What is Public Health?

1. What is Public Health? Allyson Hall, PhD Department of Health Services Research, Management, and Policy College of Public Health and Health Professions November 28, 2007

2. WHO’s Definition of Health HEALTH IS A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING, AND NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY WHO, 1946

3. An Ecological Model of Health • An Ecological Model: • multiple determinants of health • linkages and relationships among determinants are emphasized

4. Determinants of Population Health: The Ecological Model • Psychosocial factors • Employment status and occupational factors • Socioeconomic status • Natural and built environments • Public health and health care services Source: Institute of Medicine, 2003

5. Assumptions about Public Health • Public health problems are multi-causal • Personal, group and population ‘behaviors’ are related to public health problems • Behaviors are influenced by a wide range of factors

6. Public Health’s Mission Protecting health on a population level Social justice emphasis

7. Health Promotion and Prevention Recognized as a means to meet public health objectives and improve public health interventions Concerned with : • Changing individuals and groups behavior • Improving their social environment

8. Health Promotion and Health Behavior Research and Practice Strives to: • Help people adopt new behaviors • Help people cease old behaviors • Reinforce healthy behavior • Ensure a supportive and healthy environment

10. The Fall in the Standardized Death Rate (per 1,000) for Nine Common Infectious Diseases in Relation to Specific Medical Measures, US 1900-1973 Scarlet Fever Measles Typhoid TB Influenza Pneumonia Whooping Cough Polio Diphtheria Source: McKinlay and McKinlay, 1977

11. Motor-vehicle related deaths per 100,000 population and per 100 million vehicle miles traveled Source: Centers for Disease Control and Prevention MMWR, 1999

12. Control of infectious disease Vaccination Motor-vehicle safety Safer workplaces Declines in death from coronary heart disease and stroke Safer and healthier food Healthier mothers and babies Family planning Fluoridation of drinking water Recognition of tobacco as health hazard Ten Great Public Health Achievements – United States, 1900-1999 Centers for Disease Control and Prevention, MMWR, 1999

13. The Essential Public Health Services • Monitor health status to identify community health problems. • Diagnose and investigate health problems and health hazards in the community • Inform, educate and empower people about health issues • Mobilize community partnerships to identify and solve health problems • Develop policies and plans that support individual and community health efforts • 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 health and personal health care workforce • Evaluate effectiveness, accessibility, and quality of personal and population-based health services • Research for new insights and innovative solution to health problems Source: Public Health Function Steering Committee

14. In a nutshell…. • Public Health Science • Defines the problem (the who) • Identifies risk factors for the disease (the why) • Develops and implements interventions • Measures effectiveness Policy Development & Program Implementation Assessment Assurance

15. Core Public Health Areas • Epidemiology • Biostatistics • Environmental Health • Health Services Administration/Health Policy • Social and Behavioral Sciences

16. The Public Health System Community Health care delivery system Assuring the Conditions for Population Health Governmental Public Health Infrastructure Employers & Business Academics The Media Source: Institute of Medicine, 2002

17. The Government Public Health Infrastructure • Local Health Departments • State Health Departments • Department of Health and Human Services • Centers for Disease Control and Prevention • National Institutes of Health • Health Resources and Services Administration • Food and Drug Administration

18. Jobs in Public Health Health educator Epidemiologist Health policy analyst Community organizer/activist/advocate Public health department director Occupational health and safety expert Food safety expert Public health lawyer

19. In conclusion… There is much work to be done……

20. Leading Causes of Death for Males by Race and Hispanic Origin, United States 2001 Source: National Center for Health Statistics, Health United States, 2003

21. Actual Causes of Death in the United States, 2000 Percent of all deaths Source: Mokdad et al, 2004

22. Percent Adult Current Smokers*, by selected characteristics: United States 1999-2001 *Smoked at least 100 cigarettes in lifetime and currently smokes Source: National Center for Health Statistics, Health United States, 2003

23. Percent of Women Who Are Overweight*, by Selected Characteristics: United States 1999-2001 *BMI greater than or equal to 25 Source: National Center for Health Statistics, Health United States, 2003

24. Master of Public HealthProgram • 1 course in each of the 5 core areas of public health • 3-9 courses in a core area of concentration • Public health electives • Internship • Seminar in Contemporary Public Health Issues