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1.Public Health > 1. Def P.H & Global burden of disease > Flashcards

1. Def P.H & Global burden of disease Flashcards

1
Q

First Definition of Public Health? (Person & Def)

A

Prof. CEA Winslow USA (Bacteriologist) 1920

P.h is all about: Science &Art of :

  • preventing disease
  • prolonging (verlängern) life
  • promoting physical health
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2
Q

WHO Definition

A

Public health refers to:

  • all organized measures (public or private) -
  • to prevent disease, promote health
  • prolong life - among the population as a whole
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3
Q

How can we achieve the WHO definition?

A
  • aim to provide conditions in which people can be healthy
  • focus on entriere populations
  • not only individual pat/diseases
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4
Q

Public Health Supports Conditions in which people can be healthy Basics P:H Grafik beschreiben

A
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5
Q

3 Basic Principles of Public Health?

A
  1. Population perspective

(Focus group people, population rather than one individual)

  1. Ethics

(Proportionality, no-harm principle, protection of most vulnerable groups)

  1. Evidence Based

Studien

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6
Q

Timelines & Milestones

A
  • Ancient Greece 500-323 BC
  • Roman EMpire 23BC-476 AD
  • Middle Ages 467-1450 AD
  • Birth of Modern Medicine 1650-1800
  • Great Sanitary Awakening (18-1900)
  • Modern P.H 20-12st century
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7
Q

Anciente Greece (500-323BV)

Did what for P&H?

A
  • Aesculapius : symbol of medical prfession
  • Person hygiene & fitness
  • Maturalistc concept

Hippocrates

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8
Q

Hippocraes

Did what and when?

A

460-377 BC - Ancient Greece time

Father of western medicine = Hippocratic oath

He realized:

  • Proclaimed causal relationships between health /& enviroment
    • Disease &climare, water, lifestyle, nutrion
  • 4 vital bodily fluids
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9
Q

Roman Empire 23BC - 476AD)

What have they done for PH?

A

Gret engineers

  • Aqueducts
    • transportation of water from source to villages
    • Complex system of sewers (Kanalisation)
  • Sanitation & hygiene & Admin
    • Public baths
    • Water supply
    • Markets
    • reporting systems in place
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10
Q

Middle Age

Was when?

What happend in this time?

A

476-1450 AD

Shift away from Greek & Roman values one step back!!

  • Decline of hygiene & sanitation
    • ​no rubbish collection
    • butchers in the street
    • no drains (Entwässerung)
    • no toilts in poor areas
  • No knowledge added

Plague

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11
Q

Plague

When was that?

Why is it important for PH?

A

14th Century

Black Death = killed 25-50% of the total population

  • Beginnings of public healths tools
    • Isolation pat, cleaning of areas with lime (Kalk)
    • Quarantine or isolation
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12
Q

Birth of Modern Medicine

  • Time
  • What happend
A

1650-1900

Edward Jenner & Smallpox (Pocken)

  • 1749 England
  • Father of Immunology
  • Smallpox killed a lot of childrean
    • Variotion = he took material from sick person to infect healthy
  • 1796 : first vaccination
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13
Q

Great Sanitary Awakening

Time

What happend

A

1800s-1900s

Health related consequences of industrial revolution

  • Slums, overcrowding, bad housing, lack of drainge & sewerage

Focus on sanitation & changing physical enviroment=

  • Water supply, monitoring community health status

Despite lack of scientific knowledge= Major developments in communicable disease control (TB, Cholers,Smallbox)

Hour of birth of Epidemiology, P;H

  • Ignanz Semmelweiss (Childbed) & Joh Snow (cholera)

Social Medicine

  • Edward Chadwick
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14
Q

Ignaz Semmelweis

A

1818-1865 Vienna

Child bed fever was a big problem , mortality women after childbirth 25%

Required physicians & med studens to wash hands & brush fingernails

Hygiene in hospitals

Contribution (beitrag) to the germ theory

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15
Q

John Snow

A

1832 London Cholera

  • Cholera epidemic led to the birth of public health in England around 1840
  • Growth of scientific knowledge
  • fundamental concepts of epidemiology

Snow studied the epidemiology of cholera in London and discovered role of polluted (verschmutzt) drinking water

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16
Q

Epidemiological thinking?

A

Importance of careful data collection -

documentation of diesease rates before / after intervention -

evaluation of effectiveness

17
Q

Birth of Social Medicine - Poverty in Focus

(Time Great Sanitary Awakening)

A

Connection between poverty & health

disease emerges from infavorable social conditions

  • social justice
  • Focus on vulnerable group

Edward Chadwick (1800-1890)

1842 Landmark research on disease as result of living conditions of poor people

1848 Gerneral Board of Health & Public Health Act

  • Political claims oto develop medical supply ect.
18
Q

Modern Public Health

A

>2000 - 21st century

Contagion (Ansteckung) Control

Germ theroy of disease as groundwork of modern public health

(Louis Pasteur & Robert Koch)

  • Microorganisms can lead to disease (tetanus & diphteria causing bacteria
  • New diagnostic test (TB skin testing, bacterial culture & chest X ray
  • New vaccines
  • Epidem. methods to understand diseases

(no Penicillin yet - 1928 Alexander Fleming )

19
Q

What was the role of public health in 1950-1980?

A

Filling holes

This time was the era of effective medical interventions

Role:

Filling holes in health care system

Assist clinicians to effectively deliver clincal services

Help preventive efforts (practice of medicine)

20
Q

What happend in 1950-1980?

Why is it so important for medicine and PH?

A
  • Non communicable disease first time prominent issu
    • recognized how harmful smoking is ect
  • Randomized controll trails
  • Regulation of drugs, vaccines & other interventions
21
Q

Change in mid 1980-2000 Health Promotion & Disease Prevention?

Explain

A

Health Promotion & Diesease Prevention

  • Individual level
    • Smok, Alc, obesity
  • Environmental movements
    • Gases, toxic, nuclear
22
Q

Examples of public H. Achievements 1999

A
  • Moto vehicle safety
  • Safer workplaces
  • Control of infectious diseases
  • Decline in deaths from coronary heart disease and stroke
  • Safer & healthier foods
  • Healthier mother & babies
  • Family plannung
  • Redcognition of tabacco use as health hazard
23
Q

What are changes in 21 th Century?

A
  • Globalization : New technologies
  • Rises of evidence based p.h
  • Collaborations between clinical care &p.h
  • Complexity of p.h problems need complex solutions
    • (Social norms, social system, environment, example obesity)
  • Life course approach
    • focus mother&children, ageing population
  • Prolonging life - yes but also with high quality of life
24
Q

21st Centruy Definition: Population Health

A
  • The totality of all evidence-based public&private effort
  • troughout the life cycle
  • that preserve&promote health&
  • prevent disease, disability&death
25
Q

3 core functions of public health

A

Assessment: Whats the problem

Policy development : What can we do?

Assurance : is it appropriate what we do?

Research is linked to all services (in the middle)

26
Q

10 essential services/activities related to 3 core functions

A
27
Q
  1. Assessment
A

What the problem?

  • Identify&solve community health problems
  • Diagnose& investigate h problems & hazards (Gefahren) in the community

(Really understand a problem)

28
Q
  1. Services/Activities in Policy Development
A

What can we do?

  • Inform, educate&empower people aboout health issues
  • Mobilize community partnerships & actions to tackle health problems
  • develop policies &plans to support health efforts
29
Q
  1. Services/Activities in Assurance (Sicherheit)
A

Is it appropriate what we do?

  • Enforce laws&regulations & ensure safety
  • Link people to needed health services & assure the provision off health services
  • Assure a competent health workforce
  • Evaluation , Quality of person ect.
30
Q

What is the Global Burden of Disease (GBD) Project?

A
31
Q

HALE

A

Healthy Life Expectancy

describe the average number of years that a person can expect to live in full health

(82 davon 64 gesund = 18 mit Krankheiten) = 64

32
Q

YLL

A

Years of life lost

Person dies at the age of 50, natural death 86= life loss 36 yeasr

33
Q

YLD

A

Years lived with a disability

Disability like 25, or 75 or 50%

Suffers sience the age of 50years and lives with 50% disability

86-50= 36:2= 18 years

34
Q

DALY

A

DAL = YLL & YLD

Disability adjusted life years= Years of life Lost+ years lived with disability

Healthy life until 50

Years lived with disability 5 -> 50% = death

55 bis 86 = 21 years of life lost

35
Q

Daly Picture

A

1.Public Health (9 decks)

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