Introduction to Healthcare and Public Health in the US: Public Health, Part 1

Introduction to Healthcare and Public Health in the US: Public Health, Pa rt 1

Audio Transcript

Welcome to Introduction to Healthcare and Public Health in the US: Public Health, Part 1. This is Lecture (c). This component, Introduction to Healthcare and Public Health in the US, is a survey of how healthcare and public health are organized and services are delivered in the U.S.

The Objectives for Public Health, Part 1, are to:  Discern the main differences and similarities between public and private health  Delineate the historic timeline and achievements of public health in the US  Define and discuss key terminology of public health  Illustrate the general organization of public health agencies and public health data flow  Evaluate and explain the impact and value of public health

This lecture discusses the impact and value of Public Health. In the 20th century, public health made radical improvements to population health. The achievements include a significant increase in life expectancy, and similarly significant r eductions in both infant and child mortality and in communicable diseases.

The improvements made by public health have become such a normal part of everyday life in the US that we are often not even aware of them. However, it is nearly impossible to spend a single day and not be affected by public health. This slide lists some exampl es of these public health achievements, including improvements in food safety, restaura nt inspections, water quality and fluoridation, seatbelt use, removal of lead from gasolin e, etc. Public health has a long and diverse record of working in the public interest, and t hat record is almost entirely positive.

The record of public health does have a sad and serious blotch upon it, which is its invol vement as a partner in two syphilis studies which veered into unethical behavior. These were the infamous Tuskegee Study (1932-1972) and a Guatemala study of prisoners (1 940’s). While only the Guatemala study involved deliberate infection of subjects, the Tus

Health IT Workforce Curriculum Introduction to Healthcare and Public Health in the US 1 Version 3.0/Spring 2012 Public Health, Part 1 Lecture c

This material (Comp1_Unit7c) 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. kegee Study became unethical when the new treatment penicillin was deliberately withh eld from subjects after it became the recommended treatment in 1947. While the injustic e of these studies must be both noted and remembered, it is important to also remembe r the enormous benefits of public health.

The CDC constructed a list of the top ten public health achievements in the 20th century: these are listed on this slide. From family services (improvements in hygiene, nutrition, and healthcare have reduced infant mortality 90% from the 1900 level, and reduced mat ernal mortality 99%) to safer workplaces (reduction in both diseases such as silicosis, a nd workplace injuries) and motor vehicle safety (think seat belts, child seats, motorcycle helmets), the US population has reaped enormous benefits from investment in public he alth.

A few more highlights of public health. As mentioned earlier in this unit, public health ha s significantly increased life expectancy. In fact, since 1900 the average life expectancy in the US has increased 30 years, and a startling 25 of those years are attributed to publ ic health initiatives. As recently as 1958, two million people died annually from smallpox. In 1977, a dedicated public health initiative brought about worldwide eradication of this d isease. And in the 1970’s, a huge majority (88%) of US children had elevated levels of b lood lead, but by the 1990’s public health had reduced that percentage to only 4.4%.

Childhood illnesses used to be devastating to the population, but both medical progress and public health efforts have nearly eliminated deaths from illnesses such as measles, diphtheria, scarlet fever, and whooping cough. In fact, the long-standing battle against in fectious diseases has been so successful that of the current leading causes of mortality, only two factors are NOT either chronic disease-related or injury-related factors.

The leading causes of mortality in 2007 illustrate the amazing success of communicable disease countermeasures. Of the top ten causes, only #8 (influenza and pneumonia) an d #10 (septicemia) are caused (at least, to our current accepted knowledge) by infectiou s disease agents.

This concludes Public Health, Part 1, Lecture c. In summary, the radical yet often over looked improvements which public health has made to population health are discussed. Included are some examples of amazing successes in communicable disease counterm easures.

This material (Comp1_Unit7c) 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 11 This also concludes Public Health, Part 1. In summary, the similarities and differences between public and private health were disc ussed. Criteria for assigning public health importance were explained. The history of pu blic health in the US was reviewed with the help of some important historical highlights, i ncluding the creation of the Centers for Disease Control and Prevention (CDC). Some key terminology of public health was defined. The organization and funding of pu blic health in the US was discussed. The roles of public health were discussed, and dise ase reporting and surveillance was used as an example. The radical yet often overlooked improvements which public health has made to populat ion health were discussed. Included were some examples of amazing successes in com municable disease countermeasures.

Reference Slide, Lecture (c) No audio

This material (Comp1_Unit7c) 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.