A Public Health Crash Course

1. A Public Health Crash Course Janet Brishke, MPH

2. What’s public health? Public Health: the practice of preventing disease and promoting good health within groups of people, from small communities to entire countries. (APHA, 2007)

3. My version • MDs, etc: 1 on 1 • Public Health: community level PREVENTION! What is Public Health? http://www.whatispublichealth.org/index.html

4. Why is PH important? • Saves money • Better economy • Improves QOL • Healthier, productive society • Reduces human suffering • Preparedness (APHA, 2007)

5. Prevention! • ___________: preventing something from happening maintaining non-smoker status • ___________: early detection (screening) stop smoking after noticing shortness of breath, increased coughing • ___________: damage control diagnosis of lung cancer (Curbow, 2006)

6. Core Areas of PH • Biostatistics • Environmental Health • Health Management and Policy • Epidemiology • Social and Behavioral Sciences

7. SBS/ HBHE • “Substantial suffering, premature mortality and medical costs can be avoided by positive changes in behavior” Goals of SBS and HBHE: • Help people adopt _____ behaviors • Help people cease ____ behaviors • Reinforce _______ behaviors • Ensure a __________________ environment (Lopez, 2007)

8. Where did all of this begin? • Not that it’s important… it’s just interesting.  • England, circa 1850s • Cholera= infected water or miasma? • Dr. Snow, OB/GYN: “Cholera is caused by contaminated water!” – 1849 • August 1854: Broad St. Cholera Outbreak in London • Traced nearly every case of cholera to a water pump on Broad St.- contaminated by dirty diaper (Tuthill, 2003)

9. Broad Street map

10. Broad Street Now- Broadwick Street

11. Broad Street Pump- Now

12. PH Dictionary • _________: living disease transmitter • _________: nonliving disease transmitter • _________: disease presence in geographic area • _________: disease presence in regional area • _________: worldwide disease presence • _________: measures of illness • _________: measures of death • _________: selected group from population (Gordis, 2004)

13. Incidence vs. Prevalence • _________: number of new cases of a disease # new cases of disease in a set time period # people at risk of disease in set time period • _________: number of existing cases of a disease # cases of disease in population at specified time # of people in population at that specified time (Gordis, 2004)

14. Validity • Validity: a test’s ability to distinguish between who has a disease and who doesn’t • Sensitivity: ability of a test to identify correctly those who __________ the disease • Specificity: ability of a test to identify those who _________ the disease _________ (Gordis, 2004) ___________

15. Different disciplines in PH:Maternal and Child Health • Why are workers needed? • Vulnerable populations • All states drafted child abuse reporting laws: 19___ • NYC Bureau of Child Hygiene: 19___ • Children’s Bureau: 19___ • Populations growing, and OVERgrowing • “No mother’s baby is safe until every mother’s baby is safe” (Koch, 2005)

16. Different disciplines in PH:PH Assessment and Surveillance • Identifying the needs of a community How? • Observations, • windshield tours • Event participation • Town meetings • Surveys and interviews • Focus groups (Lopez, 2008)

17. Different disciplines in PH:Program Planning • Health education • 3 Fs • ___________ • ___________ • ___________ Understand and engage Assess needs Set goals Develop intervention Implement Evaluate (McKenzie, Neiger & Smeltzer, 2005)

18. Different disciplines in PH:Health Communications

19. Different disciplines in PH:Health Disparities • Working to eliminate gaps in health care • Types of gaps: • ______________ • ______________ • ______________ • ______________ • ______________ (http://www.cdc.gov/omhd/About/disparities.htm)

20. Different disciplines in PH:PH Practice • Governmental activities to prevent disease and improve health ---CDC • Provision of care • For example: Tracing TB, investigating food histories after an outbreak (http://www.cste.org/pdffiles/newpdffiles/CSTEPHResRptHodgeFinal.5.24.04.pdf)

21. Different disciplines in PH:PH Research • Principles of bioethics that focus on the interests of individuals while balancing the communal value of research • IRB 01 and 02 • HIPAA • Benefits, risks? (http://www.cste.org/pdffiles/newpdffiles/CSTEPHResRptHodgeFinal.5.24.04.pdf)

22. Advocacy in PH • Urging action to effect change • Creation/amendment of programs, policies • Effective implementation • Improved collaboration, cooperation • Support, urge, lecture, counsel, preach, recommend (Koch, 2005)

23. 6 Steps to Advocacy Success • Be ________________ • Problem =__________ • Be ________________ • Be ________________ ___________________ • Be ________________ • Be ________________ (Koch, 2005)

24. Advocacy in Real Life

25. Advocate yourself • http://www.visi.com/juan/congress/

26. Growth in PH • Publish or Perish! • Research studies • Journal articles • Conferences • Chair committees • Review boards • More certificates, degrees

27. PH Agencies • CDC: _______________________________ • http://cdc.gov/ • HRSA:_______________________________ • http://www.hrsa.gov/ • MCHB, Ryan White, RHP • WHO:_______________________________ • http://www.who.int/en/

28. More PH Agencies • PAHO:_________________________ • http://www.paho.org/ • FDOH: _____________________ • http://www.doh.state.fl.us/ • FLAHEC:________________________ • http://flahec.org/

30. What jobs can PH Professionals hold? • Jobs MPH graduates have: • Higher education (med school, PhD, DPT) • Infection Control Practitioner (Shands, Munroe, NJ) • Implementation Consultant for Abbott Pharm. • Fellow- President’s Cancer Panel, CompMed (NIH) • Program Coordinator (DV program) • Program Director, Healthy Start of NCF • Genetic Epi Researcher (NIH) • Tobacco Prevention Specialist (Levy, Manatee, SRAHEC) • Health Planner (Health Council, Palm Beach HC District) • Employee Wellness Program Director (Gainesville) • Family Support Services Supervisor (SETA)