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48 Cards in this Set

  • Front
  • Back
public health scientists
Environmental Health
Biomedical Sciences
Health Service Administration
Social & Behavioral Sciences
– study epidemics; seek causative factors
– generate data and make sense of numbers
Environmental Health
– PH in past; disease prevention via air, water, food
Biomedical Sciences
– understand disease (diabetes, heart disease, etc.)
Health Service Administration
– effectiveness, efficiency, equity
Social & Behavioral Sciences
– most unanswered questions; great potential
“The Future of Public Health” – IOM, 1988
-shift focus from infectious disease to chronic disease (cancer, heart failure)
-refocus attention, redefine, and increase effectiveness of PH
-4 part definition of PH:
4 part definition of PH
1. Mission of PH – create conditions for people to be healthy if they want to
2. Substance of PH – utilize existing community efforts for prevention of disease and promotion of health; make things that already exist to work better
3. Organizational Framework – government, private & voluntary organizations, and individuals
4. Core Functions: assessment of PH, policy development to establish health, assurance with government responsible to act on PH scientists recommendations
“Who Will Keep the Public Healthy?” – IOM, 2002
8 new content areas of PH:
1. informatics – applying technology to PH
2. genomics - genetic factors that influence PH
3. communication – how to get your message to public
4. cultural competence – understanding diversity
5. community-based participatory research – biggest efforts & impact; understanding complexity of intervention research
6. global health – health that transcends borders (food travel)
7. policy & law – take into account all factors (economic, rights)
8. public health ethics – balance health issues that conflict w/ values or morals of society (stem cell research, cloning)
Medical Care vs Public Health Care
Medical Care
Quiet field
Heavily funded (99%)

Public Health
Under funded (1%)
3 Target Levels of Prevention
1. Primary Prevention – prevent illness via preventing exposure to risk factors; not dealing w/ sick
2. Secondary Prevention – minimize severity of illness; catch with early signs
3. Tertiary Prevention – minimize impact of illness via rehab & medical care
“Chain of Causation”
Agent … - … - … Vector … - … - … Host
Market Justice
Emphasize individual responsibility
Minimal obligation to common good
Fundamental freedom to be left alone
Social Justice
fundamental rights
Minimal levels of income
basic housing
some employment
some education
basic health care
3 major PH controversies
Libertarian view
Moral / Religious Opposition
-people that get benefits don’t pay (taxes, Medicaid)
-cost vs. benefits (not actual #)
-preventative costs – you rarely see exactly what you stopped
Individual Liberty
-Tragedy of Commons – restrict “rights” of what you can do to aid the greater good
-Libertarian view – have what to do whatever, whenever w/ no restrictions; causes to lose sight of common good and promotes indifference
Moral / Religious Opposition
-50% of health related to adaptable behaviors – how can you legislate “moral” vs. “immoral”
-values of different among cultures (USA is melting pot)
-ex. HPV vaccination in young girls
Institute of Medicine
non-gov; indep advice on medical & health
Department of Health and Human Services
gov cabinet; protect health & provide services
Surgeon General is leading spokesman
main groups: CDC, NIH, FDA
Centers for Disease Control and Prevention
under HHS
top gov agency for protecting the ph & safety
main assessment & epidemiological agency for nation; traditional focus on infectious disease; now includes chronic, genetic, injury, violence
National Institutes of Health
under DHHS; gov biomedical research; huge lab in Atlanta
biomedical; support from Congress
National Center for Health Statistics
design & maintain systems for PH data
part of CDC
Food and Drug Administration
under DHHS; regulate food, drugs, cosmetics
always met hostility w/ companies
ensure food is safe
National Library of Medicine
gov; world’s largest medical library (books)
part of NIH
Occupational Safety and Health Administration gov; create safe and healthy workplace
Environmental Protection Agency
safeguard environment (air, water, land)
one of most controversial PH agencies
American Heart Association non-gov; good cardiac care to reduce death
American Cancer Society non-gov; eliminate cancer as health problem
American Medical Association
assoc of Dr; promote PH, lobby, raise $

American Public Health Association
ed public, voice for PH, improve health, prevent
Robert Wood Johnson Foundation
health care for poor, aids, alcohol / drug abuse
Kaiser Family Foundation
focuses on health & public policy
Bill and Melinda Gates Foundation
global; healthcare & reduce extreme poverty
state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity
AIDS epidemic shows
science (epidemiology, biomedical, biostats)
ethics (individual freedom v health of public)
politics (values & ethics determining $ spent)
Core Functions
1. assessment - diagnosis
2. policy development - treatment plan
3. assurance - treatment delivery
% of GDP towards health care
% of federal health care dollars
% of private health care dollars
lower than gov % of budget (<1%)
$ spent by gov on HC
680 billion
% determinants of health status
25% genetics
50% behavior
15% environment
10% medical care
5 step approach to improve health of public
1. define the "health problem"
2. identify risk factors (behaviors that cause problem)
3. develop & test community intervention plan
4. implement interventions
5. monitor & assess effectiveness
PH goal
prevent disease & promote health
A de Tocqueville
negative assessment of extreme libertarian view - turns people to indifference
PH is social mvmnt
way of doing justice (what is right)
assert value of all human life
a set of values, beliefs, and/or behaviors that are shared by a group of people
US Death rates
1800 - 25 yrs
1900 - 47 yrs
2000 - 77 yrs
PH def by Charles-Edward Winslow (1920)
1. prevent disease, prolong life, promote physical health
2. through organized community efforts
3. for clean environment, no infections, education on hygiene, provide H C services
4. purpose: prevention of disease & social machinery that people can be healthy