Transcript File

VIRGINIA
A PUBLIC HEALTH OVERVIEW
By
Katrina Reeves
15 August 2011
Public Health Achievements
What is Public Health?
Public Health’s Mission
Core Functions
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According to The Virginia Department of
Public Health vaccination are among the top
achievements in public health next are:
Maternal and Fetal Health
Emergency Preparedness
Virginia Department of Public Health
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The Science and the art of preventing disease, prolonging life, and promoting physical
health and efficiency through organized community efforts fir 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.
(Schneider, p.5)
Dr. John Snow
Father of Epidemiology
Louis Pasteur
Father of Microbiology
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Primary Prevention
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Secondary Prevention
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Tertiary Prevention
(Schneider, p.?)
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Public health
preventions are
designed to interrupt
the chain of causation
that leads to illness or
injury
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(1) Assessment
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Monitor health status to identify community health issues
Identify, Diagnose, and investigate health issues and community health hazards
(2) Policy Development
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Inform, educate, and empower people about health issues
Involve the community to both identify and solve health issues
Develop plans and polices that support health efforts at the individual and
community level.
(Schneider p, 6)
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(3) Assurance
Enforce laws and regulations that protect health and safety
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Link people to healthcare services when it services would otherwise be
unavailable
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Provide assurance for a competent public health workforce.
(Schneider, p.6)
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Goal into Continual research into new insights and
innovative solutions for health problems.
The Basic Science
Behind
Public Health
WHAT IS EPIDEMIOLOGY?
(Epidemiology Basics, 2011)
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Epidemiology is the study of the distribution and
determinants of disease frequency in human populations.
Frequency=the number of new cases in a
population at risk,
Incidence rate= the number of new cases in an
at risk population over time.
Prevalence rate= the number of existing cases
in a defined population at a single point in time.
Epidemiology fulfills the assessment function of
public health
 Who? Where? When?
 Counts the number of cases of a diseases to
detect if there is an epidemic
 Reportable diseases are mostly infectious
Examples:
 Syphilis, hepatitis, measles, Tb,some birth
defects
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(Schneider, p.49)
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Intervention Studies
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Cohort Studies
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Case Control Studies
Legionnaire's Disease
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The American Legion had a convention in July 1976. In August 150 cases of the
disease and 20 deaths had been reported to the Pennsylvania Department of
Health who notified the CDC.
An investigation was conducted and determined that the members stayed at
four different hotels however, the people who stayed at the Bellevue Strafford
Hotel higher rates of illness than those who stayed at other hotels. Therefore,
the site of exposure was the Bellevue Stratford Hotel.
It was determined that the cause of this disease was airborne.
(Schneider)
Structure
Workforce
Public Health Struggles
Infectious Disease Programs
Chronic Disease Programs
Virginia rankings...
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top 15 states for refugee
resettlement
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Virginia trends...
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between 1990 – 2006
the Asian population more than
doubled
top 10 states with the largest
immigrant resident population
top 10 states for intended
residence of new arrivals
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Source: (Virginia Department of Public Health, 2011)
between 2000 – 2006 the
Hispanic population almost
tripled
the number of students
receiving English as a Second
Language (ESL) through Virginia
public schools more than
doubled (from 36,799 to
78,216)
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Virginia Department of Public Health has undertaken the following
challenges:
Multi-Cultural Health Care
Focus on its aging Population
Chronic disease prevention
Teen Pregnancy
Immunizations
Injury Prevention
Emergency Management
Regulation of healthcare facilities
Source: (Virginia Department of Public Health, 2011)
used with permission under the fair use policy CDC
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2009 regional data from the Virginia Department of Health
shows that the Southside (61.8) and Hampton Roads (57.6)
regions had the highest teen pregnancy rates per 1,000
females between the ages of 15 and 19.
Northern Virginia (31.5) and Valley (38.1) regions had the
lowest rates.
In 2009 there were 12,283 pregnancies reported among
teenagers in Virginia overall, or 45.5 per 1,000 females
aged 15 to 19.
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In 1990, older women outnumbered older men in Virginia by almost 42 percent.
As a result of improving survival rates and increased life expectancies for older
men, by 2025 older Virginian women are expected to outnumber older men by
only 18 percent.
(Virginia Department of Public Health, 2011)
Table used with permission from VDH
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The population of Virginians age 60 and over will grow from 14.7
percent of the total population in 1990 to almost 25 percent by 2025
when there will be more than 2 million Virginians in this age group.
The number of Virginians age 85 and older will increase dramatically
between 1990 and 2025 – five times faster than the state’s total
population growth.
Virginia's older population is growing more racially and ethnically
diverse, reflecting the growing racial and cultural diversity of the
Commonwealth and the nation.
(Virginia Department of Public Health, 2011)
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HIV/AIDS CLINIC
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STD SCREENING
STATE PHARMACEUTICAL
PROGRAM
VIRAL HEPATITIS
SYPHLLIS ERADICATION
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HIV care services to persons
living with HIV/AIDS in
Virginia since 1991.
It provides AIDS
medications to persons who
are not on Medicaid or
Medicare, and have no
health insurance.
Services are targeted to
deliver medical care and
support services, prioritizing
women, children, and
infants with HIV/AIDS.
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Public health measures to control the spread
of disease are aimed at interrupting the
chain of infection at the most vulnerable
link.
Schneider, 138
Minority Health
Rural Health
Health Mothers and Babies
Infant Mortality
Violence Prevention
Health Statistics
Epidemiology
Emergency Preparedness
Chronic Disease Prevention
Infectious Disease Control
Environmental Protection
Dental
Policy
Administrative Offices
(Virginia Department of Public Health, 2011)
(Virginia Department of Public Health, 2011)
(Virginia Performs, 2011)
Graph reused with permission from CDC under the Fair Use Policy
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Administrators
Public Health Nurses/Educators
Attorneys
Physicians, Dentists, Allied Health Workers
Social Scientists
Case Managers
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Data is collected from local, state, and federal authorities
the data collected consists of:
Demographics
Ethnicity
Race
Income Levels
Primary Language
(Virginia Department of Public Health, 2011)
Virginia uses the system to:
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Justify and develop grant proposals for CDC programs and federal block
grants using data on diabetes, cardiovascular disease prevention,
dental health, nutrition, tobacco use control, and physical activity.
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Assist health districts in identifying the need for health interventions.
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Support health districts in monitoring the effectiveness of intervention
and prevention programs.
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Disseminate data used to measure progress toward state and local
health objectives.
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Develop and promote a statewide breast and cervical cancer control
and prevention plan.
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Measure progress in identifying resources to help eliminate racial and
ethnic disparities in health status.
(Centers for Disease Control and Prevention, 2011)
What is Chronic Disease?
A disease marked by long duration or frequent
recurrence, usually incurable but not
immediately fatal.
Examples:
Alzheimer's
Diabetes
AIDS
CANCER
(Schneider)
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The Price Tag $$$$
Cancer
Smoking
Diabetes
Obesity
$89 billion
$96 billion
$116 billion
$61 billion
(Centers for Disease Control and Prevention, 2011)
(2007)
(2007)
(2004)
(2000)
Respiratory Disease
Stroke
United States
Virginia
All Cancers
Diseases of the heart
0
50
100
150
(Centers for Disease Control and Prevention, 2008)
Graph reused with permission from CDC under the Fair Use Policy
200
250
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7 out of 10 deaths among Americans each year are
from chronic diseases. Heart disease, cancer and
stroke account for more than 50% of all deaths each
year.
In 2005, 133 million Americans – almost 1 out of
every 2 adults had at least one chronic illness.
Obesity has become a major health concern. 1 in
every 3 adults is obese and almost 1 in 5 youth
between the ages of 6 and 19 is obese.
Diabetes continues to be the leading cause of kidney
failure, non-traumatic lower-extremity amputations,
and blindness among adults, aged 20-74.
(Centers for Disease Control and Prevention, 2011)
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Diabetes Management
Obesity
Cardiovascular Disease
Arthritis
Stroke Awareness
(Virginia Department of Public Health, 2011)
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Whether public health professionals are
collecting data, proposing a new health care
proposal or attempting to establish a new
policy there are federal and state laws that
must be adhered too. You can find a list of
the applicable laws on the website:
vdh.virginia.gov
Source: (Virginia Department of Public Health, 2011)
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Genomics plays a role in nine of the 10 causes of
death in the U.S., most notably cancer and heart
disease. These diseases are partly the result of how
genes interact with environmental and behavioral
risk factors, such as diet and physical activity.
By studying the relationship between genes,
environment, and behaviors, researchers and
practitioners can learn why some people get sick,
while others do not.
Family health history information can also help to
identify people who may have a higher risk for certain
diseases
(Virginia Department of Public Health, 2011)
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Argininosuccinic acidemia (ASA)
Beta-Ketothiolase deficiency (ßKT)
Biotinidase deficiency (BIOT)
Carnitine uptake defect (CUD)
Citrullinemia (CIT)
Congenital adrenal hyperplasia (CAH)
Congenital hypothyroidism (CH)
Cystic fibrosis (CF)
Galactosemia (GALT)
Glutaric acidemia type I (GA I)
Hemoglobin Sickle/Beta-thalassemia (Hb S/ßTh)
Hemoglobin Sickle/C disease (Hb S/C)
Homocystinuria (HCY)
Isovaleric acidemia (IVA)
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Long chain hydroxyacyl-CoA dehydrogenase
deficiency (LCHAD)
Maple syrup urine disease (MSUD)
Medium-chain acyl-CoA dehydrogenase deficiency
(MCAD)
Methylmalonic acidemia (mutase deficiency)
(MUT)
Methylmalonic acidemia (Cbl A,B);
Multiple carboxylase deficiency (MCD)
Phenylketonuria (PKU);
Propionic acidemia (PROP);
Sickle cell anemia (Hb SS disease) (Hb SS);
Tyrosinemia type I (TYR I);
Trifunctional protein deficiency (TFP);
Very long-chain acyl-CoA dehydrogenase deficiency
(VLCAD);
3-hydroxy 3-methyl glutaric aciduria (HMG), and
3-Methylcrotonyl-CoA carboxylase deficiency
(3MCC)
(Virginia Department of Public Health, 2011)
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Newborn screening and genetics in public health seek to build programs to
implement projects in the following areas:
Needs assessment for State newborn screening programs, genetics programs,
and service systems
Integration of newborn screening and genetic services for newborns and
children who have, or are at risk of having, heritable disorders into existing State
systems of care, which are networks of services and supports that meet the
diverse and changing needs of mothers, children, and families, including those
with special health needs
Evaluation of new technologies, such as the use of tandem mass spectrometry
and DNA-based technologies, for diagnosis and in screening programs
Development of guidelines for genetic and newborn screening services and
uniform State newborn screening program standards
(Virginia Department of Public Health, 2011)
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Public Health is the heart of today’s society;
without public health interventions we as
society would not be able to enjoy the
extended quality of life that is now enjoyed
by Americans such as the increase in
average life expectancy and the
development of vaccinations for the control
and prevention of infectious disease.
End Presentation
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Barker, T. John Snow. A portrait of John Snow. Royal Academy London, London.
Centers for Disease Control and Prevention. (2011). Chronic Diseases and
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Retrieved August 8, 2011, from State Health Departments: Eastern States:
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Dr.
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Barker, T. John Snow. A portrait of John Snow. Royal Academy London, London.
Centers for Disease Control and Prevention. (2011). Chronic Diseases and Health Promotion. Retrieved
August 11, 2011, from CDC: http://www.vda.virginia.gov/pdfdocs/2624-DeptofHealth.pdf
Centers for Disease Control and Prevention. (1999, April 2). MMWR Weekly. Retrieved August 7, 2011,
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http://www.cdc.gov/mmwr//preview/mmwrhtml/00056796.htm
Centers for Disease Control and Prevention. (2011). MMWR Weekly Report. Retrieved August 8, 2011,
from State Health Departments: Eastern States: http://www.cdc.gov/mmwr/international/eastern.html
Centers for Disease Control and Prevention. (2008). Virginia: Burden of Chronic Diseases. Retrieved
August 11, 2011, from CDC: http://www.cdc.gov/chronicdisease/states/pdf/virginia.pdf
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