
The Controversies- People take position when Public Health debate is on,
especially among the expert who refuse to part away their stands-on of
methods of intervention, application, regulations or
management/implementation part of it on human populations ( e.g.,
structural issues and other factors such as economics, politics, the values
of individuals liberty, religion and morals, and cultural context as the key
issues) The role of these factors and other structural factors such as stigma
and discrimination associated with HIV/AIDS also diminishes public health
responses to the (HIV/AIDS vulnerability) development of policies and
decision making and response in prevention and control ( Malikhoa, 2006)
Public Health Workforce
Definition
The public health workforce has frequently been defined as those individuals
employed by local, state, and Federal government health agencies for the
purpose to improve health outcomes by enhancing the training, skills, and
performance of public health workers. For purpose of this discussion,
individuals in academia who educate, train, or perform research in public
health should be considered part of the public health workforce
responsible for providing the services identified in the Public Health in
America statement regardless of the organization in which they work
(Evans & Stoddard, 1994)
objectives
o Enhance the ability of the public health workforce to improve public health at
home and abroad
o Strengthen the nation’s humans service workforce
o Improve national, state, local and tribal surveillance and epidemiology, laboratory
capacity, and support monitoring and evaluation systems that measure HIV
prevalence and incidence, behavior change, population health status. Improve
national, state, local public health, and human service workforce capacity
o To recruit, hire, retain a talented and diverse public health workforce that is
representative of the American people health services
o Create culture of wellness across public health services by assessing existing onsite
health and wellness programs, and develop plans to expand and enhance
programs across public health delivery system in the US. ETC,.
Other occupations within ph
o
o
o
o
o
Health policy & management
Epidemiology
Health communication
Occupational safety & Health,
Environmental Health Science
Wk4 Public Health & the Government
Introduction
o The role of Government in public health in the USs is complex, sometimes
difficult to discern, and always determined by legislation at the federal,
state, or local levels. Although, health is not defined in the Constitution
the states have primary authority, and within the states, local public
health agencies have responsibility for day-to-day efforts in providing
healthcare services to the need population
Gov’t Role
o
o
o
o
To provide guidelines/framework Analysis for state health departments
Functions
Structure of local Health Department
Policies, regulations, and funds
Wk 5. A Review of Fielding & Briss article on: Promoting Evidence-Based PH.
Policy & Practice
Introduction
o The discussion was on how we can integrate scientific base evidence with
community evidence-based interventions into community health system
to achieve an effective health services, and why it has not been a priority
in the US. Having this mind, Fielding & Briss ( 2006) identified scientific
base tools available that will help integrate best available information with
public health policy and practice; such tools include
o the health Impact Assessment
o scientific Review
o portfolio for assuring community fit, and
o feasibility/accessibility
Best available Information Fielding & Briss (2006) missed in their article
o Fielding & Briss failed to identify the following tools that could have
Impacted integration of information in public health policy and practice to
promote Evidence-Based concept that ensures effective interventions into
Communities, and public health policy and practice. These tools include
o Training and planning tools
o US health surveillance
o Systematic reviews and evidence-based guidelines
o Economic evaluation
o Gray literature, and above all engaging the Community in Assessment and
decision-making, and using data and information gathered from the
residence in the community
Challenges In Implementing Effective Policies & Practice in Communities
o
o
o
o
Political Interference
Lack of funding
Skilled personnel
Lack of representation of all population settings and type of methods used
in collection of data
o Economic context of the affected population
o Lack of collaboration between the sectors. Etc.,
Did PH Policies & Practice succeed using scientific evidence-base?
• YES,
o Has provided successful sources of public health recommendations based
on systematic reviews as a Guide to Community Preventive services:
targeted laws such as smoking bans, child safety seat laws, vaccination
requirements for schools, and community-wide policies on water
fluoridation. See Appendix i ( % of Ga. population covered by 100%
Smokefree Air Law. 2013)
o Provided policy makers information to make informed policy decisions to
improve the effectiveness of state public health programs and health of
the population
o Has been used to develop policy strategies, draft legislation, evaluate
proposed legislation or monitor program progress
o Helped to educate the public on disease prevention through mass media
and social marketing
o Successful Process evaluation, and Cost-effectiveness evaluation. etc.,
Wk6 . A Reviewed MMWR article on Morbidity & Mortality Rates
Introduction
o The MMWR, a prepared report on Morbidity and Mortality report by the
Center for Disease Control and Prevention (CDC). Often called “ The Voice
of CDC”
o The primary objective
o Vehicle for the agencies timely publication of scientific reports on
prevention of further spread or transmission of Mycobacterium,
tuberculosis, and regimen for preventing diseases in the environment
o Recommend early prevention and treatment o diseases in communities
and globally
o Recommend diagnosis and screening
Method Used by MMWR in investigating Disease outbreak such as
Tuberculosis (TB), include- Index Patient, and Chest Radiography
Wk7 . Disc. Infectious Disease and PH focus
In this topic we discussed- A Historic Prevalence and Distribution of Avian
A(H7N9) among wild bird
According to Olson, et al, (Feb.2013), revealed in their studies of Prevalence
and Distribution of Avian Influenza Virus A(H7N9) among Birds in China of
infections of the disease, and the researchers identified Chains of Infection
and the links in the distribution of the diseases. Also, Chen, et al, (2011), in
their studies of the A(H7N9) virus prevalence, after reviewing GenBank
data, revealed that humans were infected by domestic birds. The out
break of the and the impact on environment and humans were
devastating that Public Health officials took notice and began investigation
on the pattern or factors that enhances the spread of the infectious
disease. According to WHO ( 2012), infectious diseases are emerging
more, and prevalence in distribution of influenza virus infections which
attracted Public health prevention and control measures (e.g., SARS and
Pandemic Influenza in H1N1 in Canada)
The Impact
o PH focus on infectious diseases trends is to monitor the impact of public
health prevention and control measures (e.g., immunization health
promotion). Furthermore, public health focus on early detection,
monitoring, and carryout investigations to identify the source, including
laboratory testing of available, isolation and treatment of the sick
(quarantine people to limit spread of diseases), and follow-up with close
contacts of the sick
Wk 8. Disc.- Preventing Chronic Diseases
Introduction
o Preventing chronic diseases by PH was a success that led to a change in
the major causes of illness and death especially in the US. Despite the
multiple causes of Chronic degenerative diseases, through research
scientist ( Epidemiologists), and other Public health officials were able to
recognize significant risk factors and was able to establish preventive
measures to combat the chain links’ from spreading infectious diseases
and other related health issues especially among low income populations
( e. g.. New York City’s Health Bucks Program explored and implemented
by Public Health in Preventing Chronic Disease developments in humans).
Most Effective Measures to Prevent Chronic Diseases
These measures include,
o Primary Prevention level- is usually aimed at the population as a whole
and is considered the most effective preventative health care available
(e. g., Immunization are probably the most effective primary prevention
of diseases), and/or health education promoting the use of condoms to
prevent HIV/AIDS, infections.
o Secondary level- disease prevention is in this level is intended for those
who have risk factors for developing a disease but not yet have a diagnosis
or symptoms. The goals of secondary prevention is to identify, and treat if
necessary, those people and catch the disease as early as possible to avoid
advanced disease and symptoms' ( e. g., screening test), an excellent
secondary level disease prevention
o Tertiary – when primary prevention has failed and secondary prevention
has done all they can do to improve the patient’s condition, tertiary
prevention becomes the means to fight the disease ( e. g., follow-up and
monitoring of all regimens, and therapy to help restore individuals’
functions).
Wk9 Disc. The Role of Genetics and Genomics in Public Health
Should the Government invest significant Resources on Genomics studies
o The role of Genomics in Public Health is to integrate advances in human genetics
into Public Health research, policy, and programs. Therefore, is imperative a
significant resources is expended in Genomics to enable researchers advance
their studies especially in investigating the role of Family history which is
extremely important in determining appropriate behavior and care.
o There is need to further integration of genetic services and education in Public
Health in the US, and in developing countries in which public and private health
services are dichotomized- in other words, significant resources is needed to dedichotomize these services.
o Genomic medicine will further enhance core ph functions and essential services (
e. g., from Newborn Screening to DTC Genetic Testing), significant resources spent
on integration of Genomics into PH will enhance standards and guidelines, in
collaboration with stakeholders in development and promotion of appropriate
use of genetic information and the effectiveness, accessibility, and quality of
genetic tests and services.
o Spending significant resources in Genomics will quarantine quality Assessment,
and Assurance, Policy Developments to constituents’ that genetic information is
used appropriately, genetic test and services meet the agreed upon goals for
effectiveness, accessibility, and affordability of essential services.
Percentage Georgia State Population Covered by 100% Smokefree Air Laws
October 1, 2013
• This table represent Ga. state population covered by 100% smokefree air
laws enacted by the state and local municipal public health departments.
These ordinances and laws currently in effect.
State type
% of
state population
of laws
with 100%
laws smokefree
non-hospitality
workplace laws
GA State
0%
GA
Local
12%
% of state
% of state population
population with
with 100% smokefree
100% smokefree
bar laws
restaurant laws
0%
6.1%
% of state population
% of state population with
with 100% smokefree
any 100% smokefree
non-hospitality
laws
workplace & restaurant
& bar laws
0%
3.5%
Source: [email protected]
0%
2.3%
0%
15.9%
.
.
.
.
.
.
.
In Conclusion
o Public Health innovations has helped humans life expectancy especially in
the US and globally. Through scientific evidence information researcher
provided quality and optimized information that enabled policy makers to
provide informed policies and regulations to state and local public health
services agency’s. Public health education created awareness to the public
preventive measures to combat factors that enables the spread of
infectious diseases in humans. Public health innovation provided the
strategies in the integration of scientific evidence and Evidence-Based
studies in determining the most effective interventions in the treatment of
chronic diseases affecting low income populations.
References
Florida Public Health Review, 2004; 1: 24-29. School Health is Public Health.
Retrieved from, http://publichealth.usf.edu/fphr
Turnock, (2001), Over View of Public Health “ What Is Public Health” from
Essentials of Public Health. Jones & Bartlett Publishers, LLC.
Retrieved from, www.jblearning.com/samples/0763738514/38514_
_001_020.pdf
WHO ( 2013), Public Health: Trade, foreign policy, diplomacy and health.
Retrieved from, www.who.int/trade/glossary/story076/en/
What is Public Health? ( 2004)., Retrieved from,
www.whatispublichealth.org/what
CDC (1999), Impact of Public Health. In “Turnock, BJ. Public Health: What it
is and How it Works, 3rd Edition. Sudbury, MA; Jones Bartlett
Publishers, 2004. Retrieved from, www.hatitispublichealth.org/
impact/index.html
References cont’
Chave, ( 1998, Fee, 1187) A History of the Public Health. Retrieved from, www.nap.edu/openbook.php?
record_id=1091&pag=56
Public Health Core Functions and Community Health Planning; August 1, 2010. Administrative
Reference- Volume 1. Retrieved from, chfs.ky.gov/NR/rdonlyres/9B1E384C-40B7-444C-AA4F-7C9916
C77D6C/0/ARVol1PublicHealthCoreFunctionsandCommunityHealthPlanning.pdf
Malikhoa, ( 2006), Why Is Public Health Controversial? Retrieved from,
samples.jbpub.com/9780763817/J10658_Chapter02.pdf
Evans & Stoddard, (1994), The Public Health Workforce: An Agenda For The 21st Century. A report of the
Public Health Functions Project; U.S. Department of Health and Human Services.
Retrieved from, www.health.gov/phfunctions/pubhlth.pdf
CDC: National Center for Chronic Disease Prevention and Health Promotion: Tools for Implementing an
Evidence-Based Approaches in Public Health Practice.Pro Chronic Dis 2012,9:110324.DOI:
http://dr.doi.org/10.5888/pcd9.110324 Updated July 2012. retrieved from, www.cdc.gov/pcd/issues/
11_0.324.htm
MMWR. Series: Weekly. Vol.6 no.39. Published October 4, 2013
Public Health Agency of Canada Responding to an Infectious Disease Outbreak: Process Between SARS and
Pandemic Influenza (H1N1). Date Modfied:2012-4-11. Published Public Health Agency of Canada.
www.phac-lasp.gc.ca/ep-mu/rido-icm/index-org.php#tphd
References cont’
Recall Bias: An Approach for Assessment and Control: international Journal
of Epidemiology, 1987. Retrieved from, http://www.ife.affordjournals.org
Published by International journal of Epidemiology, 1987.
CDC: National Office of Public Health Genomics, (2007)
Retrieved from, www.cdc.gov/genomics/events/file/print/NCI2007-Sept20
pdf.