01-08C - Introduction To Healthcare and Public Health in The US - Unit 08 - Public Health Part 2 - Lecture C

Introduction to Health Care and
Public Health in the US

Public Health (Part 2)
Lecture c
This material (Comp1_Unit8c) was developed by Oregon Health and Science University, funded by the Department of Health
and Human Services, Office of the National Coordinator for Health Information Technology under Award Number
IU24OC000015.
Learning Objectives
2
Give examples of and explain the general program
categories of public health, including communicable
disease, chronic disease, terrorism response, and
environmental public health (Lecture a)

Discuss the activities and achievements of public health
in the realm of communicable disease (Lecture a )

Compare and contrast the different types of terrorism
and the different public health responses (Lecture b )

Describe chronic disease activities and achievements of
public health, and the work of public health in the realm
of environmental health hazards (Lecture c )
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Lecture c
Chronic Diseases
3
Lecture c
The success of public health in combating
infectious diseases has led to our current
situation, where chronic diseases have
taken the stage as the leading causes of
death in the US
7 of the 10 leading causes of mortality are
chronic diseases, led by the top 4: Heart
disease, Cancer, Stroke, and Chronic
lower respiratory diseases

Top Ten Leading Causes of
Mortality in US
Heart disease: 616,067
Cancer: 562,875
Stroke (cerebrovascular diseases): 135,952
Chronic lower respiratory diseases: 127,924
Accidents (unintentional injuries): 123,706
Alzheimer's disease: 74,632
Diabetes: 71,382
Influenza and Pneumonia: 52,717
Nephritis, nephrotic syndrome, and nephrosis: 46,448
Septicemia: 34,828
(CDC, 2007)
4
Lecture c
Chronic Disease Topics
5
Lecture c
Chronic disease topics include:
Arthritis
Asthma & Allergies
Cancer
Chronic Fatigue Syndrome
Diabetes
Epilepsy
Heart Disease
Hemochromatosis
Hepatitis B
Hepatitis C
Iron Overload
Osteoporosis
Overweight and Obesity
Stroke
(CDC, 2007)

Chronic Disease: Prevention
6
Lecture c
CDC estimates that 70% of deaths in the US are now
caused by chronic diseases
Public health focus on behaviour modification
Chronic diseases mainly due to four modifiable health
risk behaviors
lack of physical activity
poor nutrition
tobacco use
excessive alcohol consumption
Chronic Disease: Education
7
Lecture c
Since behavior modification is the main
public health goal, the tools to effect that
are
Education and informational materials
For the public
For health care practitioners
For policymakers
Funding opportunities
Recommendations, best practices, guidelines
World Health Organization (WHO) and
Chronic Diseases
8
Lecture c
The WHO has developed the Stepwise
Framework
PLANNING
STEP 1: Estimate population need and advocate for
action
STEP 2: Formulate and adopt policy
STEP 3: Identify policy implementation steps
IMPLEMENTATION
Table of 3 steps
WHO Stepwise Framework
8.1 Table: The Stepwise Framework. (n.d.). Retrieved December 6, 2011, from World Health Organization website:
http://www.who.int/chp/chronic_disease_report/p28_en.jpg
9
Lecture c
Policy implementation
steps
Population-wide interventions Interventions for
individuals
National Level Sub-National Level
Implementation step 1
CORE
Interventions that are feasible to implement with existing
resources in the short term.
EXPANDED
Interventions that are possible to implement with a
realistically projected increase in or reallocation of resources
in the medium term.
DESIRABLE
Evidence-based interventions which are beyond the reach of
existing resources.
Environmental Public Health
10
Lecture c
Environmental public health is vital to
population health
Removal of lead from gasoline and from
house paint are two of the numerous
triumphs of this field
Other critical functions include air and
water quality monitoring and education,
and hazardous waste management
Environmental Topics: By Means of
Contact
11
Lecture c
One way of categorizing environmental topics is by their means of
contact with the population, such as -
air quality
food protection
radiation protection
solid waste management
hazardous waste management
water quality
noise control
environmental control of recreational areas
housing quality
vector control
Another categorization method is to organize topics by public health
program,, as shown on the next slide.
Environmental Topics: By Public
Health Programs

Air Quality
Bioterrorism Agents/Diseases
Chemical Agents
Environmental Hazards and
Exposure
Food Safety
Hazardous Substances
Hazardous Waste Sites
Health Disorders and the
Environment
Herbicides

Hydrocarbons
Laboratory Measurements in
People
Lead
Natural Disasters
Pesticides
Smoking and Tobacco Use
Urban Planning for Healthy Places
Vessel Sanitation and Health
Water Quality
12
Lecture c
Public Health environmental programs and topics
include:
Chronic Diseases and Environmental
Public Health
13
Lecture c
There is some overlap between chronic diseases and environmental
topics. Some examples
Smoking, asthma, air quality
Cancer, environmental hazards and exposure, chemical agents

Similarly, there are overlaps between communicable diseases and
environmental topics, such as
Bioterrorism
Water quality and water-related diseases

Divisions between different facets of public health can be artificial,
created for efficiency of organization. In actuality, relationships
between facets of public health are often complex rather than
simple, as illustrated in the above examples.
Summary Lecture c
14
In summary, the importance and impact of
chronic diseases is discussed.
Behavior modification is considered as a
remediation tool.
The World Health Organizations Stepwise
Framework is illustrated.
Environmental public health topics are reviewed
including some overlap with chronic diseases.
Lecture c
Summary
In summary, communicable diseases were discussed in detail, using
notable examples including smallpox and polio.
Public health disease outbreak investigations were discussed using a
simplified food poisoning incident.
Public health response was discussed for the four main categories of
terrorism: bioterrorism, agricultural terrorism, chemical terrorism, and
nuclear/radiation terrorism.
Categorization of bioterrorism agents and the Laboratory Response
Network were discussed.
The importance and impact of chronic diseases was discussed.
Behavior modification was considered as a remediation tool.
The World Health Organizations Stepwise Framework was illustrated.
Environmental public health topics were reviewed, including some overlap
with chronic diseases.
15
Lecture c
References Lecture c
References
Chronic Disease Prevention and Health Promotion. (n.d.). Retrieved December 6, 2011, from
Centers for Disease Control and Prevention website:
http://www.cdc.gov/chronicdisease/index.htm
Chronic Diseases. (n.d.). Retrieved December 6, 2011, from World Health Organization website:
http://www.who.int/topics/chronic_diseases/en/
Leading Causes of Death. (2007). Retrieved December 6, 2011, from Centers for Disease Control
and Prevention website: http://www.cdc.gov/nchs/fastats/lcod.htm

Charts, Tables, Figures
8.1 Table: The Stepwise Framework. (n.d.). Retrieved December 6, 2011, from World Health
Organization website: http://www.who.int/chp/chronic_disease_report/p28_en.jpg

16
Lecture c

01-08C - Introduction To Healthcare and Public Health in The US - Unit 08 - Public Health Part 2 - Lecture C

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Introduction to Health Care and

Public Health in the US

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