Medical model individuals

1
Societies Two Arms for Health
Medical model ? individuals Public health model
? populations
2
Public health consists of ways in which a society
organizes to protect and advance health
Governmental agencies International,
WHO National State (or province)
Local Non-governmental organizations, NGO
3
Resident Population, U.S., 1950-2000
Source Health, U.S. 2003 NCHS, Hyattsville, MD
4
Decline of Selected Communicable Disease Cases,
U.S., 1920-2000
5
Death Rates (Crude) for Leading Causes of Death.
Death Registration States U.S. 1900 and 1950
6
Age-adjusted Death Rates, Selected Causes,
United States
Source Health, U.S. 2003 NCHS, Hyattsville, MD
7
Actual Causes of Death in the U.S 1990
8
Health Practices and Disabilities
Number of Good Health Practices
Figure 1. Mortality, disability, and health
practices among 1965 adult residents Alameda
County California, 1965-1974. Adjusted for age,
physical health status, and social network in
1965 and gender.
9
Health Practices and Disabilities
Number of Good Health Practices
Figure 2. Mortality, disability, and health
practices among 1973-1974 survivors Alameda
County, California, 1982-1983. Adjusted for
age, physical health status, an social network
index in 1972-1973 and gender.
Source Breslow, L. and Breslow, N. Health
Practice and Disability Some Evidence from
Alameda County. Preventive Medicine. 22 86-95,
1993.
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Services to Advance Health

• Environmental Health Protection
• Minimizes individual effort
• Personal Health Services
• Medical, Dental, Nursing, etc.
• Favorable Behavioral Conditions
• Social Milieu

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Means of Reducing Mortality and Morbidity from
Selected Health Problems
Source Maxcy-Rosenau. Preventive Medicine and
Public Health, 10th Edition. (Ed) Phillip E.
Sartwell, Appleton-Century-Crofts. New York,
(1973), p634.
12
Life Expectancy at Birth and at Age 65
1900-2000, U.S
Source Health, U.S. 1999 and 2003, NCHS
Hyattsville, MD
13
Health Status
Influence
National Health Expenditures
1.2 Trillion
10
20
88
20
50
8
4
Source Centers for Disease Control and
Prevention, University of California at San
Francisco, Institute for the Future
14
Mission of Public Health
- Fulfill societys interest in assuring
conditions in which people can be healthy
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Functions of Public Health

• Assessment
• Policy development
• Assurance

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1. Assessment

• Nature of health problems
• Ways of dealing with them
• Prevention
• Amelioration
• Resources needed

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2. Policy development

• Promote use of scientific knowledge in decision
  making
• Lead development of health strategy for society
• Formulation, advocacy of policies

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3. Assurance

• of services to reach goals
• Means of assurance
• Encouraging action by others, e.g.,
  government, NGOs
• Regulation,
• e.g., food safety
• Providing services directly,
• e.g., immunization, pre-natal care

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Organization of Public Health
-all levels perform all three functions

• Local
• State or province
• National
• International

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Local Organization of Public Health

• Department of public health
• Disease control, sanitation, health education
• 2. Other departments
• e.g. water
• 3. NGOs

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State Organization of Public Health

• State department of public health
• Leadership
• Regulations
• Technical and financial assistance to local
  agencies
• Other State Agencies
• - e.g. air pollution
• 3. NGOs

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National Organization of Public Health

• U.S. Public Health Service
• - CDC
• NIH
• 2.Other governmental agencies
• -FDA
• -EPA
• 3. NGOs
• -IOM

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International Organization of Public Health

• WHO
• Other government-sponsored
• -e.g., World Bank
• 3. NGO