Concepts and principles of public health and preventive medicine

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1 Concepts and principles of public health and preventive medicine
Sarkhell Araz MSc. Public health/Epidemiology 30 September 2019

2 Theory Quizzes Activities
10% Mid-Exam 30% Sub-total (40%) Final (60%) Total (100%) 2

3 Objectives: Define health and describe the different concepts and perspectives of Health. Describe determinants of health. Define and describe public health. Define outbreak an endemic, an epidemic or a pandemic. Hallmarks of Public Health. 3

4 Define health The world Health Organization (WHO) described health in1948, in the preamble to its constitution, as “A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. 4 4

5 Recently this statement has been expanded to include the ability to lead a “socially and economically productive life”. The World Health Organization definition of health cannot be considered as an operational definition because it does not lend itself to direct measurement. In order to overcome this lacuna a WHO group has devised an operational definition of health. 5

6 According to this definition, the concept of health is viewed as being of two orders. In broader sense health can be defined as “a condition or quality of the human organism expressing the adequate functioning of the organism in given conditions, genetic or environmental” As evident from the above definitions, health is multidimensional. The WHO definition envisages three specific dimensions (physical, mental, and social), some other dimensions like spiritual, emotional may also be included.

7 Physical health Is concerned with anatomical integrity and physiological functioning of the body. It means the ability to perform routine tasks without any physical restriction. E.g., Physical fitness is needed to walk from place to place. 7

8 Mental Health Is the ability to learn and think clearly and coherently. E.g., a person who is not mentally fit (retarded) could not learn something new at a pace in which an ordinary normal person learns. 8

9 Social health Is the ability to make and maintain acceptable interaction with other people. E.g. to celebrate during festivals; to mourn when a close family member dies; to create and maintain friendship and intimacy, etc. 9

10 Emotional health Is the ability of expressing emotions in the appropriate way, for example to fear, to be happy, and to be angry. The response of the body should be congruent with that of the stimuli. Emotional health is related to mental health and includes feelings. It also means maintaining one’s own integrity in the presence of stressful situation such as tension, depression and anxiety. 10

11 Spiritual Health Some people relate health with religion; for others it has to do with personal values, beliefs, principles and ways of achieving mental satisfaction, in which all are related to their spiritual wellbeing. 11

12 Determinants of health
Determinants of health: Health or ill health is the result of a combination of different factors. There are different perspectives in expressing the determinants of health of an individual or a community. The health field concept according to the “Health field” concept. There are four major determinants of health or ill health. A. Human Biology Every Human being is made of genes. In addition, there are factors, which are genetically transmitted from parents to offspring. As a result, there is a chance of transferring defective trait. The modern medicine does not have a significant role in these cases. 12

13 Determinants of health
a. Genetic Counseling: For instance during marriage parents could be made aware of their genetic component in order to overcome some risks that could arise. b. Genetic Engineering: may have a role in cases like Breast cancer. B. Environment: is all that which is external to the individual human host. Those are factors outside the human body. Environmental factors that could influence health include: a. Life support, food, water, air etc b. Physical factors, climate, Rain fall c. Biological factors: microorganisms, toxins, Biological waste, d. Psycho-social and economic e.g. Crowding, income level, access to health care e. Chemical factors: industrial wastes, agricultural wastes, air pollution, etc 13

14 Determinants of health
C. Life style (Behavior): is an action that has a specific frequency, duration, and purpose, whether conscious or unconscious. It is associated with practice. It is what we do and how we act. Recently life style by itself received an increased amount of attention as a major determinant of health. Life style of individuals affects their health directly or indirectly. For example: Cigarette smoking Unsafe sexual practice Eating contaminated food D. Health care organization Health care organizations in terms of their resource in human power, equipments, money and so on determine the health of people. 14

15 Effecting health of community
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16 Public health Public health has been defined in different ways. In 1920, Charles Edward Amory Winslow said it is “the science and art of preventing disease, prolonging life, and promoting health and efficiency through organized community effort … to ensure everyone a standard of living adequate for the maintenance of heal” 16

17 Introduction to Public Health
1. Public Health Definition and Key Terms 2. History of Public Health 3. A Public Health Approach 4. Core Functions and Essential Services of Public Health 5. Stakeholder Roles in Public Health 6. Determining and Influencing the Public’s Health

18 Public health Public health: is defined as the science and art of preventing diseases, prolonging life, promoting health and efficiencies through organized community effort. It is concerned with the health of the whole population and the prevention of disease from which it suffers. It is also one of the efforts organized by society to protect, promote, and restore the peoples’ health. It is the combination of sciences, skills and beliefs that is directed to the maintenance and improvement of the health of all the people through collective social actions. 18

19 World Health Organization
“Public health aims to provide maximum benefit for the largest number of people.” World Health Organization

20 Public Health Key Terms
Clinical care: prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by medical and allied health professions; also known as health care. Determinant: factor that contributes to the generation of a trait. Epidemic or outbreak: occurrence in a community or region of cases of an illness, specific health-related behavior, or other health-related event clearly in excess of normal expectancy. Both terms are used interchangeably; however, epidemic usually refers to a larger geographic distribution of illness or health-related events. Health outcome: result of a medical condition that directly affects the length or quality of a person’s life.

21 Fill in the blank with the correct answer.
A. groups of people B. individuals Public health aims to provide ___________________ with the right to be healthy and live in conditions that support health. groups of people

22 The History of Public Health
Influenza Polio HIV 500 million infected worldwide in 1918 Vaccine introduced in 1955; eradication initiative launched in 1988 34 million living with HIV worldwide; 20% decline in new infections since 2001

23 What is an outbreak? Outbreak: when more cases of a disease than expected are recorded in one area an outbreak is declared. The area could be a small community or extend to several countries. An outbreak could even be a single case of a contagious disease new to a community or not seen for a long time. Outbreaks can last for a few days, weeks or even several years . There are three types of outbreak an endemic, an epidemic or a pandemic. 23

24 A endemic What is an endemic?
A endemic is an outbreak that occurs at a predictable rate in a certain area or among a set population. Chickenpox is classed as an endemic as it occurs at a high but predictable rate amongst youngsters. Endemics remain at a steady state, but do not disappear from a population. 24

25 An epidemic What is an epidemic?
An epidemic will see a disease rapidly spread amongst a large number of people in a given population. During an epidemic the disease will normally spread in two weeks or less. There have been 14 epidemics since 2010, including the Ebola epidemic in West Africa, which killed 11,300 people between 2013 and 2016. 25

26 A pandemic What is a pandemic?
A pandemic is the worldwide spread of a new infectious disease. It stretches over a larger area, infects more people and causes more deaths than an epidemic. In history there have been a number of devastating pandemics including smallpox, tuberculosis and the black death, which killed more than 75million people in 1350. In 2009 a pandemic of swine flu killed 14,286 people worldwide. 26

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28 A Public Health Approach
Risk Factor Identification Intervention Evaluation Surveillance Implementation

29 Three Core Functions of Public Health
Assessment Systematically collect, analyze, and make available information on healthy communities Policy Development Promote the use of a scientific knowledge base in policy and decision making Assurance Ensure provision of services to those in need

30 Ten Essential Public Health Services
Monitor Health Diagnose and Investigate Inform, Educate, Empower Mobilize Community Partnership Develop Policies Enforce Laws Link to/Provide Care Assure a Competent Workforce Evaluate Research

31 Partners in the Public Health System
Ensuring the Conditions for Population Health Community Clinical Care Delivery System Government Public Health Infrastructure Employers and Businesses The Media Academia

32 Public Health Core Sciences

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