Download Lecture 3: Four Ways to Approach Public Health

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Different PH Approaches
• Population-based health: When groups of
people become our “patients”
• Active surveillance: Monitoring communities
for unusual patterns of illness
• Medical police: Limiting individual rights so the
public can be healthy
• Social justice: Providing essential services for
those in need; especially when it contributes to
the social good
Public Health Approach
Defined By Prevention
Did you know there are different types
of prevention?
Natural History Of Cancer &
Levels Of Prevention
Onset
Onsetof
of
Signs/Symptoms
Signs/Symptoms
Onset
Onsetof
of
Disease
Disease
DD1 Cure
1 Cure
Early
Early
Detection
Detection
Exposure
Exposure
AA
BB
DD2 Control
2 Control
DD3 Disability
3 Disability
CC
DD4 Death
4 Death
Primary
Primary
Prevention
Prevention
Secondary
Secondary
Prevention
Prevention
Preclinical
Notes Available
Tertiary
Tertiary
Prevention
Prevention
Clinical
Surveillance in Public Health
• Not passive intelligence gathering, but ACTIVE
surveillance
• Latin -- meaning to look over
• We are “looking over” data to find patterns
• Epidemiology is the application of the scientific
method to public health problems
• The scientific method requires the generation
and testing of hypotheses
Notes Available
Efficacy vs Effectiveness vs Equity
• Scientist sets up laboratory experiments
– Single statement as hypothesis
– Controls for confounding variables
– Explains variance with “residual effect”
– Residuals are placebo effect
• Effectiveness Research synthesizes factors
• What methods are the best for studies of equity
and empowerment?
Public Health & Social Justice
•
•
•
•
•
Access is more than an geographic issue
Equity is different from equality
Equity focuses on outcomes
Equality addresses inputs (access)
Public Health Officers function as:
– Robin Hood
– Don Quixote
– Machiavelli
Mullan F. Don Quixote, Machiavelli, and Robin Hood: Public health practice, past and present. Am J Public Health 2000;90:702-706.