Core Functions of Public Health and Key Concepts in Epidemiology
Core Functions of Public Health
- Assessment
- Policy Development
- Assurance
Prevention levels:
- Primary
- Secondary
- Tertiary
Market vs Social Justice
Market justice—individual freedoms should be left alone, minimal obligation to “common good”
Social justice—Minimum levels of income, basic housing, employment, education, and health care should be fundamental rights
Economic sources of controversy
- Cut jobs
- Increase consumer prices
- Tax increases
Types of restrictions on individual liberty
- Restriction of individual’s freedom to harm others
- Restriction of individual’s freedom to harm the “commons”
- Restriction on children/young people harmful behaviors
- Restriction of individual’s right to harm themselves
Contributions to Public Health
- John Snow—contributions and methods
- Jenner, Lind, Budd, Nightingale—contributions to public health
Constitution, role of federal government
States have primary constitutional responsibility and authority for protection of health, safety, and general welfare of citizens
DHHS, individual departments and what they do
Department of Health and Human Services, Centers for Disease Control & Prevention, Food and Drug Administration, Agency for Healthcare Research and Quality, Agency for Toxic Substances and Disease Registry
Chapter 4-5
Definition of epidemiology: The diagnostic discipline of public health, Explores incidence, distribution, and control of diseases in populations, Identifies trends in disease occurrence, Evaluates effectiveness of medical and public health
Definitions
- Endemic
- Epidemic
- Pandemic
- Incubation period
Define—epidemiologic surveillance, notifiable diseases
The system of reporting notifiable diseases in order to detect and prevent epidemics is termed epidemiologic surveillance, Notifiable diseases ~ 120 diseases that have been identified by law as “notifiable”
Steps for outbreak investigation—acute illness
- Construct a working case
- Verify the diagnosis
- Find cases
- Ask the epidemiological questions
Difference between studying acute and chronic
- Acute illness: Regulatory measures, quarantine/isolation, treatment, vaccination, etc.
- Chronic illness: Dissemination of study results, education, long-term programs for health promotion
Define—Incidence, prevalence
Incidence: Number of new cases of a disease in a defined population at risk over a defined period of time, Prevalence: Rate of all existing cases of a disease in a defined population at a specific time
Define—different types of studies
Limits of studying humans, You can’t control humans long-term or if they are in their own environment, You can’t knowingly harm a human subject, There are many potential sources of error in human observational studies
Interpret OR or RR with confidence interval; describe direction of association
Relative Risk (RR), Odds Ratio (OR), Define: confounding, types of bias
Ethics—IRB, informed consent
Institutional Review Board (IRB), informed consent
Define—mean, median, mode, p-value
Define—sensitivity, specificity
Rates—how to calculate (numerator and denominator); difference between crude and adjusted
YPLL—what it means, relative contributions of certain health outcomes
Agencies responsible for data collection
Vital statistics, U.S. Census—how done, what questions, etc.; difference between 10-year census and ACS NHIS, NHANES, BRFSS, YRBSS—differences, how performed, strengths/weaknesses
Chain of infection
Types of pathogens, how treated
Role of vaccines, contact tracing, epidemiologic surveillance
Difference between eradication and elimination, Vaccine controversy
Zoonotic diseases—define, examples
Define/discuss—misuse of antibiotics, consequences
Cardiovascular diseases (HTN, Atherosclerosis, etc.), Define and Risk factors
Diabetes complications, Causes of cancer, Actual causes of death
Define—Education, regulation; examples of each
Determinants of health—which goes into which category, Social determinants of health, examples of how SES determines health