BPH 206 Week 1
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This 5 page Class Notes was uploaded by Samantha Steel on Wednesday January 20, 2016. The Class Notes belongs to BPH 206 at University of Miami taught by Alexis Koskan in Fall 2015. Since its upload, it has received 115 views. For similar materials see Introduction To Public Health in Public Health at University of Miami.
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Date Created: 01/20/16
January 18th to 22nd I. Phase One: Health Protection Era (Antiquity-1830s) - Syphilis: Name from a poem published by Italian physician and poet Girolamo Fracastoro. a. A shepherd named Syphilis was given the disease as punishment for angering Apollo. - Association Studies - James Lind discovered the association between lack of Vitamin C (citrus fruits) and scurvy in sailors. - Edward Jenner invented the smallpox vaccine. - John Snow (1830s-1850s) II. Phase Two: Hygiene Movement (1850-1880) - John Snow discovered that the Broad Street water pump was the source of contaminated water which was causing the cholera outbreak in London in 1854. - Was considered the “Father of Epidemiology.” - Disease does not randomly distribute in human populations. - Shattuck Report a. Established boards of health b. Collection of vital statistics c. Implemented sanitary measures d. Research on disease e. Health Education f. Controlled exposure to alcohol and smoke - First state Health Dept. was created in Massachusetts in 1869. - APHA was created in 1872. III. Phase Three: Contagion Control Phase (1880-1940s) - lots of propaganda warning soldiers abroad about contracting sexually transmitted diseases. IV. Phase Four: Social Engineering Phase (1950s-mid 1980s) - By 1960s, it became apparent that health services and resources were not equally available to all people. - Poor people with a lack of education often missed the beneﬁts of health programs. - Many new hospitals were built during this phase - Lots of schools to train healthcare professionals were established. - The National Institutes of Health were established to do research and strengthen knowledge on diseases, vaccines, and drugs. - Medicare and Medicaid legislation was passed a. Medicare: 65+ b. Medicaid: Low income V. Phase Five: Health Promotion Phase (1980s-2000) - 1979 Surgeon General’s Report “Healthy People.” - Leading causes of death are chronic conditions and are also strongly associated with behavior. - Interest in disease prevention and health promotion - Victim blaming! VI. Phase Six: Population Health (2000s-Present) - focuses on the population as a whole, not just the individuals. P- Problem E- Etiology R- Recommendations I- Implementation E- Evaluation I. Burden of Disease - Morbidity: being disabled by the disease - Mortality: dying from the disease II. Incidence vs. Prevalence - Incidence Rate: (# of new cases of a disease in a year)/(# of people in the at-risk population.) - Prevalence Rate: (# of people living with speciﬁed disease)/(# of people in the at-risk population.) III. Disease Distribution - people - place - time IV. Hypothesis Generation - Is the cause associated with the effect? - Does the cause precede the effect? - If you change the cause, will the effect change? V. Studies - Group Association - Population/Ecological Study - Individual Association - Case Control Study - Cause Precedes Effect - Cohort Study - Altering the cause alters effect - Natural Experiment - Contributory Cause or Efﬁcacy - Ancillary Support R- Reach E- Effectiveness A- Adoption I- Implementation M- Maintenance I. Multi-Level Determinants and Inﬂuences - Intrapersonal - Interpersonal - Organizational - Community - State - National - Global II. Five Major Areas of Public Health - Epidemiology (incidence, distribution, and control of disease) - Biostatistics (statistics applied to the analysis of biological data) - Environmental Health Sciences (art and science of protecting against environmental factors that may impact human health) - Health Policy and Management (concerned with the delivery, quality, and cost of health care) - Social and Behavioral Sciences (behavioral, social, and cultural factors that impact health) III. Top 10 Achievements in Public Health - vaccination - motor vehicle safety - safer workplaces - control of infectious diseases - decline in deaths from coronary heart disease and smoke - safer and healthier foods - healthier mothers and babies - family planning - ﬂuoridation of drinking water - recognizing tobacco use as a health hazard IV. Determinants of Health B- Behavior I- Infections G- Genetics G- Geography E- Environment M- Medical Care S- Socioeconomic cultural Components of the Public Health System - Federal Agencies - STLT (State, Tribal, Local, and Territorial Health Departments) - Clinical Care Delivery Systems - Media - Community Based Organizations - Private Nonproﬁts - Educational Institutions - Private Industry II. Goals of Governmental Public Health Agencies - Prevent epidemics and spread of disease - Protect against environmental hazards - Prevent injuries - Promote and encourage healthy behavior - Respond to disaster - Assure the quality and accessibility III. Overlapping of State and Local Departments - Immunizations - Disease surveillance - Public health laboratories - Inspection of restaurants - Environmental health surveillance - Coordinating public health screening programs - Tobacco control - Disaster relief IV. Federal Public Health Responsibilities - Ensure all levels of government can provide the needed care - Act when threats span more than one state or region - Act when solutions may be beyond jurisdiction of states - Assist the states when they lack resources - Facilitate the formation of public health goals V. Administrations - ACF (promotes economic and social well-being of families and children) - ACL (increase access to community support and resources for older people and those with - disabilities) - AHRQ (supports research designed to improve the quality of public health) - ATSDR (prevents exposure to toxic substances) - CDC (provides leadership for the prevention of disease) - CMS (oversees Medicare and Medicaid) - FDA (ensures food is safe and quality) - HRSA (improves access to healthcare) - IHS (provides health services to American Indians and Alaskans) - NIH (supports biomedical research) - SAMHSA (prevention and treatment of mental disorders and substance abuse) VI. Global Initiatives - World Bank - World Health Organization - UNAIDS - UNICEF Health Disparities and Determinants - deﬁned as “avoidable differences between groups that systematically place socially disadvantaged groups at a further disadvantage on health - Equality does not mean equity II. Social Determinants of Health - Education - Social and Community context - Health and health care - Neighborhood and built environment - Economic stability III. Explanation of Effects - Quality of housing → Crime and Violence - Access to Primary Care → Health Literacy - Civic Participation → Perceptions and Discrimination Equity - Enrollment in Higher Education → Language and Literacy - Poverty → Employment → Food Security → Housing Stability IV. Racial Disparities - Black women have the highest rates of obesity in the country - Hispanic women have the highest rates of cervical cancer - Black men are more than twice as likely as white men to die from prostate cancer V. Friedan’s Health Impact Pyramid 1. Socioeconomic factors 2. Changing the context to make individuals’ default decisions healthy 3. Long-lasting protective interventions 4. Clinical interventions 5. Counseling and education
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