Session 1, Part 1 Epidemiology: A Basic Public Health Science E is for Epi Series Overview • Designed for non-epidemiologists • Provides introduction to: – History of epidemiology – Epidemiology specialties – Key terminology, measures, and resources • Describes examples of epidemiology in public health practice Learning Objectives Session 1, Part 1 • Define the 10 Essential Public Health Services • Explain the science of epidemiology in the broader context of the ten Essential Public Health Services Overview Session 1, Part 1 • “Quiz” • The 10 Public Health Essential Services Quiz Scenario As you read the front page of the local paper, you notice an alarming article about an outbreak of “disease X” in your community. You read on to learn about the scientifically established cause of “disease X,” and precautionary measures for avoiding exposure. Question 1 This valuable information was published as a frontpage story because: a. The local football team lost its game last night b. The front-page columnist is on vacation c. State and local health officials and their staff have worked for weeks to gather data, conduct laboratory and statistical tests, generate hypotheses, and collaborate with the media to alert and educate the public about “disease X” as effectively as possible Question 1 This valuable information was published as a frontpage story because: a. The local football team lost its game last night b. The front-page columnist is on vacation c. State and local health officials and their staff have worked for weeks to gather data, conduct laboratory and statistical tests, generate hypotheses, and collaborate with the media to alert and educate the public about “disease X” as effectively as possible Scenario 2 On your way into the local grocery store, you notice a flyer advertising a toll-free hotline number for enrolling uninsured children in a federally funded health insurance program. Question 2 This insurance program is being offered because: a. The federal government has a budget surplus and is looking for a way to spend it b. A telephone company offered the state health department a great deal on 1-800 numbers c. Public health professionals have documented the numbers of uninsured children in their states, and worked with federal and state policy makers to institute outreach and “wrap around services” that assure the universal provision of health care Question 2 This insurance program is being offered because: a. The federal government has a budget surplus and is looking for a way to spend it b. A telephone company offered the state health department a great deal on 1-800 numbers c. Public health professionals have documented the numbers of uninsured children in their states, and worked with federal and state policy makers to institute outreach and “wrap around services” that assure the universal provision of health care Scenario 3 You and your sweetheart share a romantic dinner at your favorite restaurant. Not only is the meal delicious – you do not get food poisoning! Question 3 This enjoyable experience has been brought to you by: a. The restaurant management b. Your local health department c. A joint effort of the restaurant management and your local health department Quiz #3: Question This enjoyable experience has been brought to you by: a. The restaurant management b. Your local health department c. A joint effort of the restaurant management and your local health department 10 Essential Public Health Services Comparison of Services Public Health Model Primary focus on population Medical Model Primary focus on the individual Public service ethic, tempered by Personal service ethic, concerns for the individual conditioned by awareness of social responsibilities Emphasis on community prevention and health promotion Emphasis on patient diagnosis, treatment, and care Interventions for the environment, human behavior and lifestyles, and medical care Interventions are medical care Public Health Mission: “To promote physical and mental health, and prevent disease, injury, and disability” Origin and Purpose Consensus statement defines a detailed model of core public health functions “Core Functions” of Public Health • Assessment • Policy development • Assurance 1988 1989 1990 1991 1992 1993 1994 Federal health care system reform Core Public Health Functions and Essential Services CDC, 2010 #1: Monitor health status to identify and solve community health problems • Identification of health risks and determination of health service needs • Utilization of technology to interpret and communicate health information to diverse audiences • Attention to the vital statistics and health status of specific groups that are at higher risk • Collaboration in integrating and managing public health information systems #2: Diagnose and investigate health problems and health hazards in the community • Epidemiological identification of outbreaks, patterns of infectious and chronic diseases and injuries • Public health laboratory capability using modern technology to conduct rapid screening and high volume testing • Infectious disease epidemiology programs • Technical capacity for investigation of disease outbreaks and assessing patterns of chronic disease and injury #3: Inform, educate, and empower people about health issues • Health information, health education, and health promotion activities • Health communication plans and activities such as media advocacy and social marketing • Accessible health information and educational resources • Health education and promotion program partnerships #4: Mobilize community partnerships and action to identify and solve health problems • Partnerships among community groups and associations to undertake preventive, screening, rehabilitation, and support programs • Coalitions to draw upon the full range of potential human and material resources in the cause of community health #5: Develop policies and plans that support individual and community health efforts • Systematic community-level and state-level planning • Development and tracking of measurable health objectives • Establishing strategies and actions to guide community health improvement • Development of legislation, codes, regulations, ordinances, and other policies to enable performance of the Essential Public Health Services #6: Enforce laws and regulations that protect health and ensure safety • Enforcement activities in areas of public health concern – Protection of drinking water and enforcement of clean air standards – Re-inspection of workplaces following safety violations – Enforcement of laws governing the sale of alcohol and tobacco to minors – Seat belt and child safety seat usage – Childhood immunizations #7: Link people to needed personal health services and assure the provision of health care when otherwise unavailable • Identifying populations with barriers to personal health services • Identifying personal health service needs of populations with limited access • Assuring the linkage of people to appropriate personal health services through – Coordination of provider services – Development of interventions that address barriers to care (e.g. language) #8: Assure a competent public and personal health care workforce • Education and training • Credentialing technical and professional health personnel • Adoption of continuous quality improvement and life-long learning programs • Partnerships with professional workplace development programs • Continuing education in management, cultural competence, and leadership development programs #9: Evaluate effectiveness, accessibility, and quality of personal and population-based health services • Evaluation and critical review of health programs – based on analyses of health status and service utilization data – to determine program effectiveness – to provide information for allocating resources and reshaping programs #10: Research for new insights and innovative solutions to health problems • Link with institutions of higher learning and research • Mount timely epidemiological and economic analyses • Conduct needed health services research – Survey design; conducting interviews and facilitating focus groups – Conducting clinical trials – Accessing and using public records Corresponding Services Quiz Scenario Essential Service Informing the public of an outbreak investigation in the community #2: Diagnose and investigate health problems and hazards in the community Promoting enrollment in a federally subsidized health insurance program #7: Link people to needed personal health services and assure the provision of health care when otherwise unavailable Maintenance of a sanitary #6: Enforce laws and restaurant environmental for regulations that protect public well-being health and ensure safety Summary • Core Functions of public health are assessment, policy development, and assurance • The 10 Essential Public Health Services create a “common ground” and a comprehensive infrastructure that provides a supportive context for any public health priority in a community • Epidemiology is a quantitative tool that can be used to implement Essential Public Health services References and Resources • • • • Gordis L. Epidemiology. 2nd ed. Philadelphia, Pa: WB Saunders Company; 2000. Hearne SA, Segal LM, Earls MJ, Unruh PJ. Ready or Not? Protecting the Public’s Health in the Age of Bioterrorism. Washington, DC: Trust for America’s Health; December 2004. Issue Report. Available at: http://healthyamericans.org/reports/bioterror04/BioTerror04Report.pdf. Accessed March 1, 2012. Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention 10 Essential Public Health Services [National Public Health Performance Standards Program Web site]. December 9, 2010. Available at: http://www.cdc.gov/nphpsp/essentialservices.html. Accessed March 1, 2012. Kipp A. Overview of Epidemiology in Public Health [online training]. North Carolina Center for Public Health Preparedness, University of North Carolina at Chapel Hill School of Public Health; 2004. NCCPHP Training Web Site.