MPH 602Public Health System

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Describe what Public Health is and what it does

Review the MPH Competencies assignment and Survey Monkey

Review of ANGEL website and how to access important resources for this course

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This Week’s Objectives

What is Public Health?

In your own words

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Science and art of preventing disease, prolonging life and promoting health and efficiency through organized community effort (Winslow, 1920)

Successive re-definings of the unacceptable (Vickers, 1958)

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Definitions of Public Health

Fulfilling society’s interest in assuring conditions in which people can be healthy (Institute of Medicine, 1988)

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Mission of Public Health

Early influences on public health in America• Imperialism and industrialization• British influence: Jenner, Snow, Chadwick

Early public health infrastructure• Shattuck’s report

Federal public health• US Constitution• Marine Hospital Service

Brief History

Eras in US Public Health

Prior to 1850 Battling Epidemics1850-1949 Building State and Local Public

Health Infrastructure1950-1999 Filling Gaps in Medical Care Delivery

After 1999 Preparing for and Responding to Community Health Threats

• Ecological perspective of healthoDeterminants of health: biological, behavioral,

social, cultural, environmental and their inter-relationships

• Public Health in America documentoCore functions and essential public health

services• Systems perspective of public healtho Logic modelso Feedback loopso Stocks and flows

Key Public Health Frameworks

A system is an organized collection of parts (or subsystems) that are highly integrated to accomplish an overall goal.

The system has various inputs, which go through certain processes to produce certain outputs, which together, accomplish the overall desired goal for the system.

A system is usually made up of many smaller systems, or subsystems http://managementhelp.org/systems/

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Public Health is a system

Inputs Processes Outputs Outcomes

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How does the Public Health System accomplish its mission?

Processes

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Systems Thinking:Logic Model

Inputs Outputs Outcomes

Context

Human resources Financial resources Information resources Technological resources Organizational resources Infrastructure

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Inputs

3 Core Functions 10 Essential Services Individual Competencies

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Processes (Actions)

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Outputs are goods and services produced by the Public Health System

Policies and laws Health education events, presentations, and

communications Prevention programs Data analysis and epidemiological reports Emergency notifications and alerts Community partnerships

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Outputs (examples)

Healthy people in healthy communities Reduced risk factors Increased protective factors Less morbidity Less mortality Less disability Fewer injuries More quality of life years

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Outcomes

Mortality and morbidity preventedEconomic benefitsQuality of life20th Century Achievements

Value of Public Health

Life Expectancy at Birth and Infant Mortality Rates, Selected Years, U.S.

Text Figure 1-1. Source: Data from Centers for Disease Control and Prevention, National Center for Health Statistics. Health, United States 2009. Hyattsville, MD: NCHS; 2009 and Rust G, Satcher D, Fryer GE, Levine RS, Blumenthal DS. Triangulating on success: innovation, public health, medical care, and cause-specific U.S. mortality over a half century (1950-2000). Am J Public Health. 2010;100:S95-S104.

Spotlight on Infectious Diseases

*Per 100. 000 population per year. † Adapted from Armstrong GL, Conn LA, Pinner RW. Trends in infectious disease mortality in the United States during the 20th century. JAMA 1999:281;61-6§ American Water Works Association. Water chlorination principles and practices: AWWA manual M20. Denver, Colorado: American Water Works Association, 1973.

ImmunizationsMotor Vehicle

SafetyWorkplace SafetyControl of

Infectious Diseases

Declines in Heart Disease and Stroke

Safer and Healthier Foods

Healthier Mothers and Babies

Family PlanningFluoridation of

Drinking WaterTobacco as a

Health Hazard

Ten Great Public HealthAchievements of the 20th Century

Political Economic Social Geographical Environmental Psychological Global

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Context

1. Humans have a right to the resources necessary for health.

2. Humans are inherently social and interdependent.

3. The effectiveness of institutions depends heavily on the public’s trust.

4. Collaboration is a key element to public health.5. People and their physical environment are

interdependent. 6. Each person in a community should have an

opportunity to contribute to public discourse.

Public Health Code of Ethics

7. Identifying and promoting the fundamental requirements for health in a community are of primary concern to public health.

8. Knowledge is important and powerful. 9. Science is the basis for much of our public

health knowledge. 10.People are responsible to act on the basis of

what they know.11.Action is not based on information alone.

Public Health Code of Ethics (cont’d)

Individual competencies (knowledge, skills, and attitude) are required to perform Essential Public Health Services

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Processes

Master of Public HealthBenedictine University

Vision:the first choice for those interested in practicing real world – real time public health.

Mission:prepare graduate students to enhance health in human populations through

organized community effort.

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• What every Master of Public Health should know and be able to do

• Association of Schools of Public Health “MPH Competencies”

• Courses, Learning Objectives, and Activities Develop the Competencies– Core courses (12)– Elective courses (3)– Internship and Capstone

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Competencies

1. Apply statistical reasoning and methods in addressing, analyzing and solving problems in public health; health care; and biomedical, clinical and population-based research.

2. Specify approaches for assessing, preventing and controlling environmental hazards that pose risks to human health and safety.

3. Apply the study of patterns of disease and injury in human populations to the control of health problems.4. Apply the principles of program planning, development, budgeting, management and evaluation in

organizational and community initiatives.5. Apply principles of strategic planning and marketing to public health.6. Apply quality and performance improvement concepts to address organizational performance issues. 7. Apply evidence-based approaches in the development and evaluation of social and behavioral science

interventions.8. Use informatics and communication methods to advocate for public health programs and policies.9. Develop public health programs and strategies responsive to the diverse cultural values and traditions of the

communities being served.10. Create and communicate a shared vision for a changing future; champion solutions to organizational and

community challenges and energize commitment to goals.11. Plan for the design, development, implementation and evaluation of strategies to improve individual and

community health. 12. Incorporate the biological and molecular context of public health into practice.13. Recognize system level properties that result from dynamic interactions among human and social systems

and how they affect relationships among individuals, groups, organizations, communities and environments.14. Apply the core functions of assessment, policy development and assurance in the analysis of public health

problems and their solutions. 15. Demonstrate ethical choices, values and professional practices implicit in public health decisions

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Program-level Competencies

BiostatisticsEpidemiologyMethods of Research

Competencies

Apply statistical methods in solving health.

Identify patterns of disease to control health problems.

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Courses:Health PolicyEthical and Political Issues

Competencies

Demonstrate ethical practices in public health decisions

Use informatics to advocate for public health policies.

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Course:Cultural Context of Health

Develop public health programs responsive to diverse cultural values.

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Course:Environmental Health

Competencies

Control environmental risks to human health and safety.

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Course:Management of Health Services Organizations

Competencies

• Apply planning, budgeting, management and evaluation skills.

• Apply strategic planning and marketing to public health.

• Apply quality improvement concepts.

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Course:Behavioral and Social Aspects of Public Health

Competencies

• Develop social and behavioral science interventions.

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Community Health Analysis

• Create and communicate a shared vision for a changing future.

• Implement strategies to improve individual and community health.

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Course:Public Health Biology

Incorporate the biological and molecular context of public health into practice.

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Course:Public Health System

Competencies

Community-Based

Organizations

PrivateNonprofit

Associations

OtherPublicSector

Personal

HealthService

sIndustr

yPrivateIndustr

y

Educational

Institutions

OfficialPublicHealth

Agencies

• Identify system level properties that affect social systems.

• Apply the core functions of assessment, policy development and assurance.

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Self-assessment (Excel) Analysis of where you are now

◦ Strengths◦ Weaknesses◦ Interests◦ Goals

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MPH Competencies

• http://nnlm.gov/training/publichealth/ (The field of public health encompasses a wide array of disciplines including health education, epidemiology and nursing. Digital literacy and the effective utilization of online information are among the core public health informatics competencies for the 21st century. This hands-on class will highlight web resources tailored to the public health) • John Snow Web Site. UCLA Department of Epidemiology • Public Health Code of Ethics http://www.phls.org/home/section/3-26/ Public

Health Leadership Society• Scott J. Leischow and Bobby Milstein. Systems Thinking and Modeling for

Public Health Practice. American Journal of Public Health: March 2006, Vol. 96, No. 3, pp. 403-405.

• Applications of Systems Thinking in Public Health: Creating A Roadmap for Putting Systems Thinking Approaches Into Practice http://www.eval.org/SummerInstitute07/Handouts/si07.docF.pdf

Additional Resources

Surveymonkey

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https://www.surveymonkey.com/s/GQ7G23Y

Healthiest Nation in One Generation - YouTube

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Vision of Public Health