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Introduction to Health Care and
Public Health in the US
Public Health, Part 1
Lecture c
This material (Comp1_Unit7c) was developed by [University Name], funded by the Department of Health and Human Services,
Office of the National Coordinator for Health Information Technology under Award Number IU24OC000015.
Public Health (Part 1)
Learning Objectives
 Discern the main differences and similarities between
public and private health (Lecture a)
 Delineate the historic timeline and achievements of
public health in the US (Lecture a)
 Define and discuss key terminology of public health
(Lecture b)
 Illustrate the general organization of public health
agencies and public health data flow (Lecture b)
 Evaluate and explain the impact and value of public
health (Lecture c)
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 1
Lecture c
2
Public Health Progress
In the 20th century, Public Health radically improved
population health, with achievements including:
• Significantly increased life expectancy
• Reduction in infant and child mortality
• Remarkable reduction in communicable diseases
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 1
Lecture c
3
Public Health Progress
• It is nearly impossible to spend a single day in the US without being
affected by public health – consider these daily life examples:
• food safety
• restaurant inspections
• fluoridated water
• seatbelt use
• unleaded gasoline
• influenza vaccine programs
• trans-fats and other nutritional information
• public health response to the most recent disaster
• Public health in the US has a long record of working in the public
interest; that record is almost entirely positive
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 1
Lecture c
4
A Terrible Injustice
•
A terrible episode mars the otherwise favorable record of public health in the
US
•
The Public Health Service was one of several sponsors of two related and
horrific studies (physician John Cutler was involved in both studies):
– 1932 – Public Health Service began the infamous Tuskegee Study
which recorded effects of syphilis on black men. Even after penicillin
became the recommended drug treatment in 1947, the men did not
receive adequate treatment. In 1972, an advisory panel found the study
"ethically unjustified” and it was immediately halted
– 1940’s – Experiment which deliberately sought to infect inmates at the
Guatemalan National Penitentiary with syphilis in order to study the
effects of early penicillin treatment
•
Public Health has worked tirelessly to improve population health. While the
injustice of these studies must be both noted and remembered, it is
important to also remember the enormous benefits that Public Health has
conferred
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 1
Lecture c
5
Top Ten Public Health Achievements
in the 20th Century
1. Vaccination
2. Motor-vehicle safety
3. Safer workplaces
4. Control of infectious diseases
5. Decrease in coronary heart disease/stroke deaths
6. Safer and healthier foods
7. Healthier mothers and babies
8. Family planning
9. Fluoridation of drinking water
10. Recognition of tobacco as health hazard
(CDC, 1999)
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 1
Lecture c
6
Highlights
• Since 1900, the average life expectancy for
Americans has increased about 30 years; 25 of
those years are attributed to public health
initiatives
• 1950 - in anti-tuberculosis efforts, more than 2
million X-ray examinations were made by the
Public Health Service
• 1977 - Worldwide eradication of smallpox (as
recently as 1958, two million people a year die
from smallpox)
• 1990’s – only 4.4% of US children have
elevated blood lead levels (in the 1970’s, 88.2%
had elevated blood lead levels)
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 1
Lecture c
7
Highlights
• A combination of medical progress and public health
efforts have nearly eliminated deaths from previouslyrampant childhood diseases such as
–
–
–
–
Measles
Diphtheria
Scarlet fever
Whooping cough
• The battle against communicable diseases has been so
successful that in 2007, of the top 10 causes of mortality,
only two factors (#8 and #10) are not either chronic
disease- or injury-related
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 1
Lecture c
8
Top 10 Leading Causes of Mortality in
the US
1. Heart disease: 616,067
2. Cancer: 562,875
3. Stroke (cerebrovascular diseases): 135,952
4. Chronic lower respiratory diseases: 127,924
5. Accidents (unintentional injuries): 123,706
6. Alzheimer's disease: 74,632
7. Diabetes: 71,382
8. Influenza and Pneumonia: 52,717
9. Nephritis, nephrotic syndrome, and nephrosis: 46,448
10. Septicemia: 34,828
(CDC, 2007)
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 1
Lecture c
9
Public Health, Part 1
Summary – Lecture c
• The radical yet often overlooked
improvements which public health has
made to population health are discussed.
• Included are some examples of amazing
successes in communicable disease
countermeasures.
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 1
Lecture c
10
Public Health, Part 1
Summary
• Similarities and differences between public and private health were
discussed. Criteria for assigning public health importance were
explained. The history of public health in the US was reviewed with
the help of some important historical highlights, including the
creation of the Centers for Disease Control and Prevention (CDC).
• Some key terminology of public health was defined. The
organization and funding of public health in the US was discussed.
The roles of public health were discussed, and disease reporting
and surveillance was used as an example.
• The radical yet often overlooked improvements which public health
has made to population health were discussed. Included were some
examples of amazing successes in communicable disease
countermeasures.
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 1
Lecture c
11
Unit Title
References – Lecture c
References
•
Leading Causes of Death. (2007). Retrieved December 6, 2011, from Centers for Disease Control
and Prevention website: http://www.cdc.gov/nchs/fastats/lcod.htm.
•
Public Health Achievements in the 20th Century. (1999). Morbidity & Mortality Weekly Report ,
48(12), 241-243.
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Public Health, Part 1
Lecture c
12