who can complete this assignment by tomorrow, Thursday, October 22, 2020 by 6pm?
Review the powerpoints and then answer this discussion.
Pick a health issue and discuss how you would create a primary, secondary, and tertiary prevention program to address that health issue. (Include one example for each level of prevention.) Make sure to research your response rather than simply stating your opinion. Please include at least three in-text citations and the full references at the bottom of your post.
Your initial post should be a minimum of 500 words.
Chapter 1
Community and Public Health: Yesterday, Today, and Tomorrow
Chapter Objectives
After studying this chapter, you will be able to:
Define the terms health, community, community health, population health, public health, public health system, and global health.
Briefly describe the five major determinants of health.
Explain the difference between personal and community health activities.
List and discuss the factors that influence a community’ s health.
Briefly relate the history of community and public health, including the recent U.S. history of community and public health in the twentieth and early twenty-first centuries.
Provide a brief overview of the current health status of Americans.
Describe the purpose of the Healthy People 2020 goals and objectives as they apply to the planning process of the health of Americans.
Describe the major community and public health problems facing the United States and the world today.
Introduction
Much progress made over last 100 years in health and life expectancy
Still room for improvement
Achievement of good health is worldwide goal of 21st century
Requires individual actions to improve personal health and organized community actions
20th Century Achievements in Public Health
Vaccination
Motor vehicle safety
Control of infectious diseases
Decline of deaths from CHD and stroke
Healthier mothers and babies
Safer and healthier foods
Safer workplaces
Family planning
Fluoridation of drinking water
Recognition of tobacco use as a health hazard
Definition: Health
Can mean different things to different people
A dynamic state or condition of the human organism that is multidimensional in nature, a resource for living, and results from a person’s interactions with and adaptations to his or her environment
Definition: Community
A group of people who have common characteristics
Can be defined by location, race, ethnicity, age, occupation, interest in particular problems or outcomes, or common bonds
Characterized by
Membership, common symbol systems, shared values and norms, mutual influence, shared needs and commitment to meeting them, shared emotional connection
Other Definitions (1 of 2)
Public health – actions that society takes collectively to ensure that the conditions in which people can be healthy can occur; most inclusive term
Community health – health status of a defined group of people and the actions and conditions to promote, protect, and preserve their health
Population health – health outcomes of a group of individuals, including the distribution of such outcomes within the group
Other Definitions (2 of 2)
Global health – health problems, issues, and concerns that transcend national boundaries
May be influenced by circumstances or experiences in other countries
Best addressed by cooperative actions and solutions
Personal Health Activities Versus Community/Public Health Activities
Personal health activities
Individual actions and decision making that affect the health of an individual or his or her immediate family members or friends
Community/public health activities
Activities aimed at protecting or improving the health of a population or community
Maintaining birth and death records, protecting food and water supply, etc.
Factors that Affect the Health of a Community
Physical
Social and Cultural
Interconnections of the determinants of health.
Physical Factors
Geography
Environment
Community size
Industrial development
Social and Cultural Factors
Beliefs, traditions, and prejudices
Economy
Politics
Religion
Social norms
Socioeconomic status
Community Organizing
A process through which communities are helped to identify common problems or goals, mobilize resources, and in other ways develop and implement strategies for reaching the goals they have collectively set
Is not a science, but an art of consensus building within a democratic process
Individual Behavior
Takes the concerted effort of many individuals to make a program work
Herd immunity
The resistance of a population to the spread of an infectious agent based on the immunity of a high proportion of individuals
A History of Community and Public Health
Almost as long as the history of civilization
Knowledge of the past helps us better prepare for future community health challenges
Earliest Civilizations
Many community health practices went unrecorded
Practices may have involved taboos, rites, and spiritual beliefs
Archeological evidence of community health activities dating back to 2000 B.C.E.
The Eighteenth Century
Characterized by industrial growth
Cities overcrowded, water supplies inadequate and unsanitary, problems with trash, workplaces unsafe
1796: Dr. Jenner demonstrated process of vaccination against smallpox
First census taken: 1790
The Second Half of the Nineteenth Century
Epidemic problems in major cities
London cholera epidemics and Dr. John Snow
Many scientific discoveries
1850: Shattuck report
1850: Modern era of public health begins
The Twentieth Century
1900: life expectancy less than 50 years
Leading causes of death were communicable diseases
Vitamin deficiencies and poor dental health common in slums
Health Resources Development Period
(1900-1960)
Growth of healthcare facilities and providers
Reform phase (1900-1920)
1920s
Great Depression and WWII
Postwar years
Period of Social Engineering (1960-1973)
Federal government became active in health matters
1965: Medicare and Medicaid established
Improved standards in health facilities
Influx of federal dollars accelerated rate of increase in cost of health care
Period of Health Promotion
(1974-present)
Identification that premature death traceable to lifestyle and health behaviors
Healthy People publication established
Healthy People 2020
MAP-IT
National Prevention Strategy
The Twenty-First Century
U.S. Community/Public Health in Early 2000s
Health care delivery
Environmental problems
Lifestyle diseases
Communicable diseases
Alcohol and other drug abuse
Health disparities
Disasters
Public health preparedness
World Community and Public Health in the Twenty-First Century
Communicable diseases
Poor sanitation and unsafe drinking water
Hunger
Migration and health
Twenty-First Century Global Health Achievements
Reductions in child mortality
Vaccine-preventable deaths
Access to safe water and sanitation
Malaria prevention and control
Prevention and control of HIV/AIDS
Tuberculosis control
Control of neglected tropical diseases
Tobacco control
Global road safety
Improved preparedness and response
Discussion Questions
How do you define health?
How can understanding the history of community health efforts better help today’s planning?
How can Healthy People documents affect health outcomes?
What role does the United States play in world health planning?
Chapter 2
Organizations that Help Shape Community and Public Health
Chapter Objectives (1 of 2)
After studying this chapter, you will be able to:
Explain the need for organizing to improve community and public health.
Explain what a governmental health organization is and give an example of one at each of the following levels—international, national, state, and local.
Explain the role the World Health Organization (WHO) plays in community and public health.
Briefly describe the structure and function of the United States Department of Health and Human Services (HHS).
State the three core functions of public health.
List the 10 essential public health services.
Explain the relationship between a state and local health department.
Chapter Objectives (2 of 2)
Explain what is meant by the term Whole School, Whole Community, Whole Child (WSCC).
Define the term quasi-governmental and explain why some health organizations are classified under this term.
List the four primary activities of most voluntary health organizations.
Explain the purpose of a professional health organization/association.
Explain how philanthropic foundations contribute to community and public health.
Discuss the role that service, social, and religious organizations play in community and public health.
Identify the major reason why corporations are involved in community and public health, and describe some corporate activities that contribute to community and public health.
Introduction
Only in past ~100 years have communities taken explicit actions to deal aggressively with health issues continuously
Community response to own problems hindered by various issues
Three classifications based on funding sources, responsibilities, and organizational structure
Governmental
Quasi-governmental
Nongovernmental
Governmental Health Agencies
Part of governmental structure
Federal, state, or local
Funded primarily by tax dollars
Managed by government officials
Authority over some geographic area
Exist at four levels
International, national, state, local
International Health Agencies
World Health Organization (WHO) most widely recognized international governmental health organization
Headquartered in Geneva, Switzerland
Six regional offices around the world
Not oldest world health-related international agency, but largest
History of WHO
1945: charter of the United Nations; article calling for establishment of health agency with wide powers
1946: UN representatives created and ratified the constitution of WHO
1948: constitution went into force and WHO began work
Organization of WHO
Membership open to any nation that has ratified constitution and receives majority vote of World Health Assembly
World Health Assembly – delegates of member nations
Approves WHO programs and budget
194 member countries
WHO administered by different levels of staff
Purpose and Work of WHO
Primary objective: attainment of the highest possible level of health by all peoples
Six core functions to achieve objective
Work financed by member nations
Most notable work: helping to eradicate smallpox
Work guided by 12th General Programme of Work and the UN’s Millennium Declaration
2003 Millennium Summit established Millennium Development Goals
Sustainable Development Goals established in 2015 to build on the MDGs
National Health Agencies
Each nation has department or agency within its government responsible for protection of health and welfare of its citizens
U.S. primary national health agency: Department of Health and Human Services (HHS)
Other federal agencies contribute to health – Dept. of Agriculture, EPA, OSHA, DHS
Department of Health and Human Services
Headed by Secretary of Health and Human Services
appointed by president; member of cabinet
~25% of federal budget; largest department in federal government
New healthcare reform law provides series of new duties and responsibilities for HHS
Organized into 11 operating agencies; 10 regional offices
Operating Agencies of the DHHS (1 of 2)
Administration for Community Living (ACL)
Administration for Children and Families (ACF)
Agency for Healthcare Research and Quality (AHRQ)
Agency for Toxic Substances and Disease Registry (ATSDR)
Centers for Disease Control and Prevention (CDC)
Operating Agencies of the DHHS (2 of 2)
Food and Drug Administration (FDA)
Centers for Medicare and Medicaid Services (CMS)
Health Resources and Services Administration (HRSA)
Indian Health Services (IHS)
National Institutes of Health (NIH)
Substance Abuse and Mental Health Services Administration (SAMHSA)
State Health Agencies
All 50 states have their own state health departments
Purpose: to promote, protect, and maintain the health and welfare of their citizens
Usually headed by a medical director who is appointed by the governor
Purposes represented in “Core Functions of Public Health” (assessment, policy development, assurance)
Core Functions of Public Health
and 10 Essential Services
Reproduced from: Centers for Disease Control and Prevention (2014). The Public Health System and the 10 Essential Public Health Services. Available at http://www.cdc.gov/nphpsp/essentialservices.html
State Health Departments
Most organized into divisions or bureaus
Play many different roles
Can establish health regulations
Provide link between federal and local health agencies
Serve as conduits for federal funds aimed at local health departments
Have laboratory services available for local health departments
Local Health Departments
Responsibility of city or county governments
Jurisdiction often depends on size of population
State mandated services provided locally
Restaurants, public buildings, and public transportation inspections; detection and reporting of certain diseases; collection of vital statistics
Approximately 2,800 in the United States
Organization of Local Health Departments
Whole School, Whole Community, Whole Child (WSCC) Model
Schools under category of governmental health agency – funded by tax dollars
Schools have great potential for impacting community health
Ecological approach directed at the whole school
Expands on the 8 elements of the coordinated school health (CSH) approach
Expanded components – social and emotional climate, physical environment, community involvement, and family engagement
Quasi-Governmental Health Organizations
Some official health responsibilities; operate more like voluntary health organizations
Operate independently of government supervision
Derive some funding and work from government
Examples: American Red Cross, National Academy of Sciences, National Science Foundation
The American Red Cross
Official duties
Provide relief to victims of natural disasters
Serve as liaison between members of armed forces and their families during emergencies
Nongovernmental services
Blood drives, safety services, community volunteer services, international services
Part of international movements
Nongovernmental Health Agencies
Funded by private donations or membership dues
Arose due to unmet health need
Operate free from governmental interference
Meet specific IRS guidelines with tax status
Many types
Voluntary, professional, religious, social, philanthropic, corporate, service
Voluntary Health Agencies
Created by one or more concerned citizens that felt a specific health need was not being met by governmental agencies
Most exist at national, state, and local levels
National often focused on research, state links national with local offices, local often carry out programming
Usually combination of paid staff and volunteers
Purpose of Voluntary Health Agencies
Four basic objectives
Raise money to fund programs and/or research
Provide education to professionals and the public
Provide services to those afflicted
Advocacy
Fundraising is a primary activity
Examples, ACS, AHA, March of Dimes, MDA
Professional Health Organizations
Made up of health professionals who have completed specialized training and have met standards of registration/certification or licensure for their fields
Mission: to promote high standards of professional practice
Funded primarily by membership dues
Examples: American Medical Association, American Public Health Association
Philanthropic Foundations
Endowed institutions that donate money for the good of humankind
Fund programs and research on prevention, control, and treatment of many diseases
Some have broad support, others very specific
Examples: Bill and Melinda Gates Foundation, Commonwealth Fund, Robert Wood Johnson Foundation, local Community Foundations
Service, Social, and Religious Organizations
Many do not have health as primary mission, but make significant health-related contributions
Examples: Kiwanis, Elks, Shriners, Lions, FOP
Contributions of religious groups to community health are substantial
History of volunteerism, influence on families, donation of space, sponsorship of programs (food banks, shelters)
Corporate Involvement in Community Health
Biggest role is provision of healthcare benefits
Worksite health promotion programs aimed at lowering healthcare costs and reducing absenteeism
Safety, counseling, education courses, physical fitness centers
Discussion Questions
How have voluntary health organizations impacted health outcomes?
How does the Department of Health and Human Services impact individuals?
How can the World Health Organization overcome the obstacles they face?