Public Health: Now More Than Ever

The Core Functions of Public Health

• Assessment• Assurance• Policy Development

The Ten Essential Services of Public Health

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

community 3. Inform, educate, and empower people about health issues 4. Mobilize community partnerships to identify and solve health problems 5. Develop policies and plans that support individual and community health

efforts 6. Enforce laws and regulations that protect health and ensure safety 7. Link people to needed personal health services and assure the provision

of health care when otherwise unavailable 8. Assure a competent public health and personal health care workforce 9. Evaluate effectiveness, accessibility, and quality of personal and

population-based health services 10. Research for new insights and innovative solutions to health problems

Definitions• Health Disparity - Statistical differences in health status that occur among

population groups defined by specific characteristics.• Health Inequalities - Generic term used to designate differences,

variations, and disparities in the health status and risk factors of individuals and groups that may be due to any cause or random variation.

• Health Inequity - Inequalities in health that are avoidable, unfair or stemming from some form of injustice.

• Health Equity - Fair and equal access to the conditions for good health.• Social Determinants of Health - The economic and social conditions that

influence the health of individuals and communities and determine the extent to which a person possesses the physical, social, and personal resources to identify and achieve personal aspirations, satisfy needs, and cope with the environment. These include but are not limited to: conditions for early childhood development; education, employment, and work; food security, health services, housing, income, and income distribution; social exclusion; the social safety net; and unemployment and job security. (Adapted from Dennis Raphael)

Upstream – Downstream:A Public Health Parable

Once upon a time the people living in a village by a river began noticing bodies floating downstream.

One of the townspeople was assigned the job of diving in and rescuing them.

…a huge crowd of townspeople were spending most of their days and nights jumping in the river and pulling out the drowning people.

One day one of the townspeople just stopped and turned around and started walking upstream.

Some people were trying to cross the river on a bridge, but it had a hole in it and they fell through!

Some people had to live so close to the river bank that when it flooded they got washed away!

Some people got pushed in!

And some got so sad they jumped in!

When you are poor and the flood’s at your doorYou know you’ll probably go – downstream

Bodies are floatin’ ‘cause the bridges are broken So you’re sure to go - downstream

Us people down the river will try valiantly to rescueThe bodies floating down the stream, we know it’s what we must do…… But we are tired…..

The bodies keep floating down, there are so many more daily, and more of them drown

So we go upstream – that’s where the problems areUpstream – prevention is not too far

Upstream – answers are waiting for us

The Saga of Sister Public Health and Brother Planning

Sister Public Health became deathly ill with diarrhea and wasn’t expected to live.

• Why?• Because.• Why?• Because.• Why?• Because.• Why?• Because…

He carefully took out his tools…

…and began designing a neighborhood with healthy housing and clean water and sewage systems…

…and all manner of wonderful things.

His Sister Public Health survived, thanks to the help of some nice nurses who came to visit her…

…and took care of her while she was sick.

…to save their friends and families from the suffering caused by the infections that are spread when people don’t have clean, healthy places to live or to work.

During the Great Depression they even took a trip to New Mexico.

…a special program called “WPA” – to help wipe out malaria in Rio Arriba, Mora, Santa Fe, Sierra and Doña Ana counties.

They got to help with the WPA Sanitary Privy Project that built thousands and thousands of healthy outhouses.

…designing better roads so that people wouldn’t die in accidents so much

Sister Public Health got really fascinated with the new wonders of medicine – things like antibiotics…

…and vaccines.

…fewer and fewer of those pesky infectious diseases

killing people

A lot more people who were sick from things they didn’t actually “catch” from other people.

And once they got sick, it lasted a long time, sometimes the rest of their whole life.

So even if people were living longer, they were living sicker.

She realized that they couldn’t eat the good food she kept telling them to eat because they didn’t have enough money.

…and instead of grocery stores, their neighborhood was filled with McDonald’s and Allsup’s mini-marts.

The neighborhood was run-down and dreary with not a park in sight and no kids out playing.

There was no sidewalk and it made her never want to walk there again.

But the problems just kept getting worse.

He had meanwhile become quite occupied with super-highways and fancy housing developments with shopping malls out in the suburbs.

…how much healthier and happier people had been in those old neighborhoods.

…and the families could eat together almost every night because the moms and dads didn’t have to work two jobs each to make enough money to pay the rent.

…how powerful they felt as a team when they were young.

1. Behavior is dependent on resources.

1. Behavior is dependent on resources.

2. Solutions require partnerships.

1. Behavior is dependent on resources.

2. Solutions require partnerships.

3. Policy makes change.

Essentials of Public Health Work (My Favorite Things)

Monitor status – who’s sick and who’s healthy

Look at the difference ‘tween poor folks and wealthy Find all the hazards, investigate risks

Let people know what is making them sick

Why do some people live longer than others

Work with them closely, see what you discover

Mobilize partnerships, work hand in hand

Make some new policy – change all the bad

Make sure the laws and the regs will protect us

Link up the people with care that they can trust

Build public health workforce and make sure they’re paid

And that the services do what they say

Find the new insights, start new ways of thinking

Cutting edge answers to questions we’re linking

Improve the system with what we have learned

These are essentials of public health work

When disease hits populations

Makes us feel so sad

We simply remember how public health works

And then we don’t feel so bad

Amazing Place

Amazing place, how sweet the song

Our neighborhood is great

We once were sick, but now we’re strong

Our homes and streets are safe

I once would search good food to eat

To help my kids get fed

But all I found were Burger Kings

My kids got fat instead

The doctor said to take a walk

To help me shed the pounds

I stepped outside, fought dogs and cars

And turned right back around

So friends and neighbors made a plan

The policies to change

Good food and sidewalks were the start

And more is on the way

Amazing place, how sweet the song

Our neighborhood is great

We once were sick, but now we’re strong

Our homes and streets are safe

Let It Be – Equity

When some are healthier than others

Graphs and charts are what we see

Numbers on the page – disparity

But when we notice it’s not right

They’re dying young ‘cause they’re not white

Then it’s just not fair – inequity

Disparity, inequity, inequity, disparity

Yes, there is a difference – can’t you see 

If we choose to treat the illness

But we just ignore the cause

Thinking it will change disparity 

Others will continue dying

Poverty will take its toll

That is just not fair - inequity 

Inequity, don’t let it be, let it be equity

We can make a difference – can’t you see 

Let it be equity, let it be equity

We can make it happen – equity 

The Core Functions andEssential Services of Public Health

THANKS TO OUR CAST & CREW!

• Professor – Dr. Floyd Frost• Child #1 – Martín Muñoz• Child #2 – Leigh Caswell• Grandma – Linda Peñaloza• Grandpa – Marsha McMurray-Avila• Musical support – Enrique Cardiel • AV Tech – Matt Cross-Guillén

Row row row your boat gently up the streamDon’t forget the real cause

may not be what it seems