Introduction to Public Health Flashcards
Public Health
Includes all of the organized and holistic efforts to improve policy, education, and access to make the healthiest choice the easiest choice for everyone.
Where we’re born, where we work, where we live that determine access to the resources we need to be our healthiest selves like safe drinking water and reliable healthcare.
Population-based approach
Focuses on societes as a whole rather than individuals
Informs educators, policymakers, community leaders who play a crucial role in improving the health of the community
Upstream Interventions
- focus on addressing root causes and determinants of health issues
- aim to prevent health issues before they occur or at an early stage
- often involve changes at the societal, community, or policy level
- emphasize systemic and structural changes to improve overall population health
Social determinants of health
Have an impact on health
conditions in the environment where individuals are born, live, learn, work, play, worship, and age, which significantly impact a broad spectrum of health outcomes, functioning, and quality of life, as well as associated risks.
Equality
Giving the same assistance to all
Racial Inequity
The unfair and unequal distribution of resources along racial lines
Health Disparities
Differences in health that is closely linked to social or economic disadvantage
Some examples include:
- money/socioeconomic status
- water quality
- air quality which leads to high rates of asthma
Health Equity
- a right to the highest possible standard of health
- focuses on reducing and eliminating disparities in health and its determinants, including social determinants
- no one is denied the possibility to be healthy for belonging to a group that has historically been economically or socially disadvantaged.
You’re in a particular setting and I give you the set of tools.
health inequities
unfair and avoidable health differences between groups of people within countries or between countries
WHO social determinant framework
social determinants that lead to inequalities
- structural determinants
- intermediary determinants
structural determinants
socioeconomic and political context in which a person is a born into and lives in
- governance
- social and public policies
- social and cultural values that communities place on health
all impact a person’s socioeconomic position
socioeconomic position describes
a person’s place in society which can affect their exposure, vulnerability, and outcome to conditions that have an impact in their health
socioeconomic position is determined by a number of factors such as:
- education
- occupation
- income
- gender
- race or ethnicity
- social class
Affects the intermediary determinants
intermediary determinants of health
- material circumstances
- psychosocial factors
- behaviours
- biological
Factors that bridge the structural and intermediary determinants
- social cohesion
- social capital
How can we change these determinants?
- identifying the structural and intermediary determinants of health and taking appropriate actions to improve them
- needs actions in all sectors and levels including local, national, and international
Health Promotion
process of enabling people to increase control over and to improve their health
Health
a state of physical, mental, social wellbeing
5 action areas for health promotion
- building healthy public policy
- creating supportive environments
- strengthening community action
- developing personal skills
- reorienting health services
Strategies for Health Promotion
- advocate
- mediate
- enable
Examples of upstream interventions:
- Policy changes: Rules for safer environments (e.g., smoking bans, healthy food policies, implementing laws and regulations in schools, corporations, and businesses)
- Socioeconomic interventions: Programs to reduce poverty, improve education, and offer affordable housing and healthcare.
- Health equity initiatives: Efforts to address disparities in health outcomes (e.g., income inequality, racism).
Downstream Interventions:
- focus on treating and managing immediate health problems and symptoms
- come into play after health problems have already manifested
- primarily target the individual or patient level
- emphasize individual-level care and treatment for disease and injury
Examples of downstream interventions include:
- Clinical treatments: Medical treatments for diseases (e.g., prescribing medication for high blood pressure).
- Health screenings: Identifying health problems through tests (e.g., mammograms).
- Health education: Providing info to promote healthier behaviors (e.g., quit smoking programs).
Midstream interventions
aim to prevent health issues by addressing both the physical environment and behavior.
- Preventive (to reduce the risk of health problems before they occur)
- Physical environment (improving access to safe recreational spaces, reducing pollution, or ensuring clean water sources to promote better health)
- Promotes healthier behavior (regular exercise, healthy eating, and smoking cessation)
Stages of Prevention
- Primary
- Secondary
- Tertiary
Primary Prevention
- prevent development of disease or injury
- examples: pre-exposure medication, administering vaccines
Secondary Prevention
- midstream
- early detection and treatment reduce impact of disease to prevent long term health effects
- disease onset
- examples include screenings for cancer, diabetes, and cholesterol
Tertiary Prevention
- clinical treatment after the clinical diagnosis
- minimize the impact of disease
- examples: administer drugs, therapies that help manage the condition
Individual-Based Strategies for Health Improvement
- targets individual health behaviors and outcomes
- improves health at the individual level by addressing personal behaviors and healthcare needs
- examples: health education, medical treatment, behavior change programs (e.g., smoking cessation).
- personalized care and support tailored to individuals
- success based on individual health outcomes
Population-Based Strategies for Health Improvement
- targets entire populations or communities
- improves overall community or population health by addressing common risk factors, social determinants, and environmental factors
- examples: public health policies, community initiatives, vaccination campaigns, health equity programs
- systemic changes, policy development, and interventions affecting a broad range of people
- success based on population-level health outcomes and community well-being
Social Justice
Fair and equitable division of resources, opportunities and privileges in society
5 Categories of social determinants of health
- economic stability
- education access and quality
- healthcare access and quality
- neighborhood and built environment
- social and community context
Herd Immunity
occurs when a significant portion of a population becomes immune to a specific infectious disease, either through vaccination or previous exposure, making it difficult for the disease to spread within the community.
- Protects everyone-even those who cannot get vaccinated (e.g., allergies, or weak immune systems, children)
- Threshold for herd immunity varies by infectious disease
R0 (Basic reproduction number)
Number of cases that are expected to occur on average as a result of a single infected individual.
R0 Assumptions
- Population is homogenous — factors like age, vaccination status, and behaviors that can affect disease transmission are not taken into consideration.
- Everyone in the population is susceptible (e.g., start of the pandemic)
- No widespread immunity yet
If R0 > 1
infection will spread
What does it mean when R0 is high?
- an infectious disease has the potential to spread rapidly and widely within a population
- this leads to epidemics or outbreaks because they can infect a significant portion of the population before effective control measures are implemented
R0 is affected by
- how many people are susceptible to the disease initially and how crowded/dense the population is
- how easily the disease spreads from person to person
- how quickly cases either recover or pass away
If R0 < 1
slow spread, will eventually disappear
8 reasons why immunization rates are important
- Disease Prevention
- Reduction of Disease Burden
- Protection of Vulnerable Populations
- Eradication and Control
- Cost Savings
- Public Health Preparedness
- Global Health
- Long-Term Health and Well-Being
Re (Effective reproduction number)
The number of people in a population that can be infected by an individual at a given time
- Goal: Re < 1
- Assumption: population has mixed susceptibility and immunity
Re changes with time due to
- Increasing immunity in the population
- Rate of death
- The pathogen itself (e.g., alpha vs. delta vs. omicron)
Re is affected by:
- Number of people infected
- Number of susceptible people in contact with infected people
Why is Re important?
- If Re > 1, spread increases exponentially, faster spread, cases go up
- If Re < 1, spread slows down, cases decline
Relationship between R0, Re, and immunity
When R0 goes up, in order to keep Re less than or equal to 1, the number of people in the population that need to be immune, will go up.
Hybrid immunity
also known as mixed immunity, refers to a state in which an individual is protected against a particular infectious disease through a combination of both natural infection and vaccination.
The concept of the Chicken Pox Party
a practice where individuals intentionally expose themselves or their children to the chickenpox virus in an attempt to build natural immunity, but it is not a recommended or safe method for achieving herd immunity.
