Rob Dog
Public health is the "science and art" of preventing disease, prolonging life and promoting health through organized community effort
What is the definition of public health in the early 1990s
The substance of public health is the "organized community efforts aimed at the prevention of disease and the promotion of health."
What is the definition of public health in more recent years
The totality of all evidence-based public and private efforts that preserve and promote health and prevent disease, disability, and death.
What is the definition of public health in the 21st century
An examination of the full range of environmental, social, and economic determinants of public health and clinical health care
How did the definition of public health broaden in the 2000s?
1. fridge: food/product safety
2. water chlorination
3. hand washing
4. indoor plumbing
5. brushing, flossing, fluoridation of water
6. radiation safety: regulation of microwave ovens
7. highway safety: seatbelts, child restraints, airbags
8. Improvement in the quality of air, instillation or smoke detectors, removal of asbestos from buildings
what are the examples of public health initiatives
1. Organized community efforts to promote health and prevent disease go back to ancient times
2. public health awareness began to emerge in Europe and the US in teh mid 1800s
3. 1980s and 1990s were characterized by a focus on individual responsibility for health and interventions at the individual levels
History of public health
father of epidemiology in the 1850s
Focuses on those with the highest probability of developing disease and aims to bring their risk close to the levels experienced by the rest of the population
What is a high risk approach
Focuses on the entire population and aims to reduce the risk for everyone
What is the Improving-the-Average
Maternal and child health, as well as high-risk occupations
Vulnerable populations for most of the 1990s
The frail elderly, disabled, those without health insurance, people with HIV/AIDS, people with higher risk of infection/illness
Current vulnerable populations
An immediate cause of disease
Contributory causes
Examples of contributory causes
HIV virus, cigarette smoking
Underlying factors that ultimately bring about disease, BIG GEMS
Determinants
behavior
infection
genetics
geography
environment
medical care
socioeconomic-cultural
BIG GEMS
a characteristic of individuals or an exposure that increases the probability of developing a disease. Does not imply that a contributory cause has been established
Risk factor
cigarette smoke, toxic substances, high risk sexual behavior
examples of risk factors
problem
etiology
recommendation
implementation
evaluation
PERIE Approach
what is/are the contributory causes
etiology
the occurrence of disability and death due to a disease
- morbidity and mortality
Number of individuals who have a disease a ta particular time divided by number of individuals who could potentially have the disease
- # living with a particular disease/# in the at-risk population
- Tells us the proportion of individuals who have the disease
at a point in time
A study that begins by identifying individuals with a disease and individuals without a disease.
- retrospective studies
case-control studies
An investigation that begins by identifying a group that has a factor under investigation and a similar group that does not have the factor. Outcome in each group is then assessed.
- prospective study
cohort study
An investigation in which individuals are assigned to study or control groups using a process of randomization
- experimental study
Randomized control trail