Download I. What is Public Health?

Public Health & Epidemiology: An Introduction
Since, epidemiology is the basic discipline of public health, you should first be acquainted with the
science of public health.
I. What is Public Health?
A. science responsible for protecting & improving health & preventing disease in communities
(populations)
B. public health focuses on safeguarding entire populations
a. populations can be a small local neighborhood, or as big as an entire town
C. do this through:
a. education,
b. promotion of healthy lifestyles, &
c. research for disease & injury prevention
II. Public health professionals
A. examine health events (any occurrences that affect wellbeing)
B. investigative health events may occur due to:
a. disease/conditions (acute, chronic, latent, genetic)
b. accidents & injuries
c. mental health conditions
d. personal /lifestyle choices
e. environmental exposures
III. Public health professionals try to prevent problems from happening or re-occurring by:
A. implementing educational programs, developing policies, administering services, & conducting
research
a. examples:
i. educational programs: H1N1 virus, perinatal conditions, diabetes, hand-washing
ii. developing policies: gay bathhouses subject to government-imposed health regulations
iii. administering services: vaccinations,
iv. conducting research: HIV, addictions
IV. Public health is also a field that is concerned with:
A. limiting health disparities
B. large part of public health is the fight for health care equity, quality, & accessibility
V. The field of public health is highly varied and encompasses many academic disciplines.
A. The field is mainly composed of the following core areas:
1. Environmental Health
2. Biostatistics
3. Behavioral Science/Health Education
4. Epidemiology
5. Health Services Administration/Management
6. Maternal and Child Health
7. Nutrition
8. International/Global Health
9. Public Health Laboratory Practice
10. Public Health Policy
11. Public Health Practice
Public Health & Epidemiology: An Introduction
1. Environmental Health
The air we breathe; the water we drink; the complex interactions between human genetics and our
surroundings. How do the built and natural environments influence our health and how can we reduce
risk factors? These environmental risk factors can cause diseases such as asthma, cancer, and food
poisoning. Specialists from chemistry, toxicology, engineering, and other disciplines combine their
expertise to answer these important questions. Environmental health studies the impact of our
surroundings on our health. Because environmental health is so broad in scope, it is often broken down
in areas of contact:
 air quality
 food protection
 radiation protection
 solid waste management
 hazardous waste management
 water quality
 noise control
 environmental control of recreational areas
 housing quality
 vector control
2. Biostatistics
Estimating the number of deaths from gun violence or looking at trends in drunk driving injuries by
using math and science is the study of biostatistics. Using biostatistics, one can identify health trends
that lead to life-saving measures through the application of statistical procedures, techniques, and
methodology. Forecasting scenarios, identifying health trends within the community, explaining
biological phenomena, as well as determining the causes of disease and injury, biostatistics are an
integral part of public health. Biostatistics are often utilized in tandem with epidemiology.
3. Behavioral Science / Health Education
Stopping the spread of sexually transmitted diseases, such as herpes and HIV/AIDS; helping youth
recognize the dangers of binge drinking; and promoting seatbelt use. Behavioral Science/Health
Education focuses on ways that encourage people to make healthy choices. This includes the
development of community-wide education programs that range from promoting healthy lifestyles in
order to prevent disease and injury, to researching complex health issues.
Specialists encourage people to make healthy choices and develop educational programs that promote
healthy lifestyles and prevent disease and injury. They also promote more efficient uses of health
services, adopt self-care practices, and participate actively in the design and implementation of health
programs. Some examples of concentrations include mental health, aging, health promotion and disease
prevention, public health practice, health education and behavior change, disability and health, and
social research.
4. Epidemiology
When food poisoning or an influenza outbreak attacks a community, the "disease detectives" or
epidemiologists are asked to investigate the cause of disease and control its spread. Epidemiologists do
fieldwork to determine what causes disease or injury, what the risks are, who is at risk, and how to
prevent further incidences. They spot and understand the demographic and social trends that influence
disease and injury and evaluate new treatments. The initial discovery and containment of an outbreak,
such as West Nile virus, often comes from epidemiologists. Some of the most important health-related
discoveries in history are associated with epidemiology including the landmark 1964 Surgeon General's
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report on smoking tobacco stating its harmful effects. Biostatistics are often used in tandem with
epidemiology.
5. Health Services Administration/Management
Managing the database at a school clinic; developing budgets for a health department; creating polices
for health insurance companies; and directing hospital services all depend on health administrators. The
field of health services administration combines politics, business, and science in managing the human
and fiscal resources needed to deliver effective public health services. Specialization can be in planning,
organization, policy formulation and analysis, finance, economics, or marketing.
6. Maternal and Child Health
Providing information and access to birth control; promoting the health of a pregnant woman and an
unborn child; and dispensing vaccinations to children are part of maternal and child health. Professionals
in maternal and child health improve the public health delivery systems specifically for women,
children, and their families through advocacy, education, and research.
7. Nutrition
Promoting healthy eating and regular exercise; researching the effect of diet on the elderly; teaching the
dangers of overeating and over-dieting are the responsibility of public health nutritionists. In short
supply in both public and private sectors, this field examines how food and nutrients affect the wellness
and lifestyle of population. Nutrition encompasses the combination of education and science to promote
health and disease prevention.
8. International / Global Health
Addressing health concerns from a global perspective and encompassing all areas of public health (e.g.,
biostatistics, epidemiology, nutrition, maternal and child health, etc.). International health professionals
address health concerns among different cultures in countries worldwide.
Globalization has linked our health more closely to one another than ever before. The rapid movement
of people and food across borders means that a disease can travel from a remote village to an urban hub
at breakneck speed. Global public health meets the rising health challenges that transcend national
boundaries. This international field encompasses virtually all specializations in public health.
Every school offers slightly different tracks or areas of interest. Here are examples from various schools:
 Health-Care Finance and Economics
 Population Policy and Demography
 Maternal and Child Health/Primary Health Care/Health Services
 Communication and Behavioral Science
 Coping with Complex Emergencies
 Mental Health and Medical Anthropology
 Program Evaluation/Information Systems
 Public Nutrition and Food Security
 International Health Policy and Management
 Infectious Disease Epidemiology and Control
 Research and Evaluation Methods
 Health Promotion
9. Public Health Laboratory Practice
Public health laboratory professionals such as bacteriologists, microbiologists, and biochemists test
biological and environmental samples in order to diagnose, prevent, treat, and control infectious diseases
in communities. In order to ensure the safety of our food and water, to screen for the presence of certain
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diseases within communities, and to respond to public health emergencies, such as bioterrorism, public
health laboratory practice is essential.
10. Public Health Policy
Analyzing the impact of seat belt laws on traffic deaths; monitoring legislative activity on a bill that
limits malpractice settlements; advocating for funding for a teen anti-smoking campaign. Professionals
in public health policy work to improve the public's health through legislative action at the local, state,
and federal levels.
11. Public Health Practice
Public health is an interdisciplinary field and professionals in many disciplines such as nursing,
medicine, veterinary medicine, dentistry, and pharmacy routinely deal with public health issues. A
degree in public health practice enables clinicians to apply public health principles to improve their
practice.
VI. Impact of Public Health
The dramatic achievements of Public Health in the 20th century have improved our quality of life: an
increase in life expectancy, world wide reduction in infant and child mortality, and the elimination or
reduction of many communicable diseases.
In 1999, the Centers for Disease Control and Prevention named the ten greatest public health
achievements of the 20th century. These advances have been largely responsible for increasing the
lifespan of populations; over twenty-five of the 30 years can be accredited to public health initiatives,
while medical advances account for less than 4 years. Furthermore, since 1900, the average life
expectancy for Americans has increased by about 30 years.
Today, Public Health leaders continue to strengthen their roles as advocates for improved populationbased health in an international, global community.
The 20th Century's Ten Great Public Health Achievements in the United States*
1. Vaccination
Programs of population-wide vaccinations resulted in the eradication of smallpox; elimination of polio
in the Americas; and control of measles, rubella, tetanus, diphtheria, Haemophilus influenzae type b, and
other infectious diseases in the United States and other parts of the world.
2. Motor-vehicle safety
Improvements in motor-vehicle safety have contributed to large reductions in motor-vehicle-related
deaths. These improvements include engineering efforts to make both vehicles and highways safer and
successful efforts to change personal behavior (e.g., increased use of safety belts, child safety seats, and
motorcycle helmets and decreased drinking and driving).
3. Safer workplaces
Work-related health problems, such as coal workers' pneumoconiosis (black lung), and silicosis -common at the beginning of the century -- have been significantly reduced. Severe injuries and deaths
related to mining, manufacturing, construction, and transportation also have decreased; since 1980, safer
workplaces have resulted in a reduction of approximately 40% in the rate of fatal occupational injuries.
4. Control of infectious diseases
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Control of infectious diseases has resulted from clean water and better sanitation. Infections such as
typhoid and cholera, major causes of illness and death early in the 20th century, have been reduced
dramatically by improved sanitation. In addition, the discovery of antimicrobial therapy has been critical
to successful public health efforts to control infections such as tuberculosis and sexually transmitted
diseases (STDs).
5. Decline in deaths from coronary heart disease and stroke
Decline in deaths from coronary heart disease and stroke have resulted from risk-factor modification,
such as smoking cessation and blood pressure control coupled with improved access to early detection
and better treatment. Since 1972, death rates for coronary heart disease has decreased 51%.
6. Safer and healthier foods
Since 1900, safer and healthier foods have resulted from decreases in microbial contamination and
increases in nutritional content. Identifying essential micronutrients and establishing food-fortification
programs have almost eliminated major nutritional deficiency diseases such as rickets, goiter, and
pellagra in the United States.
7. Healthier mothers and babies
Healthier mothers and babies are a result of better hygiene and nutrition, availability of antibiotics,
greater access to health care, and technologic advances in maternal and neonatal medicine. Since 1900,
infant mortality has decreased 90%, and maternal mortality has decreased 99%.
8. Family planning
Access to family planning and contraceptive services has altered social and economic roles of women.
Family planning has provided health benefits such as smaller family size and longer interval between the
birth of children; increased opportunities for preconceptional counseling and screening; fewer infant,
child, and maternal deaths; and the use of barrier contraceptives to prevent pregnancy and transmission
of human immunodeficiency virus and other STDs.
9. Fluoridation of drinking water
Fluoridation of drinking water began in 1945 and in 1999 reaches an estimated 144 million persons in
the United States. Fluoridation safely and inexpensively benefits both children and adults by effectively
preventing tooth decay, regardless of socioeconomic status or access to care. Fluoridation has played an
important role in the reductions in tooth decay (40%-70% in children) and of tooth loss in adults (40%60%).
10. Recognition of tobacco use as a health hazard
Recognition of tobacco use as a health hazard in 1964 has resulted in changes in the promotion of
cessation of use, and reduction of exposure to environmental tobacco smoke. Since the initial Surgeon
General's report on the health risks of smoking, the prevalence of smoking among adults has decreased,
and millions of smoking-related deaths have been prevented.
*Courtesy of CDC's MMWR Web Page