Introduction to Health Care and Public Health in the US: Public
Health, Part 2
Audio Transcript
Slide 1
Welcome to Component 1: Introduction to Health Care and Public Health in the
US : Public Health, Part 2. This is Lecture (b).
The component, Introduction to Healthcare in the US , is a survey of how healthcare and public health are organized and services are delivered in the US.
Slide 2
The Objectives of Public Health, Part 2, are to:

give examples of and explain the general program categories of public health, including communicable disease, chronic disease, terrorism response, and environmental public health;

discuss the activities and achievements of public health in the realm of communicable disease;

compare and contrast the different types of terrorism and the different public health response; and

describe chronic disease activities and achievements of public health, and the work of public health in the realm of environmental health hazards.
Slide 3
This lecture will discuss Public Health and terrorism. Concern over terrorism continues in the US public. Public health has responded by forming Emergency
Preparedness and Response programs. There are four main categories of terrorism: bioterrorism, agricultural terrorism, chemical terrorism, and nuclear/radiation terrorism.
Slide 4
Bioterrorism is defined as the intentional use of either microbes or their derivations to produce death or disease. The target of bioterrorism may be humans, animals, or plants. Terrorism may be either overt (announced) or covert
(unannounced). In addition to physical damage, overt attacks are designed to also create psychological damage or panic. Panic also induces flight, which can help to spread an agent. Covert attacks are intended to cause as much damage as possible before an effective response can be mounted.
Health IT Workforce Curriculum
Introduction to Healthcare and Public Health in the US
1
Version 3.0/Spring 2012
Public Health, Part 2
Lecture b
This material was developed by Oregon Health and Science University, funded by the Department of Health and Human Services,
Office of the National Coordinator for Health Information Technology under Award Number IU24OC000015.

Slide 5
In the US, there have been few bioterrorism attacks. The short list might include the military’s apparent distribution of smallpox-contaminated blankets to Native
Americans in the 1700’s. The list definitely includes a 1984 incident in Oregon when a cult intentionally contaminated salad bars, causing 751 cases of food poisoning. In 2001 anthrax-contaminated letters killed five people. And in 2003 and 2004, several letters were found to be contaminated with the plant toxin ricin
(no injuries).
Slide 6
Bioterrorism agents are categorized by CDC according to their ease of transmission and severity. The highest risk is Category A – these agents are easily transmitted and have high mortality. Examples include anthrax and botulism. Category B agents are the next highest risk
– they are moderately easy to spread and cause moderate illness rates. An example is ricin toxin. Category
C agents are the third highest risk – these emerging pathogens are easily available and have the potential for high illness rates. Examples include the
Hantaviruses and multi-drug resistant Tuberculosis.
Slide 7
Public health preparedness and response programs have three main activities – planning, monitoring, and education. The Lab Response Network is also a part of public health response.
Slide 8
The Lab Response Network or LRN is a network of testing laboratories that provide response capacity for biological and chemical terrorism, as well as other public health emergencies. There are more than 150 biological and 62 chemical
LRN labs. Most of the labs are state public health labs, but veterinary, military, and international labs are also important participants.
Slide 9
Agricultural terrorism is thought by many to be an underrated threat. Agriculture is essentially the foundation of all civilizations, and thus makes an attractive target. There have been many unfortunate instances of importation of foreign pests and pathogens, both in the US and other countries. A prime example of this is chestnut blight, a fungus which effectively wiped out the beloved American chestnut tree. However, to date these incidents have been caused by accident, neglect, or ignorance, and not by terrorist efforts. The USDA Animal and Plant
Inspection Service is the main line of defense against agricultural terrorism and hazards in the US.
Health IT Workforce Curriculum
Introduction to Healthcare and Public Health in the US
2
Version 3.0/Spring 2012
Public Health, Part 2
Lecture b
This material was developed by Oregon Health and Science University, funded by the Department of Health and Human Services,
Office of the National Coordinator for Health Information Technology under Award Number IU24OC000015.

Slide 10
Chemical terrorism, or exposure of the population to chemical hazards, is another concern of public health. As with other categories of terrorism, an attack could be either covert or overt. Both a surveillance system (Hazardous
Substances Emergency Events Surveillance) and a registry (Agency for Toxic
Substances and Disease Registry) attempt to mitigate this risk.
Slide 11
CDC categorizes hazardous chemicals by chemical type and exposure effects.
Some examples are biotoxins (poisons from plants or animals), caustics
(chemicals that burn or corrode), metals (metallic poisons), and organic solvents
(damage tissue by dissolving fats or oils).
Slide 12
Nuclear / radiation terrorism threats are divided by their means of dispersal: these vary from “dirty bombs” to the simple tactic of placing a radioactive source in a heavily populated area. The public health response to nuclear threats consists primarily of education and information.
Slide 13
This concludes Lecture (b) of Public Health, Part 2 . In summary, public health response is discussed for the four main categories of terrorism: bioterrorism, agricultural terrorism, chemical terrorism, and nuclear/radiation terrorism.
Categorization of bioterrorism agents and the Laboratory Response Network are discussed.
Slide 14 Reference Slide, Lecture (b)
No audio
Health IT Workforce Curriculum
Introduction to Healthcare and Public Health in the US
3
Version 3.0/Spring 2012
Public Health, Part 2
Lecture b
This material was developed by Oregon Health and Science University, funded by the Department of Health and Human Services,
Office of the National Coordinator for Health Information Technology under Award Number IU24OC000015.