Introduction to Health Care and Public Health in the US

Public Health (Part 1)

Lecture bThis material (Comp1_Unit7b) 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.

Public Health (Part 1)Learning Objectives

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Discern the main differences and similarities between public and private health (Lecture a)

Delineate the historic timeline and achievements of public health in the US (Lecture a)

Define and discuss key terminology of public health (Lecture b)

Illustrate the general organization of public health agencies and public health data flow (Lecture b)

Evaluate and explain the impact and value of public health (Lecture c)

Health IT Workforce Curriculum Version 3.0/Spring 2012

Introduction to Health Care and Public Health in the US Public Health, Part 1

Lecture b

Selected Public Health Terminology

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Introduction to Health Care and Public Health in the US Public Health, Part 1

Lecture b

• Endemic – disease native to an area or population• Epidemic – disease affecting numerous people at the same time• Epidemiology – study of incidence, distribution, and control of disease in a

population• Incidence – the number of new events/cases in a population. Requires a specified

time period and a defined population. • Intervention – in public health, refers to an action/program that is meant to benefit

the health of a population. Examples might include legislation, education, or service delivery.

• Morbidity – proportion of disease/illness in a population; relative incidence of a disease

• Mortality – number, frequency, or proportion of deaths in a population• Outbreak – sudden rapid development of a disease in a population• Pandemic – an extensive epidemic, affecting a very large region such as a country,

continent, or the world• Prevalence - proportion of a population with a specified condition/illness. Requires a

specified time period or point in time. • Relative risk – several meanings, including: risk of an outcome in those exposed to a

disease versus those not exposed; the calculated odds ratio resulting from a study.• Risk – odds of an event occurring; as in, a one in one hundred chance, or risk, of

dying.

Public Health Expenditures

7.2 Chart: FY 2011 President’s Budget for HHS

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Introduction to Health Care and Public Health in the US Public Health, Part 1

Lecture b

The public perception of public health is often restricted to highly visible aspects such as communicable disease programs, and in recent years, bioterrorism surveillance. However, communicable disease surveillance is a very small portion of the public health arena. In the US, the mandatory programs Medicare and Medicaid consume the majority of the HHS budget.

Core Areas of Public Health

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Lecture b

• Behavioral Science/Health Education• Biostatistics• Emergency Medical Services• Environmental Health• Epidemiology• Health Services Administration/Management• International/Global Health• Maternal and Child Health• Nutrition• Public Health Laboratory Practice• Public Health Policy• Public Health Practice

Organization of Public Health in the US

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Lecture b

• Three general levels of public health – local, state, federal– Local health departments– State health departments– CDC and other federal agencies

• Most – but not all – states are associated with a network of local or county health departments

Public Health Roles

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Lecture b

• Public Health is multi-disciplinary, improving population health through many roles

• Some examples include– Education – such as promotion of healthy lifestyles– Policy – such as advocating for legislative funding– Health care services – such as public health nursing, clinics; providing

vaccinations; maternal and child healthcare– Regulation – such as mandating state reportable conditions for

laboratories, health care providers, veterinarians– Laboratory services – public health laboratories provide sophisticated

testing for biological and environmental samples– Monitoring and surveillance – such as tracking occurrences of

communicable diseases or elevated blood lead levels

Public Health Laws and PoliciesDisease Reporting Regulations

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Lecture b

• States mandate certain diseases and conditions to be reportable in their jurisdictions – laboratories, health care providers, and veterinarians are then required to report these conditions to public health

• Certain diseases are termed Nationally Notifiable Diseases (NND). States and CDC together determine which diseases should be on this list

• Since 1961, CDC has collected and published NND data. Reporting of de-identified NND data to the CDC is technically voluntary, but is quite complete

• NND are reported weekly to the CDC by means of the National Electronic Telecommunications System for Surveillance (NETSS)

Examples of Nationally Notifiable Diseases, 2010

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Lecture b

• Infectious Conditions– Anthrax– Diphtheria– Giardiasis– Hepatitis – Lyme disease– Malaria– Measles

• Non-Infectious Conditions– Cancer– Elevated blood lead levels– Pesticide-related illness

(CDC, 2010)

Generalized Public Health Data Flow

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Introduction to Health Care and Public Health in the US Public Health, Part 1

Lecture b

7.3 Chart: The generalized flow of public health data.

Public Health (Part 1)Summary – Lecture b

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• Key terminology • Organization and funding in the US• Roles

Health IT Workforce Curriculum Version 3.0/Spring 2012

Introduction to Health Care and Public Health in the US Public Health, Part 1

Lecture b

Public Health (Part 1)References – Lecture b

References• Nationally Notifiable Infectious Conditions - United States 2010. (2010). Retrieved December 6,

2011, from Centers for Disease Control and Prevention - Office of Surveillance, Epidemiology, and Laboratory Services website: http://www.cdc.gov/osels/ph_surveillance/nndss/phs/infdis2010.htm.

Charts, Tables, Figures7.2 Chart: Advancing the Health, Safety, and Well-Being of Our People - FY 2011 President’s Budget

for HHS. (2011). Retrieved December 6, 2011, from Department of Health and Human Services website: http://dhhs.gov/asfr/ob/docbudget/2011budgetinbrief.pdf

7.3 Chart: The generalized flow of public health data – Created by Magnuson, JA (2011).

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Lecture b