Public Health Practice 101

1
Public Health Practice 101

• Module II
• 4 Definitions of Public Health

Henry G. Taylor MD MPH Public Health Education
Program htaylor_at_hepc.wvnet.edu
Rachel Abraham MD MPH WVU Office of Public Health
Practice rabraham_at_hsc.wvu.edu
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Overall Course Objectives

• By the end of these modules, the learner will
• Be familiar with basic concepts of public health
  practice
• Understand 4 ways to describe and define public
  health
• Describe the Public Health System at multiple
  levels
• Recite the 3 Core Functions of Public Health
• Recognize the 10 Essential Services
• Be aware of the 13 Core Competencies of Public
  Health
• Recognize the variety of public health careers
• See themselves as a continuation of the grand
  tradition of public health

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Module II Objectives

• By the end of the module, the learner will
• Be able to recite the 4 definitions presented
• Be able to describe the similarities between the
  process of clinical care and community care
• Define surveillance, both active and passive
• Appreciate how public health professionals must
  sometimes function as medical police
• Recognize the social justice dimension of
  public health
• Confront their own beliefs about the causes of
  disease and why people change their behaviors

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C.E.A. Winslow 1920

• The science and art of preventing disease and
  promoting health and efficiency through organized
  community effort.
• Functions
• Sanitation of the environment
• Control of community infections
• Education of individuals in personal hygiene
• Organization of medical and nursing service for
  early diagnosis and preventive treatment
• Development of social machinery

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The Process of Clinical Care

• Patient
• Practitioner
• Chief complaint
• History Physical
• Laboratory tests
• Treatment plan
• Home monitoring and follow-up testing
• Follow-up visit

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The Process of Community Care

• A defined population
• A health system
• Community perceived needs
• Professional opinion of community need
• Epidemiologic analysis
• Interventions
• Monitoring efforts
• Modification of all the above steps.

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Both are the same process!

• Patient
• Practitioner
• Chief complaint
• History Physical
• Laboratory tests
• Treatment plan
• Self-care and testing
• Follow-up visit and revised treatment plan

• A defined population
• A health system
• Community perceptions
• Professional opinions
• Epidemiologic analysis
• Interventions
• Monitoring efforts
• Modification of all the above steps

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What all health professionals do

• We figure out what makes people sick or healthy.
• We learn what makes communities healthy or
  unhealthy.
• We recommend what can be done about the causes of
  ill-health and what things promote health.
• We make sure that we know what should be done is
  getting done right.
• We only do it ourselves when we have to.

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Health results from a combination of health
activities

• Diagnose and Treat illness and injuries.
• Prevent epidemics and the spread of disease.
• Protect against environmental hazards.
• Prevent injuries.
• Promote and encourage healthy behaviors.
• Respond to disasters and assist communities in
  recovery.
• Certify and License facilities and certain health
  personnel.
• Assure the quality and accessibility of health
  services.

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4 Ways to define Public Health

• Population based health
• When groups of people become our patients.
• Active surveillance
• Monitoring communities for unusual patterns of
  illness.
• Medical police
• Limiting individual rights so the public can be
  healthy.
• Social Justice
• Providing essential services for those in need
  especially when it contributes to the social good.

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Incidence and Prevalence

• Prevalence
• the number of cases (new and old) of the disease
  (or other health-related phenomenon) at a point
  or period in time.
• Incidence
• the number of new cases of a disease (or other
  health-related phenomenon) that occur during a
  specified period of time in a population at risk.

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Surveillance in Public Health

• Not passive intelligence gathering.
• But ACTIVE surveillance.
• Latin -- meaning to look over.
• We are looking over data to find patterns.
• Epidemiology is the application of the scientific
  method to public health problems.
• The scientific method requires the generation and
  testing of hypotheses.

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Value of Surveillance

• Focuses attention on public health issues
• Clarifies the cause of problems
• Suggests solutions that fit local conditions
• Supports later research
• In occupational health, surveillance can reduce
  lost work time, workers compensation, and
  insurance costs

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4 Ways to define Public Health

• Population based health
• When groups of people become our patients.
• Active surveillance
• Monitoring communities for unusual patterns of
  illness.
• Medical police
• Limiting individual rights so the public can be
  healthy.
• Social Justice
• Providing essential services for those in need
  especially when it contributes to the social good.

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4 Ways to define Public Health

• Population based health
• When groups of people become our patients.
• Active surveillance
• Monitoring communities for unusual patterns of
  illness.
• Medical police
• Limiting individual rights so the public can be
  healthy.
• Social Justice
• Providing essential services for those in need
  especially when it contributes to the social good.

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The Ecologic Model of health
A guide to thinking about the determinants of
population health
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What is Public Health?

• Public Health is what it takes to get
• Healthy People in Healthy Communities.