Mission of Public Health “…to fulfill society’s interest in assuring conditions in which people can be healthy.” IOM. Future of Public Health.
Population Health Improving Everyone’s Quality of Life: Group Health Foundation, 2001
Population Health Considers a broad set of options for improving and sustaining health Highlights role of social and economic forces in combination with biological and environmental factors Results in benefits to all
Public Health Practice Compared to Clinical Nutrition Practice Public Health Practice Clinical Nutrition Practice FocusPreventionDisease treatment TargetPopulationsIndividuals SettingStates & Communities Clinics & Hospitals StrategiesMultiple, Reinforcing Counseling and education
Assessment Assess the problems and needs of the population Monitor the health of populations Assess and monitor the determinants of population health
Policy Development Develop policies, programs and activities that address health outcomes and the determinants of those outcomes
Assurance Assure the implementation of effective strategies by providing or monitoring policies, activities, and services.
The Future of the Public’s Health in the 21 st Century, IOM, November, 2002 Areas of action and change: –Adopting a focus on population health that includes multiple determinants of health –Strengthening the public health infrastructure –Building partnerships –Developing systems of accountability –Emphasizing evidence –Improving communication
Societal policies and processes influencing the population prevalence of obesity
Christakis N and Fowler J. N Engl J Med 2007;357:370-379 Part of the Social Network from the Framingham Heart Study with Information about Body-Mass Index According to Year
How are the functions of Public Health performed?
10 Essential Public Health Services: Public Health Functions Steering Committee - State and Local Monitor Health Status to identify community health problems Diagnose and investigate health problems 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 heath care workforce Evaluate effectiveness, accessibility, and quality of personal and population-based public health services Research for new insights and innovative solutions to health problems
Public Health Nutritionists: Guidelines for Comprehensive Programs to Promote Healthy Eating and Physical Activity (CDC, ASTDPHN) Leadership: create vision, convene partners Planning/Management: structure, planning, communication, funding Coordination: integration of nutrition efforts across programs at the national, state, and local level – consistent messages
Achievements in Public Health, 1900- 1999: Safer and Healthier Foods (MMWR ) “During the early 20th century, contaminated food, milk, and water caused many foodborne infections, including typhoid fever, tuberculosis, botulism, and scarlet fever.” “Once the sources and characteristics of foodborne diseases were identified--long before vaccines or antibiotics--they could be controlled by handwashing, sanitation, refrigeration, pasteurization, and pesticide application. Healthier animal care, feeding, and processing also improved food supply safety.”
“The discovery of essential nutrients and their roles in disease prevention has been instrumental in almost eliminating nutritional deficiency diseases such as goiter, rickets, and pellagra in the United States.”
“During 1922-1927, with the implementation of a statewide prevention program, the goiter rate in Michigan fell from 38.6% to 9.0 %.” “In 1921, rickets was considered the most common nutritional disease of children, affecting approximately 75% of infants in New York City.”