Modern Public Health:Tools and Functions

2 of 28

Objectives

• Describe the difference between medical care and public health.

• Define epidemiology and give an example.

• List the core functions of public health.

• Classify examples according to the 10 essential services.

3 of 28

How is Public Health Different From Medicine?

• Public health is population-based

• Medicine is based on the individual

4 of 28

Goals

MedicineIndividual Health

Public HealthPopulation Health

• Best outcome for individual

• Healthy community

• Balance of individual autonomy vs. limitations on individual

• Balance in allocation of resources

• Focus on prevention

5 of 28

Spending in 2001

• Total national healthexpenditures:

• $1,424.5 billion

• Public health activities:

• $46.4 billion

• Distribution of national health dollars:

• 86.8% to personal health services/supplies

• 3.3% to government PH activities

6 of 28

Diagnostic Tools

MedicineIndividual Health

Public HealthPopulation Health

• Thermometer

• Stethoscope

• Individual data, medical history

• Demographics

• Vital statistics

• Epidemiology

7 of 28

What is Epidemiology?

• The study of the distribution and determinants of disease in populations, to seek the causes of both health and disease.

• Epidemiologist—a medical detective who links observed problems with potential causes, to arrive at a diagnosis and design and implement a mitigating response.

8 of 28

The Epidemiology Triangle

Host

Agent Environment

9 of 28

Examples

Host Agent Environment

Human Bacteria, Virus Water, Food, Air

Human Energy Automobile

10 of 28

Public Health Tools

• Engineering

• Enforcement

• Education

Host

Agent Environment

11 of 28

Public Health & Life Expectancy

Host

Agent Environment

In the next 5 minutes:

Brainstorm a current or historic problem

• Identify Agent, Host, Environment

Map interventions that address the problem

• Education, Enforcement, Engineering

Core Functions andEssential Services

of Public Health

13 of 28

A Public Health System Is Complex

Schools

Mental Health

Drug Treatment

Civic GroupsCHCs

Laboratory Facilities

Hospitals

EMS

Tribal Health

Police

Fire

Jails

Economic Development

Doctors

Philanthropist

Employers

Elected Officials

MCOs

Parks

Mass Transit

Health Department

Environmental Health

Community Centers

Home Health

Churches

14 of 28

Six Obligations

1. Prevent epidemics and the spread of disease.

2. Protect against environmental hazards.

3. Prevent injuries.

4. Promote and encourage healthy behaviors.

5. Respond to disasters and assist communities in recovery.

6. Assure the quality and accessibility of health services.

15 of 28

Three Functions

16 of 28

Ten Essential Services

17 of 28

As we cycle through the following slides:

Break into groups.

Select a leader/reporter.

List examples of the essential service.

18 of 28

Monitor Health Status to Identify and Solve Community Health Problems• Diagnose community’s health status.

• Identify threats to health & assess needs.

• Collect, analyze, and publish information on access, utilization, costs, and outcomes of personal health services.

• Collect and analyze vital statistics and health status of higher risk groups.

• Integrate information systems with private providers and health benefit plans.

19 of 28

Diagnose and Investigate Health Problems and Health Hazards in the Community• Epidemiologically identify emerging health threats.

• Use modern laboratory technology to conduct rapid screening and high volume testing.

• Use active surveillance programs to epidemiologically address infectious diseases.

• Maintain technical capacities to undertake epidemiologic investigations of disease outbreaks and to examine patterns of chronic disease and injury.

20 of 28

Inform, Educate and Empower People About Health Issues

• Market community health issues; communicate to targeted media.

• Provide access to health information resources at community levels.

• Collaborate with personal health care providers to reinforce health promotion messages and programs.

• Participate in joint health education programs; collaborate with schools, churches, and worksites.

21 of 28

Mobilize Community Partnerships to Identify and Solve Health Problems

• Undertake inclusive prevention, screening, rehabilitation, and support programs by convening and facilitating community groups and associations; include groups not typically considered health-related.

• Build community health coalitions, drawing upon the full range of potential human resources and material resources.

22 of 28

Develop Policies and Plans That Support Individual and Community Health Efforts• Develop leadership at all levels of public health.

• Plan community-level and state-level health improvement in all jurisdictions.

• Develop and track health objectives to measure quality improvement.

• Collaborate with medical communities to create policies on prevention and treatment services.

• Develop codes, regulations, and legislation to guide the practice of public health.

23 of 28

Enforce Laws and Regulations That Protect Health and Ensure Safety• Enforce sanitary codes, especially in the food

industry. Enforce clean air standards.

• Protect drinking water supplies.

• Follow up on hazards, preventable injuries, and exposure-related diseases identified in occupational and community settings.

• Monitor quality of medical services (e.g., laboratory, nursing homes, and home health care).

• Review new drug, biologic, and medical device applications.

24 of 28

Link People to Needed Personal Health Services and Assure Health Care When Otherwise Unavailable• Assure clinical care for disadvantaged people.

• Link populations with services by ensuring culturally/linguistically appropriate materials/staff.

• Provide ongoing "care management“ and transportation services.

• Target information to high risk population groups.

• Provide technical assistance for worksite health promotion/disease prevention programs.

25 of 28

Assure a Competent Public Health and Personal Health Care Workforce• Provide education and training for personnel.

• License professionals and certify facilities; regular verification and inspection follow-ups.

• Continue quality improvement and life-long learning within all licensure/certification programs.

• Partner with professional training programs to assure community-relevant learning experiences.

• Assure continuing education in management and leadership for administrators and executives.

26 of 28

Evaluate Effectiveness, Accessibility, and Quality of Personal and Population- Based Health Services

• Evaluate health programs based on analysis of health status and service utilization data—assess program effectiveness and provide information necessary for allocating resources and reshaping programs.

27 of 28

Research for New Insights and Innovative Solutions to Health Problems

• Link with appropriate institutions of higher learning and research.

• Maintain internal capacity to mount timely epidemiologic and economic analyses.

• Conduct needed health services research.

28 of 28

Which services does your job cover?

In the next 3-5 minutes:

Think about your job and list the essential services covered in your current position.