WHAT IS PUBLIC HEALTH?Allyson Hall, PhDDepartment of Health Services Research, Management, and PolicyCollege of Public Health and Health Professions

WHO’s Definition of Health

HEALTH IS A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING, AND NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY

WHO, http://www.who.int/about/definition/en/print.html

An Ecological Model of Health

An Ecological Model: multiple determinants of health linkages and relationships among

determinants are emphasized

Source: Institute of Medicine, 2003

Determinants of Population Health: The Ecological Model

• Psychosocial factors• Employment status

and occupational factors

• Socioeconomic status• Natural and built

environments• Public health and

health care services

Assumptions about Public Health

Public health problems are multi-causal

Personal, group and population ‘behaviors’ are related to public health problems

Behaviors are influenced by a wide range of factors

Public Health September 10, 2007

Definition

Public health is what we, as a society, do collectively to assure the conditions in which people can be healthy.

Public Health’s Mission

Protecting health on a population level

Social justice emphasis

Health Promotion and PreventionRecognized as a means to meet public

health objectives and improve public health interventions

Concerned with : Changing individuals and groups

behavior Improving their social environment

Health Promotion and Health Behavior Research and Practice Strives to:

Help people adopt new behaviors

Help people cease old behaviors

Reinforce healthy behavior Ensure a supportive and

healthy environment

Measles

TB

Pneumonia

Diphtheria

Scarlet Fever

Typhoid

Influenza

Whooping Cough

Polio

The Fall in the Standardized Death Rate (per 1,000) for Nine Common Infectious Diseases in Relation to Specific Medical Measures, US 1900-1973

Source: McKinlay and McKinlay, 1977

Source: Centers for Disease Control and Prevention MMWR, 1999

Motor-vehicle related deaths per 100,000 population and per 100 million vehicle miles traveled

Ten Great Public Health Achievements – United States, 1900-1999

Control of infectious disease

Vaccination Motor-vehicle

safety Safer workplaces Declines in death

from coronary heart disease and stroke

Safer and healthier food

Healthier mothers and babies

Family planning Fluoridation of

drinking water Recognition of

tobacco as health hazard

Centers for Disease Control and Prevention, MMWR, 1999

The Essential Public Health Services

1. Monitor health status to identify community health problems.2. Diagnose and investigate health problems and health hazards in the

community3. Inform, educate and empower people about health issues4. Mobilize community partnerships to identify and solve health

problems5. Develop policies and plans that support individual and community

health efforts6. Enforce laws and regulations that protect health and ensure safety7. Link people to needed personal health services and assure the

provision of health care when otherwise unavailable8. Assure a competent public health and personal health care workforce9. Evaluate effectiveness, accessibility, and quality of personal and

population-based health services10. Research for new insights and innovative solution to health problems

Source: Public Health Function Steering Committee

In a nutshell….

Public Health Science• Defines the problem (the who)• Identifies risk factors for the disease (the why)• Develops and implements interventions• Measures effectiveness

Assessment

Policy Development

& Program Implementation

Assurance

Core Public Health Areas

• Epidemiology• Biostatistics• Environmental Health• Health Services Administration/Health Policy• Social and Behavioral Sciences

The Public Health System

Community Health caredelivery system

Employers & Business

Governmental Public Health Infrastructure

Academics The Media

Assuring the Conditions for Population Health

Source: Institute of Medicine, 2002

The Government Public Health Infrastructure

• Local Health Departments• State Health Departments• Department of Health and Human Services

• Centers for Disease Control and Prevention• National Institutes of Health• Health Resources and Services Administration• Food and Drug Administration

Jobs in Public Health

Health educatorEpidemiologistHealth policy analystCommunity organizer/activist/advocatePublic health department directorOccupational health and safety expertFood safety expertPublic health lawyer

In conclusion…

There is much work to be done……

Leading Causes of Death for Males by Race and Hispanic Origin, United States 2001

All Races White Black Hispanic

All Ages Diseases of the heart

Diseases of the heart

Diseases of the heart

Diseases of the heart

1-14 Accidents Accidents Accidents Accidents

15-19 Accidents Accidents Homicide Accidents

20-24 Accidents Accidents Homicide Accidents

25-34 Accidents Accidents Homicide Accidents

35-44 Accidents Accidents Diseases of the heart

Accidents

45-54 Diseases of the heart

Diseases of the heart

Diseases of the heart

Diseases of the heart

55-64 Cancer Cancer Cancer Cancer

65+ Diseases of the heart

Diseases of the heart

Diseases of the heart

Diseases of the heart

Source: National Center for Health Statistics, Health United States, 2003

Actual Causes of Death in the United States, 2000

Tobacco

Poor Diet/Physical InactivAity

Alcohol Consumption

Microbial agents

Toxic Agents

Motor Vehicles

Firearms

Sexual Behavior

Illicit Drug Use

0

5

10

15

20 1817

4 3 2 2 1 1 1

Source: Mokdad et al, 2004

Percent of all deaths

Percent Adult Current Smokers*, by selected characteristics: United States 1999-2001

18-24 25-44 45-64 65-74 75+ Below Poverty

>= to <2 times

poverty

>=2-<4 times

poverty

< 4 times poverty

0

5

10

15

20

25

30

35

27 2724

13

6

3229

26

18

Source: National Center for Health Statistics, Health United States, 2003

*Smoked at least 100 cigarettes in lifetime and currently smokes

Percent of Women Who Are Overweight*, by Selected Characteristics: United States 1999-2001

18-24 25-44 45-64 65-74 75+ Below Poverty

>= to <2 times

poverty

>=2-<4 times

poverty

< 4 times poverty

0

10

20

30

40

50

60

70

33

46

59 59

47

56 5551

43

Source: National Center for Health Statistics, Health United States, 2003

*BMI greater than or equal to 25

Want to work in public health?

Public Health at the University of Florida

http://www.mph.ufl.edu/