❤️‍🩹Intro to Public Health Unit 1 – Public Health: Scope and Introduction

What's Public Health All About?

• Focuses on protecting and improving the health of entire populations through organized efforts and informed choices of society, organizations, public and private communities, and individuals
• Aims to prevent disease, prolong life, and promote health through the organized efforts of society
• Addresses the root causes of health threats and implements large-scale solutions (clean water, seat belt laws)
• Involves a multidisciplinary approach that includes epidemiology, biostatistics, social sciences, and health services
• Emphasizes prevention rather than treatment of diseases and conditions
  • Primary prevention aims to prevent disease or injury before it occurs (vaccinations, altering risky behaviors)
  • Secondary prevention detects and treats disease or injury as soon as possible to halt or slow its progress (screenings, regular exams)
  • Tertiary prevention aims to reduce the impact of disease and disability (cardiac rehabilitation after a heart attack)
• Strives for health equity by working to ensure everyone has the opportunity to attain their full health potential without disadvantage due to social position or other socially determined circumstances
• Collaborates with diverse stakeholders (government agencies, healthcare providers, community organizations, academia, businesses) to address complex health challenges

Key Concepts and Definitions

• Health defined as a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity
• Population health focuses on the health outcomes of a group of individuals, including the distribution of such outcomes within the group
• Determinants of health include the range of personal, social, economic, and environmental factors that influence health status
  • Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect health, functioning, and quality-of-life outcomes and risks
• Health disparities refer to differences in health status between groups that are closely linked with social, economic, and/or environmental disadvantage
• Health equity is the attainment of the highest level of health for all people, requiring valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities
• Public health system includes all public, private, and voluntary entities that contribute to the delivery of essential public health services within a jurisdiction
• Global health focuses on improving health and achieving health equity for all people worldwide, emphasizing transnational health issues, determinants, and solutions

Historical Milestones in Public Health

• 1798: Edward Jenner develops the first vaccine for smallpox, laying the foundation for immunization
• 1854: John Snow's investigation of cholera outbreak in London establishes epidemiology as a science
• 1900s: Improvements in sanitation and hygiene, including water treatment and sewage systems, significantly reduce disease transmission
• 1906: The Pure Food and Drug Act is passed in the US, regulating food safety and labeling
• 1918-1919: The influenza pandemic kills an estimated 50 million people worldwide, highlighting the need for global health cooperation
• 1964: The US Surgeon General's report on smoking and health links cigarette smoking to lung cancer and other diseases
• 1980s: The HIV/AIDS epidemic emerges, requiring new approaches to disease surveillance, prevention, and treatment
  • 1981: First cases of AIDS reported in the US
  • 1985: First HIV antibody test becomes available
• 1988: The Global Polio Eradication Initiative is launched, leading to a 99% reduction in polio cases worldwide
• 2003: SARS outbreak demonstrates the rapid spread of emerging infectious diseases in a globalized world
• 2010: The Affordable Care Act is passed in the US, expanding access to health insurance and preventive services

Core Functions and Essential Services

• Assessment
  • Monitor health status to identify and solve community health problems
  • Diagnose and investigate health problems and health hazards in the community
• Policy Development
  • Inform, educate, and empower people about health issues
  • Mobilize community partnerships and action to identify and solve health problems
  • Develop policies and plans that support individual and community health efforts
• Assurance
  • 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 and personal healthcare workforce
  • Evaluate effectiveness, accessibility, and quality of personal and population-based health services
• Research
  • Research for new insights and innovative solutions to health problems

Public Health vs. Clinical Medicine

• Public health focuses on the health of populations, while clinical medicine focuses on the health of individuals
• Public health emphasizes prevention and health promotion, while clinical medicine emphasizes diagnosis and treatment of diseases and injuries
• Public health interventions often occur at the population level (policies, programs, education), while clinical interventions occur at the individual level (medications, surgeries, counseling)
• Public health professionals come from diverse disciplines (epidemiology, biostatistics, social sciences, health education), while clinical professionals are primarily physicians, nurses, and other healthcare providers
• Public health is primarily government-funded, while clinical medicine is funded through a mix of government, private insurance, and individual payments
• Collaboration between public health and clinical medicine is essential for improving overall health outcomes
  • Public health can identify community health needs and develop targeted interventions
  • Clinical medicine can provide individual-level care and contribute to disease surveillance and research

Major Public Health Challenges Today

• Chronic diseases such as heart disease, cancer, and diabetes are leading causes of death and disability worldwide
  • Linked to modifiable risk factors like tobacco use, unhealthy diet, physical inactivity, and excessive alcohol use
• Infectious diseases continue to emerge and re-emerge, posing threats to global health security
  • Examples include COVID-19, Ebola, Zika, and antibiotic-resistant infections
• Mental health disorders are a growing concern, affecting millions of people worldwide
  • Often co-occur with physical health problems and social determinants like poverty and discrimination
• Environmental health challenges such as air pollution, water contamination, and climate change have significant impacts on human health
• Health disparities persist across populations, reflecting inequities in social determinants of health like education, income, and housing
• Aging populations in many countries are increasing the burden of chronic diseases and straining healthcare systems
• Vaccine hesitancy and misinformation are undermining efforts to control vaccine-preventable diseases
• Obesity rates are rising globally, contributing to a range of health problems and healthcare costs

Key Players and Organizations

• Government agencies at the local, state, and federal levels (CDC, FDA, NIH, state and local health departments)
  • Responsible for public health surveillance, research, policy development, and program implementation
• World Health Organization (WHO) is the leading international agency for global health
  • Sets global health priorities, provides technical assistance to countries, and coordinates international health responses
• Non-governmental organizations (NGOs) like the Red Cross, Doctors Without Borders, and the Bill and Melinda Gates Foundation
  • Provide health services, conduct research, and advocate for health policies and funding
• Academic institutions conduct public health research, train the public health workforce, and collaborate with government and community partners
• Healthcare providers and health systems play a crucial role in delivering preventive services and reporting disease outbreaks
• Community-based organizations, faith-based organizations, and other local groups are key partners in implementing public health interventions and reaching underserved populations
• Private sector companies can contribute to public health through workplace wellness programs, product safety, and corporate social responsibility initiatives
• Media outlets and communication professionals help disseminate public health information and shape public opinion on health issues

Future Trends and Emerging Issues

• Precision public health uses big data, genomics, and other technologies to tailor interventions to specific populations and individuals
• Health information technology, including electronic health records and mobile health apps, is transforming the way health data is collected, analyzed, and used for decision-making
• Social media and online platforms are increasingly important for health communication and behavior change, but also pose challenges related to misinformation and privacy
• Climate change is expected to have wide-ranging impacts on health, including increased heat-related illnesses, vector-borne diseases, and mental health problems
• Globalization and urbanization are changing disease patterns and creating new health challenges, such as the spread of infectious diseases and the rise of non-communicable diseases in developing countries
• Health literacy and cultural competence are becoming increasingly important for effective public health communication and engagement with diverse communities
• Public health is becoming more interdisciplinary and collaborative, requiring skills in systems thinking, communication, and leadership
• Health equity and social justice are guiding principles for public health practice, recognizing the need to address the root causes of health disparities and promote health as a human right