Public Health Colin Mayfield 2012 Public Health 2 Public Health Definition of Public Health 1: • The approach to medicine that is concerned with the health of the community as a whole. Public health is community health. It has been said that: "Health care is vital to all of us some of the time, but public health is vital to all of us all of the time." • The mission of public health is to "fulfill society's interest in assuring conditions in which people can be healthy." The three core public health functions are: – The assessment and monitoring of the health of communities and populations at risk to identify health problems and priorities; – The formulation of public policies designed to solve identified local and national health problems and priorities; – To assure that all populations have access to appropriate and cost-effective care, including health promotion and disease prevention services, and evaluation of the effectiveness of that care From: Medicine.net Public Health 3 Definition of Public Health 2: 1. Public Health is "the science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organisations, public and private, communities and individuals." It is concerned with threats to the overall health of a community based on population health analysis. The population in question can be as small as a handful of people or as large as all the inhabitants of several continents (for instance, in the case of a pandemic). Public health is typically divided into epidemiology, biostatistics and health services. Environmental, social, behavioral, and occupational health are also important subfields. 2. The focus of public health intervention is to prevent rather than treat a disease through surveillance of cases and the promotion of healthy behaviors. In addition to these activities, in many cases treating a disease may be vital to preventing it in others, such as during an outbreak of an infectious disease. Hand washing, vaccination programs and distribution of condoms are examples of public health measures. 3. The goal of public health is to improve lives through the prevention and treatment of disease. The United Nations' World Health Organization defines health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." 4. In 1920, C.E.A. Winslow defined public health as "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals.“ From: Wikipedia December 28 2008 Public Health 4 In the United Kingdom, public health functions include: 1. Health surveillance, monitoring and analysis 2. Investigation of disease outbreaks, epidemics and risk to health 3. Establishing, designing and managing health promotion and disease prevention programmes 4. Enabling and empowering communities to promote health and reduce inequalities 5. Creating and sustaining cross-Government and intersectoral partnerships to improve health and reduce inequalities 6. Ensuring compliance with regulations and laws to protect and promote health 7. Developing and maintaining a well-educated and trained, multi- disciplinary public health workforce 8. Ensuring the effective performance of NHS services to meet goals in improving health, preventing disease and reducing inequalities 9. Research, development, evaluation and innovation 10. Quality assuring the public health function From: Wikipedia December 28 2008 Public Health 5 See also: • Wikipedia - Population Health • Public Health Agency of Canada • Canadian Journal of Public Health • Google Books - The Future of Public Health • Google Scholar Search for "Public Health" in article titles (first 500 references of 232,000) • Google Scholar search for Public Health with "microbiology", "bacteria" or "microbial" in title (477 references) Public Health 6 Public Health 7 Public Health 7 Figure illustrates the individuals and groups that may play a role in the public health assessment process. Overview – Environmental Health - WHO http://www.who.int/topics/environmental_health/en/ http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTHEALTHNUTRITIONANDPOPULATION/EXTPHAAG/0,,enableDHL:TRUE~m enuPK:64229809~pagePK:64229836~piPK:64229814~theSitePK:672263,00.html Environmental Health WHO Summary: 1. Public Health is viewed differently in Developed and Developing nations: • Developed - Social Change, education, social engineering, immunization, etc • Developing – Hygiene, disease prevention, education, basic changes in behaviour 2. Funds available are different in Developed and Developing Nations: (See Details from WHO 1995-2008 – PDF file) Details of Health Expenditures by Country - WHO http://www.who.int/nha/country/en/ Excel Spreadsheet from WHO on Country Expenditures on health Data fields from Excel Spreadsheets General government General government expenditure External resources for health as Total expenditure on health as Private expenditure on health as expenditure on health as % of on health as % of total % of total expenditure on health % of Gross domestic product b % of total expenditure on health total expenditure on health b government expenditure c Social Security expenditure on Out-of-Pocket expenditure as % of Private prepaid plans as % of Per capita total expenditure on health at health as % General government private expenditure on health private expenditure on health average exchange rate (US$) expenditure on health Per capita government expenditure on health at Per capita government expenditure on health Per capita total expenditure on health (PPP int.$) average exchange rate (US$) (PPP int.$) Seems to be an upper boundary on life expectancy no matter how much is spent! But… quality of life and freedom from disease is directly correlated with income (and expenditure on health care?) Why this reversal? People from High Income Countries have more DALYs than Upper Middle Income Countries – Why?: Can take time off for lesser causes (flu, cold, etc) Live longer and so deteriorate and have more illnesses? Are insured so can have the luxury of getting medical care? Diagnostic Systems are better? Better statistics available? Better tracking of diseases and time off work? Are wimps? All of the above?
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