Chapter 8: Public Health

Introduction

What is public health? The tag line for the Montgomery County Public Health
Department is “Prevent. Promote. Protect.” If you think about it, that is what public
health is all about. They work with the community to prevent the spread of disease
through various immunization and health programs. They promote health through
public outreach and education. They protect the community through tracking of
diseases and inspections of the public water supply and businesses such as food
service and tattoo shops. Look around you, probably in one way or another, public
health probably has an impact on it.

More and more our environment is being impacted by a wide variety of natural disasters
- fires, floods, tornadoes, hurricanes. These each have a unique impact on public
health. Take any of these four things (fires, floods, tornadoes, hurricanes) and think
about what may happen to the water supply, the ground/soil that impacts the food that is
grown, and the air we breathe - those are all public health.

In the end of 2017 and beginning of 2018, the

country was hit with the worst flu season in a
long time. Many people were extremely sick and
many had to go to the hospital because of how ill
they were. Compared to previous years many
died. Often when we talk about the very young
and very old being the ones hit the hardest but in
this flu season, it hit across all age groups. The
flu shot is often the most effective way to help
decrease the number of flu cases but the flu shot
that year did not target the correct strain. But for those who got the flu shot and still got
the flu, they did not get it quite as bad. Public health is responsible for the tracking of
diseases and predicting the spread of diseases. They also have clinics that are
accessible to ANYONE. They charge on a sliding fee scale so what it costs is based on
your income. This is public health.

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Do you like to go out to eat? Is the food you eat
safe? Is the restaurant following food safety
guidelines? Who monitors this? Who tracks
outbreaks of food based illnesses? This is public
health.

Now let’s take a look at the impact of the opioid

problem. In 2017, Montgomery County unfortunately hit national status with being the
highest number of deaths from opioid overdoses in the country...not just the state of
Ohio but THE ENTIRE COUNTRY. This is not a distinction a city or a county wants.
Who tracks and works with other agencies to try to make a change? Did you guess
public health?

Although much of what I discussed above was based on the Montgomery County Public
Health Department, public health is local, statewide, countrywide and global. THAT IS
PUBLIC HEALTH.

Importance to Student

Public health has two important functions for you as a student. First, it is a place to get
information. You need to learn the services and information your local public health
department provides and how that will help you in your field of study. For some of you
that might be a lot; others, maybe not so much. Even if you might not access public
health for information, often students don’t have the money for needed health services.
Public health is there for you. Remember, cost is based on a sliding fee scale. And the
other good thing for us here at Sinclair College, the Montgomery County Public Health
Department is in the Ribold Building on the corner of Main Street and Fourth
Street...just a couple of blocks from campus.

Public health is also a possible future employer. If you are interested in the wide range
of services that public health provides or believe in its mission to “Prevent. Promote.
Protect.” you might want to see what you can do to become involved in the public health
department as a student. It might just lead to a job when you graduate.

Did you know we offer an Associate’s Degree in Public Health? Yes...it is TRUE!

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Importance to Professional

There are many ways in which the public health department is important to you as a
professional. It is a source of information and a resource for both you and your patients.
Public health can often be one of the agencies “at the table” when working on a problem
in the community. Again look at the opioid crisis. Public health was there along with
many other local agencies on trying to work through this crisis.

But understand that your local public health department is just one part of a much larger
view that can go to the state level, the national level and the global level. Our terms will
also identify those different agencies.

Terms

● Public Health – The art and science of preventing disease, prolonging life and
promoting a healthy environment through an organized community effort.
Science is the knowledge-base we have for prevention, and art is the application
of that knowledge. The four functions of public health are assessment, policy
development, assurance, systems management.
● Types of health
○ Population health - Working to improve the health of an entire population
part of which is done by focusing on the elimination of health inequities
among population groups.
○ Occupational health - Protecting and promoting the health and safety of
people in their place of employment. This can include minimizing
exposure to hazardous substances, looking at work practices and
environments to reduce injury, and identifying other health threats so as to
reduce or eliminate them.
○ Environmental health - Minimizing the public's exposure to
environmental hazards through an organized community effort. Hazards
can include a disease or injury agent, the agent's transmission through the
environment, or the exposure to contaminated and hazardous
environments.
○ Global health - Identification, prevention and protection of health going
beyond national borders and looking at the issues in their worldwide
context. Issues identified often have a global, political and/or economic
impact.

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 ● Public Health Agencies
○ U.S. Department of Health and Human Services - The top public health
agency in the US; responsible for overseeing all the other health-related
agencies and setting the healthcare agenda for the nation.
○ Surgeon General - Protects and advances the health of the nation;
thought of as the “nation’s doctor”.
○ Center for Disease Control (CDC) - The FBI of healthcare. It is
responsible for protecting the American public's health through monitoring
disease trends, investigating outbreaks of diseases, determining health
and injury risks, and implementing illness and injury control and prevention
measures.
○ National Institutes of Health (NIH) - The research arm of the Department
of Health and Human Services. There is a national institute of health for
almost any problem.
○ Food and Drug Administration (FDA) - The agency that assures the
safety of foods and cosmetics and the safety and efficacy of
pharmaceuticals, biological products and medical devices.
● Regulatory Agencies
○ The Joint Commission - Evaluates and accredits nearly 15,000
healthcare organizations and programs in the US and serves as the
nation's predominant standards-setting and accrediting body in healthcare.
○ The Ohio Department of Health (ODH) - Serves as the accrediting body
for extended care facilities, such as nursing homes and assisted living
facilities. Licenses and certifies nursing home facilities for participation in
Medicare and Medicaid programs. Ensures the quality of care and quality
of life for residents of the nursing facilities by conducting on-site
inspections for compliance with state and federal rules and regulations.
○ The Commission on Accreditation of Rehabilitation Facilities (CARF)
- A private, not-for-profit organization that promotes quality rehabilitation
services. Establishes standards of quality for organizations to use as
guidelines in developing and offering their programs or services to
consumers.

● General Terms
○ Epidemiology - Study of the distribution and
patterns of health-related issues or events in
specified populations and areas. Uses
information found to possibly control diseases
and other factors relating to health.

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 ○ Epidemic - Increased prevalence of a disease within a specific
geographic area.
○ Pandemic - A disease that is prevalent over a whole country or around
the world.
○ Prevalence – Number of existing cases with a particular condition in a
specified area at a specified time.
○ Incidence - The number of new cases of a problem or condition that are
identified or occur in a specific area during a specific time. Think of the
tracking that was happening across the nation in relationship to the flu
outbreak winter of 2018. They were looking for the number of new cases,
where those cases were occurring and when they were occurring.
○ Life expectancy - Average expected length of life for a specific group of
people.
○ Mortality – A measure of deaths in a given population; can include
location or other groupings of interest.
○ Morbidity - A measure of disease incidence or prevalence in a given
population; can include location or other groupings of interest.
○ Indicator - A measure used to identify a specific health improvement
component strategy.
○ Unintended consequences – Actions by people and/or the government
that can have effects which are unanticipated or unintended. These can
be either positive or negative.
○ Children's Health Insurance Program (CHIP/SCHIP) - Program funded
by both states and the federal government to provide medical insurance
coverage for low income children not covered by state Medicaid-funded
programs.
○ Burden of disease - The measure of the gap between the current state of
a population’s health and the optimal state where all people can attain a
full life expectancy without suffering major ill-health.
○ Safety net - Providers delivering significant amounts of healthcare and
other related services to the uninsured, Medicaid and other vulnerable
populations through legal mandate or explicitly adopting an “open door”
mission.

Please go to the Learning Activities page for the Wellness, Illness and Public Health
lesson to access the Practice Games to help you prepare for your quiz on these terms.

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Photo References:
First Photo:
Author creation not for reuse

Second Photo:
Public Domain

Third Photo:
No restrictions under CC, located at pixabay

Fourth Photo:
No restrictions under CC, located at pixabay

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