chapter 1: the population health approach
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Chapter 1: The Population Health Approach. Introduction. What do we mean by Public Health? How has the Approach to Public Health Changed over Time? What is Meant by Population Health? What are the Implications of Each of the Four Components of Population Health?. Introduction. - PowerPoint PPT PresentationTRANSCRIPT
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Introduction
• What do we mean by Public Health?
• How has the Approach to Public Health Changed over Time?
• What is Meant by Population Health?
• What are the Implications of Each of the Four Components of Population Health?
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Introduction
• Should we focus on Everyone or on Vulnerable Groups?
• What are the Approaches to Protect and Promote Health?
• What Factors Determine the Occurrence of Disease Disability and Death?
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Eras ofPublichealth
Focus ofattention/Paradigm
Action framework Notable eventsand movements in public health and
epidemiology
Healthprotection(Antiquity
-1830s)
Authoritybased control ofindividual andCommunitybehaviors
Religious and culturalpractices and prohibited
behaviors
Quarantine for epidemics;sexual prohibitions to
reduce diseasetransmission;
dietary restrictions toreduce food-borne disease
Eras of Public Health
Awofeso N. What’s new about the “New Public Health” American Journal of Public Health. 2004;94(5):705–709
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Eras of Public Health
Eras ofPublichealth
Focus ofattention/Paradigm
Action framework Notable events andmovements in public
health andepidemiology
Hygienemovement(18401870s)
Sanitaryconditions asbasis forImprovedhealth
Environmental action ona community-wide basisdistinct from healthcare
Snow on Cholera;Semmelweis and puerperalfever; collection of vitalstatistics as empiricalfoundation for public healthand epidemiology
Awofeso N. What’s new about the “New Public Health” American Journal of Public Health. 2004;94(5):705–709
![Page 6: Chapter 1: The Population Health Approach](https://reader035.vdocuments.us/reader035/viewer/2022072015/56813048550346895d95f35f/html5/thumbnails/6.jpg)
Eras of Public Health
Eras of public health
Focus ofattention/Paradigm
Action framework Notable events andmovements in public
health andepidemiology
Contagioncontrol(1880–1940s)
Germ theory:Demonstrationof infectiousorigins ofdisease
Communicable diseasecontrol throughenvironmental control,vaccination,sanatoriums, andoutbreak investigation
ingeneral population
Linkage of epidemiology,bacteriology, andimmunology to form TBsanatoriums;outbreak investigation, e.g.,Goldberger and pellagra
Awofeso N. What’s new about the “New Public Health” American Journal of Public Health. 2004;94(5):705–709
![Page 7: Chapter 1: The Population Health Approach](https://reader035.vdocuments.us/reader035/viewer/2022072015/56813048550346895d95f35f/html5/thumbnails/7.jpg)
Eras of Public HealthEras ofPublichealth
Focus ofattention/Paradigm
Action framework Notable events andmovements in public
health andepidemiology
Filling holesin theMedicalcare system(1950s-mid-1980s)
Integration ofcontrol ofCommunicablediseases;modification ofrisk factors; andcare of high-risk populationas part ofmedical care
Public system for careof and control ofspecific infectiousdiseases and vulnerablepopulations distinctfrom general health caresystem; Integratedhealth maintenanceorganizations withintegration of preventiveservices into generalhealth care system
Antibiotics; randomizedclinical trials; concept ofrisk factors; SurgeonGeneral reports on cigarettesmoking; Framingham study on cardiovascularrisks; health maintenanceorganizations andcommunity health centerswith integration ofpreventive services intogeneral healthcare system
Awofeso N. What’s new about the “New Public Health” American Journal of Public Health. 2004;94(5):705–709
![Page 8: Chapter 1: The Population Health Approach](https://reader035.vdocuments.us/reader035/viewer/2022072015/56813048550346895d95f35f/html5/thumbnails/8.jpg)
Eras of Public Health
Eras ofPublichealth
Focus ofattention/Paradigm
Action framework Notable events andmovements in public
health andepidemiology
HealthPromotionDiseaseprevention(Mid-1980-2000)
Focus onIndividualbehavior andDiseasedetection invulnerable andGeneralpopulations
Clinical and populationoriented prevention withfocus on individualcontrol of decisionmaking and multipleinterventions
AIDS epidemic and needfor multiple interventions toreduce risk; reductions incoronary heart diseasethrough multipleinterventions
Awofeso N. What’s new about the “New Public Health” American Journal of Public Health. 2004;94(5):705–709
![Page 9: Chapter 1: The Population Health Approach](https://reader035.vdocuments.us/reader035/viewer/2022072015/56813048550346895d95f35f/html5/thumbnails/9.jpg)
Eras of Public Health
Eras ofPublichealth
Focus ofattention/Paradigm
Action framework Notable events andmovements in public
health andepidemiology
Populationhealth(21st
century)
Coordination ofpublic healthand health caredelivery basedupon sharedevidence-basedSystemsthinking
Evidence-basedrecommendations andInformationmanagement; focus onharms and costs as wellas benefits ofinterventions;globalization
Evidence-based medicineand public health;information technology;medical errors; antibioticresistance; globalcollaboration, e.g., SARS,tobacco control, climatechange
Awofeso N. What’s new about the “New Public Health” American Journal of Public Health. 2004;94(5):705–709
![Page 10: Chapter 1: The Population Health Approach](https://reader035.vdocuments.us/reader035/viewer/2022072015/56813048550346895d95f35f/html5/thumbnails/10.jpg)
Components of Population Health
Health Population Examples ofsociety-wide
concerns
Examples of
Vulnerablegroups
Historical Physical Geographically limited
Communicable disease
High riskmaternal andchild, high riskoccupations
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Components of Population Health
Health Population Examples ofsociety-wide
concerns
ExamplesOf
Vulnerablegroups
Current Physicaland mental
Local, state,national, global,Governmentally-defined
Toxicsubstances,product andTransportationsafety,Communicablediseases, costsof health care
Disabled, frailelderly,uninsured
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Components of Population Health
Health Population Examples ofsociety-wide
concerns
Examplesof
Vulnerablegroups
Emerging Cosmetic,genetic,Socialfunctioning
Defined by local,
national, andGlobalcommunications
Disasters,climate change,Technologyhazards,EmergingInfectiousdiseases
Immune-suppressed,Geneticvulnerability
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Approaches to Population Health
Characteristics Examples
Health care Systems for deliveringone-on-one individualhealth servicesincluding those aimedat prevention, cure,palliation, andrehabilitation
Clinical preventiveservices including:vaccinations,behavioral counseling,screening for disease,and preventivemedications
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Approaches to Population Health
Characteristics Examples
Traditionalpublic health
Group- andcommunity-basedinterventions directedat health promotion anddisease prevention
Communicable diseasecontrol, control ofenvironmental hazards,food and drug safety,reduction in riskfactors for disease
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Approaches to Population Health
Characteristics Examples
Social Interventions withanother non-healthrelated purpose, whichhave secondary impactson health
Interventions thatimprove the builtenvironment, increaseeducation, alternutrition, or addressSocioeconomicdisparities throughchanges in tax laws;globalization andmobility of goods andpopulations
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Population Health
Health Care Systems
Traditional Public Health Social Policy
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Improving the Average
Risk Factor