A Public Health Crash Course

Janet Brishke, MPH

What’s public health?

Public Health: the practice of preventing disease and promoting good health within groups of people, from small communities to entire countries. (APHA, 2007)

My version

• MDs, etc: 1 on 1• Public Health: community level

PREVENTION!

What is Public Health?http://www.whatispublichealth.org/index.html

Why is PH important?

• Saves money– Better economy

• Improves QOL– Healthier, productive

society

• Reduces human suffering

– Preparedness(APHA, 2007)

Prevention!

• ___________: preventing something from happening

maintaining non-smoker status• ___________: early detection (screening)

stop smoking after noticing shortness of breath, increased coughing

• ___________: damage controldiagnosis of lung cancer

(Curbow, 2006)

Core Areas of PH

• Biostatistics• Environmental Health• Health Management and Policy• Epidemiology• Social and Behavioral Sciences

SBS/ HBHE

• “Substantial suffering, premature mortality and medical costs can be avoided by positive changes in behavior”

Goals of SBS and HBHE:• Help people adopt _____ behaviors• Help people cease ____ behaviors

• Reinforce _______ behaviors• Ensure a __________________ environment

(Lopez, 2007)

Where did all of this begin?

• Not that it’s important… it’s just interesting. • England, circa 1850s• Cholera= infected water or miasma?• Dr. Snow, OB/GYN: “Cholera is caused by

contaminated water!” – 1849• August 1854: Broad St. Cholera Outbreak in

London• Traced nearly every case of cholera to a water

pump on Broad St.- contaminated by dirty diaper (Tuthill, 2003)

Broad Street map

Broad Street Now- Broadwick Street

Broad Street Pump- Now

PH Dictionary

• _________: living disease transmitter• _________: nonliving disease transmitter• _________: disease presence in geographic area• _________: disease presence in regional area• _________: worldwide disease presence• _________: measures of illness• _________: measures of death• _________: selected group from population

(Gordis, 2004)

Incidence vs. Prevalence

• _________: number of new cases of a disease# new cases of disease in a set time period

# people at risk of disease in set time period

• _________: number of existing cases of a disease# cases of disease in population at specified time # of people in population at that specified time

(Gordis, 2004)

Validity

• Validity: a test’s ability to distinguish between who has a disease and who doesn’t

– Sensitivity: ability of a test to identify correctly those who __________ the disease

– Specificity: ability of a test to identify those who _________ the disease

(Gordis, 2004)___________

____

____

_

Different disciplines in PH:Maternal and Child Health

• Why are workers needed?– Vulnerable populations

• All states drafted child abuse reporting laws: 19___• NYC Bureau of Child Hygiene: 19___• Children’s Bureau: 19___• Populations growing, and OVERgrowing

• “No mother’s baby is safe until every mother’s baby is safe”

(Koch, 2005)

Different disciplines in PH:PH Assessment and Surveillance

• Identifying the needs of a communityHow?

• Observations, • windshield tours

• Event participation• Town meetings

• Surveys and interviews• Focus groups (Lopez, 2008)

Different disciplines in PH:Program Planning

• Health education• 3 Fs

– ___________– ___________– ___________

Understand and engage

Assess needs Set goals Develop

intervention Implement Evaluate

(McKenzie, Neiger & Smeltzer, 2005)

Different disciplines in PH:Health Communications

Different disciplines in PH:Health Disparities

• Working to eliminate gaps in health care

• Types of gaps:– ______________– ______________– ______________– ______________– ______________

(http://www.cdc.gov/omhd/About/disparities.htm)

Different disciplines in PH:PH Practice

• Governmental activities to prevent disease and improve health ---CDC

• Provision of care• For example: Tracing TB, investigating food

histories after an outbreak

(http://www.cste.org/pdffiles/newpdffiles/CSTEPHResRptHodgeFinal.5.24.04.pdf)

Different disciplines in PH:PH Research

• Principles of bioethics that focus on the interests of individuals while balancing the communal value of research

• IRB 01 and 02• HIPAA• Benefits, risks?

(http://www.cste.org/pdffiles/newpdffiles/CSTEPHResRptHodgeFinal.5.24.04.pdf)

Advocacy in PH

• Urging action to effect change

• Creation/amendment of programs, policies• Effective implementation• Improved collaboration, cooperation

• Support, urge, lecture, counsel, preach, recommend

(Koch, 2005)

6 Steps to Advocacy Success

1) Be ________________2) Problem =__________3) Be ________________4) Be ________________

___________________5) Be ________________6) Be ________________

(Koch, 2005)

Advocacy in Real Life

Advocate yourself

• http://www.visi.com/juan/congress/

Growth in PH

• Publish or Perish!

• Research studies• Journal articles• Conferences• Chair committees• Review boards• More certificates, degrees

PH Agencies

• CDC: _______________________________• http://cdc.gov/

• HRSA:_______________________________• http://www.hrsa.gov/– MCHB, Ryan White, RHP

• WHO:_______________________________

• http://www.who.int/en/

More PH Agencies

• PAHO:_________________________• http://www.paho.org/

• FDOH: _____________________• http://www.doh.state.fl.us/

• FLAHEC:________________________• http://flahec.org/

What jobs can PH Professionals hold?

• Jobs MPH graduates have:– Higher education (med school, PhD, DPT)– Infection Control Practitioner (Shands, Munroe, NJ)– Implementation Consultant for Abbott Pharm.– Fellow- President’s Cancer Panel, CompMed (NIH)– Program Coordinator (DV program)– Program Director, Healthy Start of NCF– Genetic Epi Researcher (NIH)– Tobacco Prevention Specialist (Levy, Manatee, SRAHEC)– Health Planner (Health Council, Palm Beach HC District)– Employee Wellness Program Director (Gainesville)– Family Support Services Supervisor (SETA)