HLTH130

State of compelete physical,mental or social well being and not merely the absence of disease

Resource for everyday life and not the objective living

He defines it as an ability to be able to perform certain valued social roles

It is that disease is a relatively onjective pathologic phenomenon where as health and illness are subjective

• Disability
• Symptoms
• Signs
• Awareness
• Education
• Growth
• This shows that illness and wellness are in a continioum and are evolving concepts

• Sins and the wrath of gods ( disease due todecline in mortality and religion)
• Origins of environmental theory ( variety of environmental influances on human disease)
• Humoral theory ( disease due to imbalance in 4 circulating fluids)
• Mysticism and church ( demonology was cause of diease, touturing body, later prayers)
• Scientific revolution (the body was seen as machine)
• Germ theory ( pasture, father of microbiology behaviors influancing transmission of the disease) the epidimiological triangle ( host, agent , environment)
• multicasul theory ( more than one factor must be present for development of the disease, web of causation)

• Violence
• Alcoholism
• ADHD
• Premenstrual syndrome
• Shortness

Fullfillment of society's interest in assuring the conditions in which people can be healthy

Public health mission is not done and compelete till the goal has been achieved. Also there is a mean to measure and evaluate succecss at achiving the agenda ( healthy people 2010)

• National prevention initiative
• Id opportunities to improve American's health
• Scoreboard for monitoring health status
• Contribution to health for all strategy

• Increase quality and Years of healthy life
• Quality of life( Overall well being, individual- Pleasant and supportive environment-community)
• Eliminate health disparities ( Infant mortality, cancer screening, cardiovascular,diabetes, HIV,immunization)

• Epidemiology (Study of distribution and determinant of the disease)
• Biostatistics( making inferences from small to large group)
• Health policy and administration ( focus on organization, access, quality, types of services)
• Environmental health services( focus on environment)
• Social and behavioral sciences (focus on factors that shape and reinforce individual and behavior)

• Conditions of where we live
• ( Natural vs. Built environement)
• Conditions affecting our behavior

• Develope health promoting behavior
• Abandoning behavior that pose threat
• Maintain behavior change

Health is a multidimensional subject

• Organized community effort is to prevent disease and promote health
• Cadre of public health professionals moblized to engage in prevention activities

That the success is measured by absence of symptoms

• Individual
• Family
• Living and working conditions
• Social economical and cultural

• Population based
• Evidence based
• Prevention
• Social Justice

• Total Population
• -total key indicator
• Sub-population
• -person level factor( sociodemographic)
• -defined by place

• Rigor ( objective, dispassionate,observer)
• Vigor( Passionate,advocate,subjective)

• Primary, secondary, tertiary prevention
• Most of the focus is on primary prevention

• founding principle
• assures conditions that eliminate disparities

Being unjust and unfair. Paying woman less then men

• it is bedrock of public health
• argues that public health is a public matter
• dictates fairness in distribution of benefits and burdens
• health itself
• factors within the society impede the fair distribution of public health benefits and burdens
• resolution of inequity needs more action

• health is more than healthcare
• health is tied to the distribution of resources
• racisim imposes health burden
• choices we make is shaped by what we have
• high demand, low control= stress
• chronic stress can be deadly
• inequality is bad for us
• social policy is health policy
• health inequalities are not natural
• we all pay the price for poor health

When people are able to achive their full state of health and no one is disadvantaged

• Heart Disease
• Cancer
• Stroke

• Immunization
• Motor vehicke safety
• Control of infectious disease
• Decline in death from stroke and heart disease
• Healthier food
• Healthier mothers and babies
• Family planning
• Floridation of drinking water
• Tabbaco as health hazard

• Resurgence of infectious disease ( globalization, drug resistant microbes, bioterrorism)
• Pass success give raise to new threats ( industrialization, deforestation, global warming)
• Challange of understanding and altering behavior
• Continued emphasis on creative medicine

Class

• We are uncomfortable with the concept of class
• Class is difficult to define
• SES or class exhibits a strong inverse , stepsise relationship with health

• Brings prestige and income
• Offers access to healthcare

• Low income is the most important predictor of mortality
• Inequitable distribution of income and wealth potent factor

• It opens doors of opportunity
• Key to economic and social advancement
• Instills values and understanding of health advancement

• This is the most important mechanism
• Lack of control
• Social isolation
• Chronic physiologic arousal

• Describe mechanism
• Tie mechanism to health outcome
• Remove/Eliminate inequalities

• epi: upon
• demos: people
• ology: study of

• distribution of health determinants
• determinants of disease
• application of control of health problem
• Study of distribution and determinants of disease and injury in humans and application of study to control health problems

• census
• statistics
• disease reporting
• disease registries
• medical care settings
• population survays

• Morbidity is a disease
• Incidence (number of new cases/ population at risk) over time
• Prevalance ( number of existing/ average total population) at one point

• Mortality is death
• CDR ( # of death per year/ average total population that year)
• PMR ( # of death from specific disease/ total number of death in population over time)

• Descriptive
• Analytic

Examines distribution of disease in population and observe basic features of distribution ( person, place and time) case reports

Tests specific hypothesis anout relationship of disease to hypothesised cause (how , why) observational study, case control and before after studies

• Determine the impact of disease in people
• Detect changes in occurance of disease in population
• Measure exposure between exposure and disease
• Evaluate the efficiacy of the intervention/treatment

• can't tell an individual the cause
• can't prove particular exposure casued illness based on single study
• provide credible science w/o good measurement of exposure

• Define the problem
• Id risk factors
• Develop and test interventions
• Implement intervention
• Monitor and evaluate

• predisposing
• reinforcing
• enabling constructs in educational
• environmental diagnosis and evaluation

• policy
• regulatory
• organizational constructs in educational
• environmental development

• Social assessment
• epidemiological
• behavioral
• educational
• administrative

• capacity of GVPT agencies to perform essential health functions was lacking
• emphasized on assuring the conditions so people can be healthy

• Assessment ( collection /analyse/communicate)
• Policy development ( setting priorities & developing strategy in collaboration with leaders and community)
• Assurance ( assuring services are available)

• Moblize and engage in the community
• Action with and by the community
• Plan driven by the community
• Partnership strengthen

• Monitor health status to ID community health problems
• Diagnose and investigate health problems
• Evaluate effectiveness, accessibility and quality
• Mobilize community partnership
• Develope policy and plans
• Inform, educate,empower
• Link people to needed health services
• assure a competant public health work place
• Enforce laws/ regulations that protect safety
• Research for new insights

• Advocate role
• vigor, passion (subjectivity) address social determinant, eliminate disparities
• Practitioner rule
• rigor,dispassionate(objectivity), scientific method,high risk focus

Getting the right answer to the wrong question

Rigor of research design, method Vs. Inherent ( easily seen) bias in research question , theoretical frameworks and methods

• If health care and public health were not embeded in the society and if health care and public health professionals were not trained and did not work within these institutions
• BUT
• since this is not the case, science is free of bias and not so much objective

• It is our cultural preference ( ethic of individuality)
• Maverick (someone who thinks dependently and does not conform to norm)
• Picking up by your bootstraps ( start from nothing)
• Personal habits are disease culprits ( behavioral pathogens)
• individuals can play role in modifying risk

• tabacco
• diet
• alcohol
• firearms
• sexual behavior
• motor vehicle injuries
• illicit use of drugs

• Danger of overemphasizing individual responsibility
• - bootstraps
• -a tale of 3 tails ( focus on high risk groups, tail end of causality, tail chasing its tail/ risk factor tail)
• Poverty causes diminished opportunity for control
• Takes the GVPT of the hook

Educating : informing individuals about risks

• Information is understandable
• Health and well being are shared priorities
• Information alone ( healthy behavior)
• ** provision of info will empower individuals

Regulation: take decision making out individulas hands

• Consensus exist on the need for extent
• Available scientific info to guide regulation
• Decision making is objective
• ** regulation will guid behavior and discourage reckless behavior

• Direct harm to other person/property
• Harm to the environment
• Harm self

Department of health and human services

• Agency for toxic substances and disease registry
• Center for disease control
• FDA
• Indian health services
• Agency for health care research and quality
• Health resources and service administration
• Office of global health affairs
• NIH
• Substance abuse and Mental health services
• Office of assistant sercretary for preperedness

NIH

• Foster research medical and scientific knwledge and their applications
• Develop, maintain, renew scientific resources
• Reflect and promote the highest level of scientific integrity, public accountibility and social responsibility

• atmosphere stifles debate
• atmosphere that discourage discussion within FDA
• leadership vaccume
• antiregulatory philosophy

• culture that encourages scientific exchange
• culture that respect alternative view point
• culture that value transparency
• better surveillance of approved drugs
• strong and independent leadership

• health is key outcome
• agency must look to prevent problems
• consider both benefit and risk approvals
• collaborate with other public health agancies
• communicate risk clearly
• integrity and transparancy

science in pursuit of fundamental knowledge about nature and behavior of living system

To collaborate to create the expertise information and tools that people and communities need to protect their health through health promotion, prevention of disease, injury and disability and preparedness of new health threats

Maryland department of health and mental hygiene

American public health association

• strengthen the nation's health system
• increase funding for vital public health agencies
• adress public health implications
• give FDA authority to regulate Tabacco products
• adress public health impacts of climate change

Facts and values can not be separated in scientific research.

• Removing hazard ingrediants
• Focusing on limiting the impact of advertising on youth
• Expanding warning lables
• Stopping use of characterization