Presentation on theme: "2003 What is Public Health? Presentation by: Dawn Gentsch, MPH, CHES"— Presentation transcript:
12003 What is Public Health? Presentation by: Dawn Gentsch, MPH, CHES Connecting Workshop2003What is Public Health?Presentation by:Dawn Gentsch, MPH, CHES
2What is Public Health? - Overview Public Health DefinitionsWhat does Public Health Do?History of Public HealthCore Functions and Essential ServicesHow does Public Health Work?
3What is Health? The absence of Disease or Disability The “complete physical, mental and social well being and not merely the absence of disease or infirmity”. (W.H.O.)The word “health” does not appear in the U.S. Constitution, therefore health became a power to be executed by the states. 09/17/1787Health is a primary public good because many aspects of human potential such as employment, social relationships, and political participation are contingent on it. In view of the value of health to employers, business, communities, and society in general, creating the conditions for people to be healthy should also be a shared social goal.
4What does the term Public Health mean to you? Do a black board exercisePersonal experiences?Larger view?How could the terms expressed be related?
5Public HealthPublic Health encompasses a population-focused, organized effort to assist individuals, groups, and communities in the reduction of health risks, and the maintenance or improvement of health status.Healthy environmentObtain needed health care servicesAccess to health promotion and disease prevention servicesWHO & IOM; ASPH June 2001
6Selected Definitions of Public Health “The science and art of preventing disease, prolonging life and promoting health and efficiency through organized community action.” Winslow“Successive re-definings of the unacceptable.” Vickers“Fulfilling society’s interest in assuring conditions in which people can be healthy” IOMHow is this unique in the health arena? How does public health differ from Medicine?
7The Paradigm of Public Health What we,as a society, do collectivelyto assure the conditions in which people can be healthy.IOM focused on ways to strengthen the public health infrastructure.IOM provided strong evidence to suggest that the public health system – the organizational mechanism for achieving the best population health – was in disarray.1988Institute of MedicineThe Future of Public Health
8Public health affects all of us, all of the time. The health of populations and individuals is shaped by a wide range of factors in the social, economic, natural, built and political environments.
9What is Public Health?Governmental Services (Especially Medical Care for the Poor)The Methods (Knowledge and Techniques)The ProfessionThe System and Social EnterpriseThe Health of the PublicPublic health includes voluntary organizations, private organizations and individuals.Bernard J. Turnock
10What does Public Health do? The public health system exists to address:the physical,mental,and environmental health concerns of comminutes and populations at risk for disease and injury
11Public Health in America Vision:Healthy People in Healthy CommunitiesMission:Promote Physical and Mental Health andPrevent Disease, Injury and DisabilityPublic HealthPrevents epidemics and the spread of diseaseProtects against environmental hazardsPrevents injuriesPromotes and encourages healthy behaviorsResponds to disasters and assists communities in recoveryAssures the quality and accessibility of health servicesHealthy People Vision: Healthy People in Healthy Communities.Healthy People is the health initiative for the nation.
12The History of Public Health Prior to Epidemics: Avoidance and AcceptanceSanitary Reform through State and Local InfrastructureGaps in Medical Care and Expanding AgendaAfter Community PH Practice and Bio-TerrorismPeople are healthier, live longer and enjoy lives that are less likely to be marked by injuries, ill health or premature death.Infant mortality and decreased and life expectancy had increased.
13Ten Great Public Health Achievements VaccinesRecognition of Tobacco as a HazardMotor Vehicle SafetySafer WorkplacesControl of Infectious DiseaseFewer deaths from heart disease and strokeSafer and healthier foodsHealthy mothers and babiesFamily planningFluoridationMMWR Vol 48, No 12
14- How we do it - Public health practice is based on scientifically sound strategiesfor improving the quality of life and reducing morbidity and premature mortality.
15Prevention is the primary obligation of public health. -- William Foege, MD,Bill and Melinda Gates FoundationVaccines and antibiotics prevent life threatening ailments.Car seats and safety belts, among other safety items all work to increase safety of the public and decrease injury.Unparallel medical advances and a national investment in health care have resulted in improved health outcomes. Despite this success, U.S. lags behind.Health care spending: 95% of our spending is for medical care and biomedical research.Behavior and the environment are responsible for up to 70% of mortality.Health care is just one of the determinants of health.
16Distinctions Between PH and Medicine PUBLIC HEALTHPrimary focus on populationPublic service ethic, tempered by concerns for the individualEmphasis on prevention, health promotion for the whole communityPublic health paradigm employs a spectrum of interventions aimed at the environment, human behavior and lifestyle, and medical careMultiple professional identities with diffuse public imageVariable certification of specialists beyond professional public health degreeMEDICINEPrimary focus on individualPersonal service ethic, conditioned by awareness of social responsibilitiesEmphasis on diagnosis and treatment, care for the whole patientMedical paradigm places predominant emphasis on medical careWell-established profession with sharp public imageUniform system for certifying specialists beyond professional medical degreeHarvey Fineberg MD, PhD
17Distinctions Between PH and Medicine PUBLIC HEALTHMEDICINELines of specialization organized, for example, by: analytical method (epidemiology) setting and population (occupational health) substantive health problem (nutrition) skills in assessment, policy development, and assuranceBiologic sciences central, stimulated by major threats to health of populations; move between laboratory and fieldNumeric sciences an essential feature of analysis and trainingSocial sciences an integral part of public health educationClinical sciences peripheral to professional trainingLines of specialization organized, for example, by: organ system (cardiology) patient group (pediatrics) etiology, pathophysiology (oncology, infectious disease) technical skill (radiology)Biologic sciences central, stimulated by needs of patients; move between laboratory and bedsideNumeric sciences increasing in prominence, though still a relatively minor part of trainingSocial sciences tend to be an elective part of medical educationClinical sciences an essential part of professional training
18The Evolving Agenda of Public Health HygieneInfectionsChronic DiseaseDeterminants of Health
19Three Core Functions of Public Health AssessmentPolicy DevelopmentAssuranceThis is the IOM Model as identified in 1988 that lead to the Essential Public Health Services.
20Assessment The Process of Understanding Population Health Status Threats to HealthCommunity Health ResourcesMany U.S. citizens lack health insurance or they are underinsured.The CHNA-HIP is an Iowa example on assessing the health of the population.Kristine Gebbe
21Policy Development Reduce the threats to health Support positive resourcesReduce diseaseAdvance overall community health
22AssuranceThe process of assuring:AvailabilityAccessibilityQuality
24Public health agencies are a lot like fire departments Public health agencies are a lot like fire departments. They teach and practice prevention at the same time they maintain readiness to take on emergencies. They are most successful—and least noticed—when their prevention measures work the best.Public Health Improvement Plan,Washington State Department of Health
25Public Health in America Essential Public Health Services Vision:Healthy People in Healthy CommunitiesEssential Public Health ServicesMonitor health statusDiagnose and investigate health problems and health hazardsInform, educate, and empower people about health issuesMobilize community partnerships to identify and solve health problemsDevelop policies and plans that support individual and community health effortsEnforce laws and regulations that protect health and ensure safetyLink people to needed personal health servicesAssure a competent public health and personal health care workforceEvaluate effectiveness, accessibility, and quality of personal and population-based health servicesResearch for new insights and innovative solutions to health problems
26Public Health SystemA public health system includes: All public, private, and voluntary entities that contribute to the delivery of public health services within a jurisdiction.A public health system is: A network of entities with differing roles, relationships, and interactions.All entities contribute to the health and well-being of the community.Public Health SystemWe know the official public health agency has many partners that contribute to accomplishing public health improvements. We think of these partners as members of the public health system. So when we speak of the public health system we mean it is all the public private, and voluntary entities that contribute to the delivery of essential public health services within a jurisdiction. This description of the members of a public health system does not fully explain what it is. So what is a public health system? It is a network of entities with differing roles, relationships, and interactions. All of these entities contribute to the health and well-being of the community. This sphere encircled with this web is one way to think about the interconnections that exist between public health and its system partners. All of these partners are linked in different ways and play various roles in the health of the community. Okay who are these partners?Governmental public health is the backbone of the system.Public health must maintain partnerships with organizations and sectors of society, working closely with communities and community based organizations, the health care delivery system, academia, business and the media.CDC, 2001
27Public Health Infrastructure “The backbone of the public health system”Resources and relationships necessary to carry out the core functions and essential services of public healthResources:Human: continuing education, leadership development, certificate programsInformational: online data, integrate informational systems, researchOrganizational: expanded partnerships, statutes, core functions funding, statewide umbrellaFinancial: to finance all of the above
28A Public Health System Is Complex Home HealthPoliceCommunity CentersChurchesEMSJailsMCOsHealth DepartmentParksSchoolsDoctorsNursing HomesElected OfficialsPhilanthropistHospitalsMass TransitA Public Health System is ComplexHere is a cluttered depiction of the complexity of a public health system and examples of organizations and groups that it make-up the network. If you can read this slide, you will see many of the partner groups represented who contribute to health and delivery of the EPS, such as:Healthcare providers like hospitals, physicians, community health centers, mental health labs, nursing homes and others who provide preventive, curative, and rehabilitative care.Public safety such as police, fire and EMS. Their work is focused on preventing and coping with injury and other emergency health situations.Human Service and Charity Organizations such as food banks, public assistance agencies, transportation providers, and others that assist people to access healthcare and receive other health-enhancing services.Education and Youth Development Organizations like schools, faith institutions, youth centers, and others groups that assist with informing, educating, and preparing children to make informed decisions and act responsively regarding health and other life choices and to be productive contributors in the community.Recreation and Arts-related Organizations who contribute to the physical and mental well-being of the community and those that live, work and play in it.Economic and Philanthropic Organizations such as employers, community development and zoning boards, United Way, community and business foundations that provide resources necessary for individuals and organizations to survive and thrive in the community.Public health system partners studied by IOM and Committee working on the “Future of the Public’s Health”CommunityHealth care delivery systemEmployers and businessMedia and AcademiaEnvironmental HealthCivic GroupsCHCsFireEconomic DevelopmentTribal HealthEmployersLaboratory FacilitiesDrug TreatmentMental Health
29Public health efforts have increased the average life span by nearly 30 years during the past century.Areas for action and change:adopting a focus on population health that includes multiple determinants of healthStrengthening the public health infrastructureBuilding partnershipsDeveloping systems of accountabilityEmphasizing evidenceImproving communication
30Behavioral and environmental risk factors – smoking, poor diet, lack of exercise, increased pollution, stress and unsafe sexual practices – have replaced infectious disease as the leading causes of premature death.
31How Does Public Health Work? Public health address health concerns through the application of:Health promotion and disease prevention technologies and interventions designed to improve and enhance quality of life*These methods encompass a broad range of activities, but are all grouped under 3 main core public health functions.