Introduction to Public Health

Introduction to Public Health.

Introduction to Public Health
.

Stephen T. Odonkor

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(MBA,MPhil, PhD, CMS, AFVS)

*

This lecture provides a fundamental understanding of public health by reviewing the mission of public health, core functions of public health and ten essential services of public health.

Readings:

The 10 Essential Services of Public Health: http://www.apha.org/ppp/science/10ES.htm

The Future of Public Health

http://www.nap.edu/books/0309038308/html/index.html

What is Public Health ?

Definition (1)

  • Public Health is the science and art of (1) preventing disease, (2) prolonging life, and (3) promoting health and efficiency through organized community efforts for

the sanitation of the environment,

the control of community infections,

the education of the individual,

 

 

*

Definition (2)

the organization of medical and nursing service for the early diagnosis and preventive treatment of disease, and

the development of the social machinery which will ensure to everyone a standard of living adequate for the maintenance of health.

  • Thus, organizing these benefits as to enable every citizen to realize his birthright of health and longevity.
  • C.E.A. Winslow, 1920 (Classic Definition)

 

*

The Substance of Public Health

  • Organized community efforts aimed at the prevention of disease and promotion of health. It links many disciplines and rests upon the scientific core of Epidemiology
  • Epidemiology is “the study of the distribution and determinants of diseases and injuries in human populations. (Mausner and Kramer 1985).

The vision of Public Health included defining the Substance of Public Health as organized community efforts aimed at the prevention of disease and promotion of health. It links many disciplines and rests upon the scientific core of Epidemiology. Epidemiology is “the study of the distribution and determinants of diseases and injuries in human populations. (Mausner and Kramer – Epidemiology and Introductory Text, W.B. Saunders Company, 2nd Edition 1985).

*

The Organizational Framework of Public Health

  • Encompasses both activities undertaken within the

formal structure of government and

the associated efforts of private & voluntary organizations and individuals

The vision of public health included defining the organizational framework of public health. That framework encompasses both activities undertaken within the formal structure of government and the associated efforts of private and voluntary organizations and individuals.

*

Goals of Public Health

  • The fulfillment of society’s interest in assuring the conditions in which people can be healthy

 

    • . Why is this important? Why can we not focus just on an individual’s health?

 

That vision included the mission of Public Health as fulfilling society’s interest in assuring the conditions in which people can be healthy. Why is this important? Why can we not focus just on an individual’s health? The water we drink, the air we breathe, the food we eat and even the messages we are exposed to via media influence our health. Just as an individual tree does not have much of a chance when the forest around it is burning, human health is very much dependent upon the environment . And why does “society” have an interest. Because many problems can not be solved by individuals alone and others can best be solved on a population or community basis. There is an expression “Can’t see the forest for the trees”. The truth is that individual and population or community medicine are both important perspectives. We must pay attention to the forest as well as the individual trees. The Mission of Public Health is that first perspective – the big picture.

*

The fundamental obligation of agencies responsible for population-based health is to:

  • Prevent epidemics and the spread of disease
  • Protect against environmental hazards
  • Prevent injuries
  • Promote and encourage healthy behaviors and mental health
  • Respond to disasters and assist communities in recovery
  • Assure the quality and accessibility of health services

*

 

What is the role of public health professionals ?

Adapted from: www.whatispublichealth.org: http://www.whatispublichealth.org/what/index.html

  • Public health can be defined in many ways.
  • Public health focuses on populations vs. individuals, prevention, and considers health outcomes in context of the big picture.

 

www.whatispublichealth.org

*

The Disciplines of Public Health*

*Adapted from: http://www.whatispublichealth.org/what/index.html#Practice

ŦPorta M, ed. A Dictionary of Epidemiology. 5th ed. New York, NY: Oxford University Press; 2008.

    • The field of public health is highly varied and encompasses many academic disciplines.
    • In addition to those listed, Behavioral Science, Health Education, Biostatistics, and Emergency Medical Services can be included

 

*

Perspectives of
Public Health and Medicine (1)

Harvey Fineberg, M.D., Ph.D. 1990

Table 1. Perspectives of medicine and public health from: Fineberg HV. Public health and medicine: where the twain shall meet. Am J of Prev Med. 2011;41(4S3):S141-S143.

Public Health Medicine
Primary focus on population Primary focus on individual
Public service ethic, tempered by concerns for the individual Personal service ethic, conditioned by awareness of social responsibilities
Emphasis on prevention, health promotion for the whole community Emphasis on diagnosis and treatment, care for the whole patient
Public health paradigm employs a spectrum of interventions aimed at the environment, human behavior and lifestyle, and medical care Medical paradigm places predominant emphasis on medical care
Multiple professional identities with diffuse public image Well-established profession with sharp public image
  • Dr. Harvey Fineberg, MD, MPH, current President at the Institute of Medicine and former Dean of the Harvard School of Medicine explains with this table the different perspectives of public health and medicine.

 

Table 1. Perspectives of medicine and public health. Fineberg HV. Public health and medicine: where the twain shall meet. American Journal of Preventive Medicine. 2011; 41(4 S3): S141-S143.

 

 

 

*

Perspectives of
Public Health and Medicine(2)

Harvey Fineberg, M.D., Ph.D. 1990

Table 1. Perspectives of medicine and public health from: Fineberg HV. Public health and medicine: where the twain shall meet. Am J of Prev Med. 2011;41(4S3):S141-S143.

 

Public Health Medicine
Variable certification of specialists beyond professional public health degree Uniform system for certifying specialists beyond professional medical degree
Lines of specialization organized, for example, by: Analytic method (epidemiology, toxicology) Setting and population (occupational health, international health) Substantive health problem (environmental health, nutrition) Skills in assessment, policy development, and assurance Lines of specialization organized, for example, by: Organ system (cardiology, neurology) Patient group (obstetrics, pediatrics) Etiology and pathophysiology (oncology, infectious diseases) Technical skill (radiology, surgery)

Table 1. Perspectives of medicine and public health. Fineberg HV. Public health and medicine: where the twain shall meet. American Journal of Preventive Medicine. 2011; 41(4 S3): S141-S143.

*

Perspectives of
Public Health and Medicine (3)

Harvey Fineberg, M.D., Ph.D. 1990

Table 1. Perspectives of medicine and public health from: Fineberg HV. Public health and medicine: where the twain shall meet. Am J of Prev Med. 2011;41(4S3):S141-S143.

Public Health Medicine
Biologic sciences central, stimulated by major threats to health of populations; move between laboratory and field Biologic sciences central, stimulated by needs of patient; move between laboratory and bedside
Numeric sciences an essential feature of analysis and training Numeric sciences increasing in prominence, though still a relatively minor part of training
Social sciences an integral part of public health education Social sciences tend to be an elective part of medical education
Engineering relevant, especially systems analysis, operations management, sanitary engineering, and information technology Engineering and physical sciences relevant, especially materials science, electronics, imaging, and information technology
Clinical sciences peripheral to professional training rooted mainly in the public sector Clinical sciences an essential part of professional training rooted mainly in the private sector

Table 1. Perspectives of medicine and public health. Fineberg HV. Public health and medicine: where the twain shall meet. American Journal of Preventive Medicine. 2011; 41(4 S3): S141-S143.

 

Definitions:

Numeric Sciences include biostatistics and epidemiology

Social Sciences include sociology, psychology, anthropology, economics

Clinical Sciences address the assessment, diagnosis and treatment of patients.

*

Vision

  • Healthy People in Healthy Communities

*

That Vision was simple – Healthy People in Healthy Communities.

Most of us know what health people are. Healthy communities help people be healthy by providing a safe environment.

Mission

  • Promote physical and mental health and prevent disease, injury, and disability.

*

The Mission was also simple:

Promote physical and mental health and prevent disease, injury and disability.

Who Provides Public Health Services?

    • Government – local, state, national
    • Other government departments, agencies
    • Health system providers – doctors, hospitals
    • Voluntary organizations and donors
    • Religious organizations e.g. Catholic hospitals
    • Fraternal organizations e.g. Rotary Club
    • Advocacy groups e.g. Groups against smoking
    • NGOs
    • Research centers
    • Private sector

 

How Does Public Health Work?

 

Core Functions

  • Assessment
  • Policy Development
  • Assurance

*

The vision of the committee was that government would be responsible for the core functions of public health. Those core functions were assessment, policy development and assurance. Although well thought out and justified, most members of the public had a difficult time understanding what these core functions meant. Beginning in 1993, efforts were made to make these functions more understandable. The result of that process which included a number of committees and iterations over time and concluded when the Core Functions of Public Health Steering Committee articulated a simpler mission, and vision as well as the what and how of public health. (See http://www.apha.org/ppp/science/10ES.htm for an excellent description of this process.)

Core Functions of Public Health

 

*

The Ten Essential Services of Public Health

*

This steering committee then defined the how of public health. The steering committee articulated 10 services that are known as the 10 Essential Services of Public Health.

Assessment

  • The assessment function is the collection, assemble, analysis and distribution of information on the community’s health

*

Although we now have the much simpler language of the newer steering committee, I believe that the original core functions are still relevant. I am providing for you the original text from the Future of Public Health on each core function followed by the Essential Services that I believe grew from and are related to the core function.

Here we have the actual text from the Future of Public Health on the topic of assessment

The Ten Essential Services – Assessment

  • Monitor health status to identify community health problems
  • Diagnose and investigate health problems and health hazards in the community
  • Evaluate effectiveness, accessibility, and quality of personal and population-based health services

*

I believe that the Essential Services related to the core function of assessment are :

 

Monitor health status to identify community health problems

Diagnose and investigate health problems and health hazards in the community

Evaluate effectiveness, accessibility, and quality of personal and population-based health services

Policy Development

  • This core function involves the development of comprehensive policies based upon scientific knowledge and decision making.

*

Here we have the text on policy development:

The Ten Essential Services – Policy

  • 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

*

And the related essential services are: 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

The Ten Essential Services – Assurance

  • Assure a competent public health and personal health care workforce
  • 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

*

The Ten Essential Services that I believe are related to assurance are:

Assure a competent public health and personal health care workforce

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

The Tenth Essential Service

  • Impacts Assessment, Policy and Assurance
  • Research for new insights and innovative solutions to health problems

*

If you have been counting you know that I have only mentioned nine Essential Services. I believe that the 10th Essential Service impacts assessment, policy and assurance. That Essential Service is Research for New Insights and Innovative Solutions to Health Problems. Public Health never sits still but must be always innovating and developing.

Examples of the 10 Essential Services in Action

 

*

Now lets look at concrete examples of each of the 10 Essential Services of Public Health

Monitor health status to identify community health problems

  • Examples: Death Certificates, Birth Certificates, Immunizations Registries, Surveillance

*

Examples of monitoring health status to identify community health problems include the many surveillance systems in place through the nation. When used correctly death certificates, birth certificates and immunization registries all tell us about the health of our communities and allow us to take action based upon solid information.

Diagnose and investigate health problems and health hazards in the community

  • Examples: Outbreak Investigations

*

When problems are identified either by surveillance systems, alert citizens or other means, they need to be investigated. Examples of the essential services “Diagnose and investigate health problems and health hazards in the community” are outbreak investigations done when foodborne illness is reported and child death review boards which examine why children die in a community and how future child deaths can be prevented.

Inform, educate, and empower people about health issues

  • Example:Lead Paint displays in hardware stores, New Releases on Rabies and West Nile Virus

*

Governments must inform, educate and empower people about health issues for many reasons. First many health issues require behavioral change by informed citizens. For others non-profit organizations and business can influence health. Finally for some health issues, laws are needed to protect citizens and money is needed to fund programs. Citizens and elected officials need to be informed of the options so they can make good decisions about government services and about their own behavior.

Mobilize community partnerships to identify and solve health problems

  • Example: Stakeholders Group, Advisory Boards, Collaborative Activities

*

Government can’t work alone. Many of the problems such as poor diets, inadequate wages and lack of physical exercise require community partnership. Hence one of the Essential Services is to mobilize community partnerships to identify and solve health problems. One example is the Allegheny County Health Department’s Tobacco Stakeholders group which met to come up with the best ways to limit sales of tobacco to minors.

Develop policies and plans that support individual and community health efforts

  • Example: Smoking Bans, Helmet Laws, Restaurant Inspection Laws

*

As mentioned previously Government agencies must also develop policies and plans that support individual and community health efforts. Something as simple as sidewalks and crime can have a large impact upon whether people can exercise. Government policies can influence both. Other examples include smoke free restaurants and helmet laws.

Enforce laws and regulations that protect health and ensure safety

  • Example: Food Inspection Certificates, Enforcement of Smoking Regulations

*

Writing good laws and policies is not enough. Governments must enforce laws and regulations that protect health and ensure safety. Citizens in communities with good restaurant inspection programs can eat out with confidence knowing that refrigeration has been tested and food handling has been observed to make sure good practices are in place.

Link people to needed personal health services and assure the provision of health care when otherwise unavailable

  • Example: Children’s Health Insurance Programs, Federally Qualified Centers.

*

Most of the public is familiar with this Essential Services -” Link people to needed personal health services and assure the provision of health care when otherwise unavailable” because of Medicaid , Medicare and the Children’s Health Insurance Programs. However may people are not covered by either employer or government insurance programs. The direct provision of services by government clinics or federally qualified centers is another way that government helps to assure the provision of services when unavailable from the private sector.

Assure a competent public health and personal health care workforce.

  • Example:Conferences, Training programs, journals, School of Public Health, Satellite Programs, Certifications

*

The Essential Services of Public Health are not much good if the the public health workforce is not capable of carrying out them. Educating the public health workforce is just one example of the essential service” Assure a competent public health and personal health care workforce”.

Evaluate effectiveness, accessibility, and quality of personal and population-based health services

  • Example: Outcome evaluation and Economic Analyses

*

Quality improvement is part of the American Way and public health takes this responsibility very seriously. Economic analysis, and outcome evaluations are just two of the ways that public health evaluates effectiveness, accessibility, and quality of personal and population-based health services.

Research for new insights and innovative solutions to health problems

  • Example: Needle Exchange Programs

*

Finally, public health is faced with new problems every day. Research for new insights and innovative solutions to health problems are therefore essential for maintaining the health of the community. Innovative ideas such as needle exchange programs need to be tested before being used population wide.

Example: Heart Disease

  • Monitor health status to identify community health problems
  • Diagnose and investigate health problems and health hazards in the community

*

At the end of this lecture you will be asked to think about ways the 10 Essential Services of Public Health can be used to solve a problem in your community. As an example let’s look at heart disease.

For the first essential service- Monitor health status to identify community health problems.

-Typically death certificate files are used to monitor deaths from heart disease

For the second service – Diagnose and investigate health problems and health hazards in the community

Investigations are need to determine which factors (smoking , lack of exercise, weight, blood pressure problems, racial and ethnic disparities) are contributing most to heart disease deaths in a community.

 

  • Inform, educate, and empower people about health issues
  • Mobilize community partnerships to identify and solve health problems

*

For the third essential service,

Inform educate, and empower people about health issues –

The local public health agency can work with news agencies to provide information to its citizens about ways to improve cardiovascular health such as walking.

An example of the 4th essential service, mobilize community partnerships to identify and solve health problems would be working with a local block watch group to make it safer for residents to walk at night or providing instruction in CPR and other rescue techniques.

 

  • Develop policies and plans that support individual and community health efforts
  • Assure a competent public health and personal health care workforce

*

Policies and plans that support individual and community health efforts include laws which require that food be labeled as to its fat and calorie content and schools that include physical activity in the curriculum.

 

Instruction of local health care professionals about ways to help people stop smoking can help assure a competent public health and personal health care workforce.

 

  • 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

*

 

Laws and regulations that improve cardiovascular health include bans on smoking at work sites.

 

Public Health can link people to needed health services by providing blood pressure screening and cholesterol testing.

 

  • Evaluate effectiveness, accessibility, and quality of personal and population-based health services
  • Research for new insights and innovative solutions to health problems

*

An example of the essential service to evaluate effectiveness, accessibility and quality of personal and population-based health services is to monitor and publish cardiovascular surgery outcomes by hospital.

 

Research for new insights and innovative solutions to health problems includes trying to find better ways to help individuals alter their behaviors.

  • Exercise: Think about a current public health problem faced by you or your institution. Take that public health problem or issue and think about how the 10 essential services of public health can solve that problem.

*

Now think about a current public health problem faced by you or your institution. Take that public health problem or issue and think about how you can provide the 10 essential services.

It is my hope that by doing this you will think of approaches you might not have other wise considered.

I also hope that you now have an appreciation of the many facets of public health and your role in them.

Thank you.

“Never doubt that a small group of throughtful, committed citizens can change the world; indeed, it is the only think that ever has”

 

Margaret Mead

*

This lecture provides a fundamental understanding of public health by reviewing the mission of public health, core functions of public health and ten essential services of public health.

Readings:

The 10 Essential Services of Public Health: http://www.apha.org/ppp/science/10ES.htm

The Future of Public Health

http://www.nap.edu/books/0309038308/html/index.html

 

*

 

*

The vision of Public Health included defining the Substance of Public Health as organized community efforts aimed at the prevention of disease and promotion of health. It links many disciplines and rests upon the scientific core of Epidemiology. Epidemiology is “the study of the distribution and determinants of diseases and injuries in human populations. (Mausner and Kramer – Epidemiology and Introductory Text, W.B. Saunders Company, 2nd Edition 1985).

*

The vision of public health included defining the organizational framework of public health. That framework encompasses both activities undertaken within the formal structure of government and the associated efforts of private and voluntary organizations and individuals.

*

That vision included the mission of Public Health as fulfilling society’s interest in assuring the conditions in which people can be healthy. Why is this important? Why can we not focus just on an individual’s health? The water we drink, the air we breathe, the food we eat and even the messages we are exposed to via media influence our health. Just as an individual tree does not have much of a chance when the forest around it is burning, human health is very much dependent upon the environment . And why does “society” have an interest. Because many problems can not be solved by individuals alone and others can best be solved on a population or community basis. There is an expression “Can’t see the forest for the trees”. The truth is that individual and population or community medicine are both important perspectives. We must pay attention to the forest as well as the individual trees. The Mission of Public Health is that first perspective – the big picture.

*

*

 

  • Public health can be defined in many ways.
  • Public health focuses on populations vs. individuals, prevention, and considers health outcomes in context of the big picture.

 

www.whatispublichealth.org

*

    • The field of public health is highly varied and encompasses many academic disciplines.
    • In addition to those listed, Behavioral Science, Health Education, Biostatistics, and Emergency Medical Services can be included

 

*

  • Dr. Harvey Fineberg, MD, MPH, current President at the Institute of Medicine and former Dean of the Harvard School of Medicine explains with this table the different perspectives of public health and medicine.

 

Table 1. Perspectives of medicine and public health. Fineberg HV. Public health and medicine: where the twain shall meet. American Journal of Preventive Medicine. 2011; 41(4 S3): S141-S143.

 

 

 

*

Table 1. Perspectives of medicine and public health. Fineberg HV. Public health and medicine: where the twain shall meet. American Journal of Preventive Medicine. 2011; 41(4 S3): S141-S143.

*

Table 1. Perspectives of medicine and public health. Fineberg HV. Public health and medicine: where the twain shall meet. American Journal of Preventive Medicine. 2011; 41(4 S3): S141-S143.

 

Definitions:

Numeric Sciences include biostatistics and epidemiology

Social Sciences include sociology, psychology, anthropology, economics

Clinical Sciences address the assessment, diagnosis and treatment of patients.

*

*

That Vision was simple – Healthy People in Healthy Communities.

Most of us know what health people are. Healthy communities help people be healthy by providing a safe environment.

*

The Mission was also simple:

Promote physical and mental health and prevent disease, injury and disability.

*

The vision of the committee was that government would be responsible for the core functions of public health. Those core functions were assessment, policy development and assurance. Although well thought out and justified, most members of the public had a difficult time understanding what these core functions meant. Beginning in 1993, efforts were made to make these functions more understandable. The result of that process which included a number of committees and iterations over time and concluded when the Core Functions of Public Health Steering Committee articulated a simpler mission, and vision as well as the what and how of public health. (See http://www.apha.org/ppp/science/10ES.htm for an excellent description of this process.)

 

*

*

This steering committee then defined the how of public health. The steering committee articulated 10 services that are known as the 10 Essential Services of Public Health.

*

Although we now have the much simpler language of the newer steering committee, I believe that the original core functions are still relevant. I am providing for you the original text from the Future of Public Health on each core function followed by the Essential Services that I believe grew from and are related to the core function.

Here we have the actual text from the Future of Public Health on the topic of assessment

*

I believe that the Essential Services related to the core function of assessment are :

 

Monitor health status to identify community health problems

Diagnose and investigate health problems and health hazards in the community

Evaluate effectiveness, accessibility, and quality of personal and population-based health services

*

Here we have the text on policy development:

*

And the related essential services are: 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

*

The Ten Essential Services that I believe are related to assurance are:

Assure a competent public health and personal health care workforce

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

*

If you have been counting you know that I have only mentioned nine Essential Services. I believe that the 10th Essential Service impacts assessment, policy and assurance. That Essential Service is Research for New Insights and Innovative Solutions to Health Problems. Public Health never sits still but must be always innovating and developing.

*

Now lets look at concrete examples of each of the 10 Essential Services of Public Health

*

Examples of monitoring health status to identify community health problems include the many surveillance systems in place through the nation. When used correctly death certificates, birth certificates and immunization registries all tell us about the health of our communities and allow us to take action based upon solid information.

*

When problems are identified either by surveillance systems, alert citizens or other means, they need to be investigated. Examples of the essential services “Diagnose and investigate health problems and health hazards in the community” are outbreak investigations done when foodborne illness is reported and child death review boards which examine why children die in a community and how future child deaths can be prevented.

*

Governments must inform, educate and empower people about health issues for many reasons. First many health issues require behavioral change by informed citizens. For others non-profit organizations and business can influence health. Finally for some health issues, laws are needed to protect citizens and money is needed to fund programs. Citizens and elected officials need to be informed of the options so they can make good decisions about government services and about their own behavior.

*

Government can’t work alone. Many of the problems such as poor diets, inadequate wages and lack of physical exercise require community partnership. Hence one of the Essential Services is to mobilize community partnerships to identify and solve health problems. One example is the Allegheny County Health Department’s Tobacco Stakeholders group which met to come up with the best ways to limit sales of tobacco to minors.

*

As mentioned previously Government agencies must also develop policies and plans that support individual and community health efforts. Something as simple as sidewalks and crime can have a large impact upon whether people can exercise. Government policies can influence both. Other examples include smoke free restaurants and helmet laws.

*

Writing good laws and policies is not enough. Governments must enforce laws and regulations that protect health and ensure safety. Citizens in communities with good restaurant inspection programs can eat out with confidence knowing that refrigeration has been tested and food handling has been observed to make sure good practices are in place.

*

Most of the public is familiar with this Essential Services -” Link people to needed personal health services and assure the provision of health care when otherwise unavailable” because of Medicaid , Medicare and the Children’s Health Insurance Programs. However may people are not covered by either employer or government insurance programs. The direct provision of services by government clinics or federally qualified centers is another way that government helps to assure the provision of services when unavailable from the private sector.

*

The Essential Services of Public Health are not much good if the the public health workforce is not capable of carrying out them. Educating the public health workforce is just one example of the essential service” Assure a competent public health and personal health care workforce”.

*

Quality improvement is part of the American Way and public health takes this responsibility very seriously. Economic analysis, and outcome evaluations are just two of the ways that public health evaluates effectiveness, accessibility, and quality of personal and population-based health services.

*

Finally, public health is faced with new problems every day. Research for new insights and innovative solutions to health problems are therefore essential for maintaining the health of the community. Innovative ideas such as needle exchange programs need to be tested before being used population wide.

*

At the end of this lecture you will be asked to think about ways the 10 Essential Services of Public Health can be used to solve a problem in your community. As an example let’s look at heart disease.

For the first essential service- Monitor health status to identify community health problems.

-Typically death certificate files are used to monitor deaths from heart disease

For the second service – Diagnose and investigate health problems and health hazards in the community

Investigations are need to determine which factors (smoking , lack of exercise, weight, blood pressure problems, racial and ethnic disparities) are contributing most to heart disease deaths in a community.

 

*

For the third essential service,

Inform educate, and empower people about health issues –

The local public health agency can work with news agencies to provide information to its citizens about ways to improve cardiovascular health such as walking.

An example of the 4th essential service, mobilize community partnerships to identify and solve health problems would be working with a local block watch group to make it safer for residents to walk at night or providing instruction in CPR and other rescue techniques.

*

Policies and plans that support individual and community health efforts include laws which require that food be labeled as to its fat and calorie content and schools that include physical activity in the curriculum.

 

Instruction of local health care professionals about ways to help people stop smoking can help assure a competent public health and personal health care workforce.

*

 

Laws and regulations that improve cardiovascular health include bans on smoking at work sites.

 

Public Health can link people to needed health services by providing blood pressure screening and cholesterol testing.

*

An example of the essential service to evaluate effectiveness, accessibility and quality of personal and population-based health services is to monitor and publish cardiovascular surgery outcomes by hospital.

 

Research for new insights and innovative solutions to health problems includes trying to find better ways to help individuals alter their behaviors.

*

Now think about a current public health problem faced by you or your institution. Take that public health problem or issue and think about how you can provide the 10 essential services.

It is my hope that by doing this you will think of approaches you might not have other wise considered.

I also hope that you now have an appreciation of the many facets of public health and your role in them.

Thank you.

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