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What is Public Health? Allyson Hall, PhD Department of Health Services Research, Management, and Policy College of Public Health and Health Professions November 28, 2007 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, 1946 An Ecological Model of Health An Ecological Model: 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 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 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 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 Assessment Policy Development & Program Implementation Assurance Core Public Health Areas • Epidemiology • Biostatistics • Environmental Health • Health Services Administration/Health Policy • Social and Behavioral Sciences The Public Health System Community Health care delivery system Governmental Public Assuring the Conditions Health Infrastructure for Population Health Academics Source: Institute of Medicine, 2002 Employers & Business The Media 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 All Ages Diseases of the heart Diseases of the heart Diseases of the heart Diseases of the heart 1-14 Accidents Accidents Accidents Accidents 15-19 Accidents Accidents Homicide Accidents 20-24 Accidents Accidents Homicide Accidents 25-34 Accidents Accidents Homicide Accidents 35-44 Accidents Accidents Diseases of the heart Accidents 45-54 Diseases of the heart Diseases of the heart Diseases of the heart Diseases of the heart 55-64 Cancer Cancer Cancer Cancer 65+ Diseases of the heart Diseases of the heart Diseases of the heart Diseases of the heart Source: National Center for Health Statistics, Health United States, 2003 Hispanic Actual Causes of Death in the United States, 2000 Percent of all deaths 20 18 17 15 10 5 4 3 2 2 1 1 1 0 To ba cc o Source: Mokdad et al, 2004 Po o rD Al co M icr ob To xi cA M ho lC iet ia ge la /P o nt ns hy g s e um nt sic s pt al i In on ac tiv Ai ty ot or Fi re Ill Se ici x ua ar tD lB m Ve ru s eh hi gU av cle se io s r Percent Adult Current Smokers*, by selected characteristics: United States 1999-2001 35 30 32 27 29 27 26 24 25 18 20 13 15 10 6 5 0 18-24 25-44 45-64 65-74 75+ Below Poverty *Smoked at least 100 cigarettes in lifetime and currently smokes Source: National Center for Health Statistics, Health United States, 2003 >= to <2 times poverty >=2-<4 < 4 times times poverty poverty Percent of Women Who Are Overweight*, by Selected Characteristics: United States 1999-2001 70 59 60 50 40 59 56 55 47 46 51 43 33 30 20 10 0 18-24 25-44 45-64 65-74 75+ Below Poverty *BMI greater than or equal to 25 Source: National Center for Health Statistics, Health United States, 2003 >= to <2 times poverty >=2-<4 < 4 times times poverty poverty Master of Public Health Program 1 course in each of the 5 core areas of public health 3-9 courses in a core area of concentration Public health electives Internship Seminar in Contemporary Public Health Issues Public Health Minor • Take 15 credits of graduate level courses in senior year (may start in summer, credits permitting) • Require 3.0 GPA • Application process: – – – – UF minor application Transcript Statement of interest Turn in to PHHP dean’s office Combined Degree • Bachelor’s to Master’s degree – any major • Use elective credits and take 15 graduate level public health courses during senior • 3.2 GPA and GRE For more information Contact: Mischka Garel, MPH Assistant Director, Student & Academic Affairs, Public Health Programs [email protected]