HSCI 130 Lecture Notes - Lecture 4: Geoffrey Vickers, Public Health, Biostatistics
19 Feb 2017
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HSCI 130 Lecture 4 Notes
Public Health: The Role of Prevention
Public Health
● “Science and art of preventing disease, prolonging life….”
● “Fulfilling society's interest in assuring conditions in which people can be healthy”
○ Institute of Medicine,1988
○ Premise: society has an interest in the health of its members!
● “I believe the history of public health might well be written as a record of successive re-defining of the
unacceptable”
○ Geoffrey Vickers
● Above all else, it is a collective effort to identify and address the unacceptable realities that result in
preventable health outcomes
4 elements in most definitions of public health
1. Decision making based on data and evidence (vital stats, surveillance, outbreak investigations)
2. Focus on populations vs. individuals
3. Goal of social justice + equity
4. Emphasis on prevention vs. cure
Upstream/Downstream
● Upstream: policies, prevention
● Downstream: cure, personalized
Public Health vs. Clinical Medicine
1. Populations vs. Individuals
2. Health vs. Disease
3. Emphasis on prevention vs. Cure
Features of Public Health
● Underlying social justice philosophy
● Political
● Expanding agenda, new problems and issues
● Connected to gov’t
● Grounded in sciences
● Focus on prevention
● Interdisciplinary
Responsibilities of the Public Health System
1. Health Emergencies
2. Chronic Disease and Injury Prevention
3. Health Promotion
Greatest Public Health Achievements (20th Century)
1. Vaccination
2. Motor vehicle safety
3. Safer workplaces
4. Infectious disease
5. Decline in deaths from CHD and stroke
find more resources at oneclass.com
find more resources at oneclass.com
Core Disciplines of Public Health
● Biostatistics
● Epidemiology
● Health policy and management
● Environmental health sciences
● Social and behavioural sciences
Prevention
● Primary Prevention: stop the development of the disease before it occurs
○ I.e. vaccines, hygiene
● Secondary Prevention: early detection of the disease: especially in the absence of symptoms
○ I.e. pap smears, physicals
● Tertiary Prevention: eliminate or reduce disability and other consequences associated with disease
● High Risk Strategies
○ Find the people at the highest risk/most susceptible and attempt to prevent
outcome
● Population Strategies
○ Attempt to control the new cases to lower the mean levels of risk factors and shift
the whole distribution over
Population Health
● Mostly interchangeable
● Refers to the health of a population area as measured by health status
● Goals:
○ Maintain and improve health status of the ENTIRE population
○ Reduce health inequalities between population groups
Epidemiology
● GREEK:
○ Epi = “among” or “upon”
○ Demos = “the people”
○ Logia= “study”
● The study of what is upon the people
● (EQ) “The study of the distribution and determinants of health-related states in specified populations, and
the application of this study to control health problems” (Dictionary of Epidemiology)
● 5 Ws (Descriptive vs. Analytical Epidemiology)
○ WHAT are you capturing, how do u define it
○ WHO has it
○ WHERE is it occurring
○ WHEN is it occurring
○ WHY are people getting sick
● Person/Host Factors
○ Not every person is susceptible
○ Personal factors people are born with
○ Acquired host factors
○ Transitory host factor (i.e. stress)
○ Behaviours (i.e. sex life)
● How are diseases changed across time, cycles, seasonal, time of day
● What’s the agent?
○ nutritive/chemical/physical/infectious
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Science and art of preventing disease, prolonging life . Fulfilling society"s interest in assuring conditions in which people can be healthy . Premise: society has an interest in the health of its members! I believe the history of public health might well be written as a record of successive re-defining of the unacceptable . Above all else, it is a collective effort to identify and address the unacceptable realities that result in preventable health outcomes. 4 elements in most definitions of public health: decision making based on data and evidence (vital stats, surveillance, outbreak investigations, focus on populations vs. individuals, goal of social justice + equity, emphasis on prevention vs. cure. Public health vs. clinical medicine: populations vs. Individuals: health vs. disease, emphasis on prevention vs. Responsibilities of the public health system: health emergencies, chronic disease and injury prevention, health promotion. Greatest public health achievements (20th century: vaccination, motor vehicle safety, safer workplaces.
