What is Public Health? Allyson Hall, PhD Department of Health Services Research, Management, and Policy College of Public Health and Health Professions

WHO’s Definition of Health HEALTH IS A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING, AND NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY WHO, http://www.who.int/about/definition/en/print.html

An Ecological Model of Health multiple determinants of health linkages and relationships among determinants are emphasized

Determinants of Population Health: The Ecological Model Psychosocial factors Employment status and occupational factors Socioeconomic status Natural and built environments Public health and health care services Source: Institute of Medicine, 2003

Assumptions about Public Health Public health problems are multi-causal Personal, group and population ‘behaviors’ are related to public health problems Behaviors are influenced by a wide range of factors

Definition Public health is what we, as a society, do collectively to assure the conditions in which people can be healthy. Public Health September 10, 2007

Public Health’s Mission Protecting health on a population level Social justice emphasis

Health Promotion and Prevention Recognized as a means to meet public health objectives and improve public health interventions Concerned with : Changing individuals and groups behavior Improving their social environment

Health Promotion and Health Behavior Research and Practice Strives to: Help people adopt new behaviors Help people cease old behaviors Reinforce healthy behavior Ensure a supportive and healthy environment

The Fall in the Standardized Death Rate (per 1,000) for Nine Common Infectious Diseases in Relation to Specific Medical Measures, US 1900-1973 Scarlet Fever Measles Typhoid TB Influenza Pneumonia Whooping Cough Polio Diphtheria Source: McKinlay and McKinlay, 1977

Motor-vehicle related deaths per 100,000 population and per 100 million vehicle miles traveled Source: Centers for Disease Control and Prevention MMWR, 1999

Ten Great Public Health Achievements – United States, 1900-1999 Control of infectious disease Vaccination Motor-vehicle safety Safer workplaces Declines in death from coronary heart disease and stroke Safer and healthier food Healthier mothers and babies Family planning Fluoridation of drinking water Recognition of tobacco as health hazard Centers for Disease Control and Prevention, MMWR, 1999

The Essential Public Health Services Monitor health status to identify community health problems. Diagnose and investigate health problems and health hazards in the community 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 health care workforce Evaluate effectiveness, accessibility, and quality of personal and population- based health services Research for new insights and innovative solution to health problems Source: Public Health Function Steering Committee

In a nutshell…. Public Health Science Defines the problem (the who) Identifies risk factors for the disease (the why) Develops and implements interventions Measures effectiveness Policy Development & Program Implementation Assessment Assurance

Core Public Health Areas Epidemiology Biostatistics Environmental Health Health Services Administration/Health Policy Social and Behavioral Sciences Epi and bio stats – methods behind the public health discipline SBS – understanding how health related behavior and social factors influences health

The Public Health System Community Health care delivery system Assuring the Conditions for Population Health Governmental Public Health Infrastructure Employers & Business Academics The Media Source: Institute of Medicine, 2002

The Government Public Health Infrastructure Local Health Departments State Health Departments Department of Health and Human Services Centers for Disease Control and Prevention National Institutes of Health Health Resources and Services Administration Food and Drug Administration

Jobs in Public Health Health educator Epidemiologist Health policy analyst Community organizer/activist/advocate Public health department director Occupational health and safety expert Food safety expert Public health lawyer

In conclusion… There is much work to be done……

Leading Causes of Death for Males by Race and Hispanic Origin, United States 2001 All Races White Black Hispanic All Ages Diseases of the heart 1-14 Accidents 15-19 Homicide 20-24 25-34 35-44 45-54 55-64 Cancer 65+ Source: National Center for Health Statistics, Health United States, 2003

Actual Causes of Death in the United States, 2000 Percent of all deaths Source: Mokdad et al, 2004

Percent Adult Current Smokers Percent Adult Current Smokers*, by selected characteristics: United States 1999-2001 *Smoked at least 100 cigarettes in lifetime and currently smokes Source: National Center for Health Statistics, Health United States, 2003

Percent of Women Who Are Overweight Percent of Women Who Are Overweight*, by Selected Characteristics: United States 1999-2001 *BMI greater than or equal to 25 Source: National Center for Health Statistics, Health United States, 2003

Want to work in public health? Public Health at the University of Florida http://www.mph.ufl.edu/