EPID-600 Introduction to Public Health
Introductory session
History, goals and organization of public health.
Students should be able to describe:
- How public health issues have affected health status over more than 4000 years.
- The purpose and outline methods used to develop public health policy and goals.
- The organization of federal, state and local health departments.
- Common activities carried out at each level, as well as certain special activities restricted to a particular organizational level.
- Who, what, when, why that make up the practice of public health
References
A History of Public Health. George Rosen, 'Future of Public Health'. IOM.
Reading
Introduction to Public health :Schneider 2nd Ed.. Chapters 1 through 3.
Essentials of Public Health. Turnock. Chapter 1
Review the USPHS & Virginia Department of Health [VDH] Web pages
To read journals on-line use this library access web page
Class Roster
Special Reference. For students who have no experience with the US Health Care System a primer is provided here. Take your time over this. It can be completed over the course of the semester and will prepare you for Dr. Lanier's class on Health Policy.
The continuing theme of this course is that epidemiologic and biostatistical expertise are the underlying skills needed for all activities, whatever the field, in public health. Visit Healthy People 2010 before each week's session and review that part of the Healthy People Process which relates to the week's discussion, to prepare your thoughts for the discussion boards.
The first, and probably the only material you need to memorize from the entire course is:
- The Ten Essential Public Health Services which are further expanded in
- The Essential Public Health Functions. (in the National Public Health Performance Standards Program)
- Principles of Ethics for Public Health
these functions are the basis of public health as it enters the second millennium. They are the most recent consensus among the major national public health groups, following the 1998 "Future of Public Health" book (see link to the on-line text below), produced by the Institute of Medicine of the National Academy of Sciences. This book should be part of your own permanent library. You can view the CDC PPT Slide Show of the 10 Essentials (you will need a fast link, preferably cable or the VCU Intranet)
The triumph of public health.
Until recently, the concept of prevention was most often tied to public health efforts, in particular to the prevention of infectious diseases. These preventive interventions had their roots in the 1800s.
In 1846, Ignaz Semmelweis instituted handwashing on his obstetrical ward in Vienna’s teaching hospital, cutting the death rate among delivering mothers more than fivefold. Joseph Lister later credited his developments in antiseptic surgery to Semmelweis, “Without Semmelweis, my achievements would be nothing.”
In 1854, John Snow, Queen Victoria’s anesthesiologist, removed the handle from the Broad Street public water pump in London’s Soho district, ending a cholera epidemic that had killed more than 70 people over two days. (http://www.rethinkingwellness.com)
The ten essentials are the culmination of over 2000 years of development of
'Hygiene" practice as identified in the web page on
the history of public
health. Dr Ted Tweel, the health director
of Hanover County Health Department, has provided a short history
of major events in Virginia's public health. Also review the
History of Public Health in Virginia, a Power Point presentation prepared by Jeff Lake, Deputy Commissioner of Health, VDH. (.pdf version)
Take a look at death rates for the five leading cause of death in 1900 and see how they have changed. Also, look at the changes in life expectancy in the U.S. over the last 150 years. Look at the WHO Global Challenges for Public Health -2002. How good is health care in the US, compared to other countries? Can you find the answer on the web and put your conclusion in the first section of the discussion board.?
An essential read: Elizabeth Fee's Unfulfilled Promise
Also, review summaries of three projects from the Robert Wood Johnson Fund (RWJF) identifying weaknesses in the Public Health System.
For every lecture/discussion of the MPH program you should consider how the specific session incorporates the five basic skills of public health which are:
- epidemiology
- biostatistics
- environmental health
- social and behavioral science
- health services administration
Also be aware of the Principles of Public Health Ethics. Then you should consider whether they are also incorporated into the following extended skill set which the IOM 2003 study recommended as being incorporated into all public health education:
- Informatics
- Genomics
- Communication
- Cultural competence
- Community based participatory research
- Global Health
- Policy and Law
- Ethics
Also look at the Core Competencies Project of the Council of Linkages. These core competencies are the application of the ten essentials (above.) While you are visiting this site look at the CCP home page to learn about the Council on Linkages. Each session will include a continuing focus on public health policy in practice. Policy development will be discussed in the Winter Term in Dr. Lanier's course. The outline of Dr. Nelson's discussion of goals and policies in the public health arena are found in the Goals web page, (pdf of Dr. Nelson's presentation) Part 2 of tonight's session
Recent literature on ethical relationships between patients and their physicians are applicable to communities and their public health agencies as partners
Also,
in preparation for the remainder of the course review
the content
for training in public health AGAIN, recommended by
the Teachers of Preventive Medicine. This
outline was prepared as a supplement to the Ten Essential
Functions, referred to above. This outline is pertinent
to anyone planning to practice public health and
should be used as a learning tool in every course
you take. This will allow you to see how the various
elements of each course fit into, and complement,
the other courses to ensure that you will be have
acquired the skills necessary to carry out the Ten
Essentials. when you are awarded your MPH. Consider
this organization
chart as one way of displaying the major elements
of health care provided in the U.S.
If you want to print out this
graphic use landscape mode. [This slide is a macro enabled Power Point slide show. Once you open the slide in Slide Show mode. move your mouse over the various boxes to get explanations of the content.]
The WHO Statistical Report of HEALTH SYSTEMS Performance for 2003 indicated that the US was 43rd when measured by health outcomes such as death rates, disability rates, and survival rates. Also review the report, issued in August 2006, from the Commonwealth Fund about development of a "High Performance Health System" in the US. If you want to follow this up I will be happy to forward the complete report (some 18 pages) by email upon request, and the update in August 2008.
Optional Viewing Primer on the Federal Budget Process, with emphasis on the health budget
Valuable URLS:
WHO A guide to statistical information at WHO
WHO Statistics 2007 Ten Highlights (.pdf)
The next two documents should be scanned for this session but read through during the rest of the course as the contents will place many of the other issues into perspective in the rapidly changing field of pubic health policy, particularly the segments on primary care access and caring for he uninsured
Health care Coverage
Obstacles to changing the system.
Dr. Buttery's Blog
Also, You may want to place the following in your Links for public health on your web browser as you start to develop a pubic health library.
National Academies Webcasts
Is American health care the best? (The website registration should be free)
Bioinformatics Standards
Preventive Counseling
Prevention Database
Key Resources on Health Coverage and the Uninsured
Additional Useful Readings:
How to read an article
WHO & US Health Care
State H.D. Organization Charts
National Academy Press
The Public's opinion about Public Health
The Future of Public Health