Public Health Theory And Convictions And Their Application In AYUSH Dr Sathyanarayana, Feb 2013 drsathya1@gmail.

com

Ground Rules!
Listen to others and value the diversity of opinions in the group Be constructive Value the differences; there are no rights or wrongs, no good or bad Be open and honest Keep to agreed time, especially start and finish Mobile phones!

www.yhtphn.co.uk/win

The Public Health System

Police EMS Community Centers

Urban

Home Health Churches Corrections

Health Department Schools

Parks

Elected Hospitals Doctors Officials Nursing Mass Transit Philanthropist Homes Environmental Civic Groups Health CHCs Fire Tribal Health Economic Laboratory Employers Drug Mental Development Facilities Treatment Health

Core Components
ASSESSMENT of the health of the community POLICY DEVELOPMENT in the publics interest

ASSURANCE of the publics health

Public Health Approach

Public Health Model
Versus

Medical Model

Public health vs Clinical health

Public Health Population Health Prevention and Health Promotion

Clinical Health Individual Disease Diagnosis and Treatment

Determinants of Health

Determinants of Health
Genetic Behavioral Social Environmental Personal health care

Achievements
Vaccination

Safer Workplaces
Safer & Healthier Food Motor Vehicle Safety

Achievements
Control of Infectious Diseases Family Planning

Decline in Deaths from Heart Disease & Stroke

Achievements
Recognition of Tobacco Use as a Health Hazard Healthier Mothers and Babies Fluoridation of Drinking Water

PUBLIC HEALTH THE PAST & THE FUTURE

3 Predominant models of health

Biomedical model Traditional/Lay model of health Social model of health

Medical Model of Health

The absence of disease and illness Medical treatment can restore health

Traditional/Lay concepts of health

Health is a positive concept Differs depending on e.g. age, culture, ethnicity
Example 1- .Older people - wholeness, inner strength & ability to cope. Example 2 - Young people fitness, energy & strength Example 3 - Middle class vs working class

Social Model of Health Dahlgren & Whitehead Social Ecological Theory

Living and working conditions Work environment Unemployment Water & sanitation Health care services

Education

Agriculture and food production

Housing

Age, sex and constitutional factors

PUBLIC HEALTH

PUBLIC HEALTH DEFINITIONS

Public health is the Science and Art of preventing disease, prolonging life, and promoting health and efficiency through organized community effort.

(C.E.A. Winslow, 1920)

PUBLIC HEALTH DEFINITIONS

Public health is what we, as a society, do collectively to assure the conditions in which people can be healthy.
The Future of Public Health, Institute of Medicine, 1988

Public health is the Science and Art of preventing disease, prolonging life, and promoting health and efficiency through organized community effort for sanitation of the environment, the control of communicable disease, the education of the individuals in personal hygiene, the organization of medical and nursing services for early diagnosis and preventive treatment of disease, and the development of the social machinery to insure everyone a standard of living adequate for maintenance of health, so organizing these benefit as to enable every citizen to realize his birthright of health and longevity. (C.E.A. Winslow, 1920)
Public health is what we, as a society, do collectively to assure the conditions in which people can be healthy. The Future of Public Health, Institute of Medicine, 1988

THE PUBLIC HEALTH PRINCIPLES The principle of the Aggregate The Principle of Prevention The Principle of Community Organization The Principle of the Greater Good The Principle of Leadership The Principle of Epidemiology

1. The principle of the Aggregate

2. The Principle of Prevention

SMOKING
PRIMARY
EDUCATION & ORDINANCING SO INDIVIDUALS DO NOT BEGIN TO SMOKE

SECONDARY
QUIT SMOKING CLASSES

TERTIARY
ASSURING THERE ARE SERVICES TO CARE FOR PEOPLE WITH COPD DUE TO A LONG

3. The Principle of Community Organization

4. The Principle of the Greater Good

5. The Principle of Leadership

LEADERSHIP DOING WHAT OTHERS WONT DO.

6. The Principle of Epidemiology

EPIDEMIOLOGY
The systematic, objective study of the natural history of disease. Within populations and the factors that determine the spread of disease.

Distribution and determinants of disease/risk factors in a defined population

THE PUBLIC HEALTH PRINCIPLES

The principle of the Aggregate The Principle of Prevention The Principle of Community Organization The Principle of the Greater Good The Principle of Leadership The Principle of Epidemiology

If the mission of public health is to flourish, a shift in values toward a more community oriented sense of common purpose will need to take place.

Move forward toward: COMMUNITY HEALTH PARTNERSHIPS TOWARD A NEW PUBLIC HEALTH PRACTICE

Essential Public Health Functions

Assure a competent public health care workforce. Evaluate effectiveness, accessibility, and quality of personal and population-based health services. Research for new insights and innovative solutions to health problems.

Public Health Approach

Define the health problem. Identify risk factors associated with the problem. Develop and test community-level interventions to control or prevent the cause or the problem.

Public Health Approach

Implement interventions to improve the health of the population.
Monitor those interventions to assess their effectiveness.

Public Health Approach

Risk Factor Identification: What is the cause?

Implementation: How do you do it? Intervention Evaluation: What works?

Surveillance: What is the problem?

Problem

Response

Public Health Approach

Requires the collection, analysis, and interpretation of data to define the problem and outline: What Where When Who How

Public Health Approach

Requires a determination of: Preventable or not preventable Controllable or not controllable Priority