Component 1: Introduction to Health Care and Public Health in the U.S. 1.7: Public Health Part I 1.7b: Public Health Terminology and Organization

Selected Public Health Terminology Endemic – disease native to an area or population Epidemic – disease affecting numerous people at the same time Epidemiology – study of incidence, distribution, and control of disease in a population Incidence – the number of new events/cases in a population. Requires a specified time period and a defined population. Intervention – in public health, refers to an action/program that is meant to benefit the health of a population. Examples might include legislation, education, or service delivery. Morbidity – proportion of disease/illness in a population; relative incidence of a disease Mortality – number, frequency, or proportion of deaths in a population Outbreak – sudden rapid development of a disease in a population Pandemic – an extensive epidemic, affecting a very large region such as a country, continent, or the world Prevalence - proportion of a population with a specified condition/illness. Requires a specified time period or point in time. Relative risk – several meanings, including: risk of an outcome in those exposed to a disease versus those not exposed; the calculated odds ratio resulting from a study. Risk – odds of an event occurring; as in, a one in one hundred chance, or risk, of dying. Component 1/Unit 7bHealth IT Workforce Curriculum Version1.0/Fall

Public Health Expenditures The public perception of public health is often restricted to highly visible aspects such as communicable disease programs, and in recent years, bioterrorism surveillance. However, communicable disease surveillance is a very small portion of the public health arena. In the US, the mandatory programs Medicare and Medicaid consume the majority of the HHS budget. Component 1/Unit 7bHealth IT Workforce Curriculum Version1.0/Fall FY 2011 President’s Budget for HHS

Core Areas of Public Health Behavioral Science/Health Education Biostatistics Emergency Medical Services Environmental Health Epidemiology Health Services Administration/Management International/Global Health Maternal and Child Health Nutrition Public Health Laboratory Practice Public Health Policy Public Health Practice Component 1/Unit 7bHealth IT Workforce Curriculum Version1.0/Fall

Organization of public health in the US Three general levels of public health – local, state, federal –Local health departments –State health departments –CDC and other federal agencies Most – but not all – states are associated with a network of local or county health departments Component 1/Unit 7bHealth IT Workforce Curriculum Version1.0/Fall

Public Health Roles Public Health is multi-disciplinary, improving population health through many roles Some examples include –Education – such as promotion of healthy lifestyles –Policy – such as advocating for legislative funding –Health care services – such as public health nursing, clinics; providing vaccinations; maternal and child healthcare –Regulation – such as mandating state reportable conditions for laboratories, health care providers, veterinarians –Laboratory services – public health laboratories provide sophisticated testing for biological and environmental samples –Monitoring and surveillance – such as tracking occurrences of communicable diseases or elevated blood lead levels Component 1/Unit 7bHealth IT Workforce Curriculum Version1.0/Fall

Public health laws and policies Disease reporting regulations Component 1/Unit 7bHealth IT Workforce Curriculum Version1.0/Fall

Reporting States mandate certain diseases and conditions to be reportable in their jurisdictions – laboratories, health care providers, and veterinarians are then required to report these conditions to public health Certain diseases are termed Nationally Notifiable Diseases (NND). States and CDC together determine which diseases should be on this list Since 1961, CDC has collected and published NND data. Reporting of de-identified NND data to the CDC is technically voluntary, but is quite complete NND are reported weekly to the CDC by means of the National Electronic Telecommunications System for Surveillance (NETSS) Component 1/Unit 7bHealth IT Workforce Curriculum Version1.0/Fall

Examples of Nationally Notifiable Diseases, 2010 Infectious Conditions –Anthrax –Diphtheria –Giardiasis –Hepatitis –Lyme disease –Malaria –Measles Non-Infectious Conditions –Cancer –Elevated blood lead levels –Pesticide-related illness Component 1/Unit 7bHealth IT Workforce Curriculum Version1.0/Fall

Generalized Public Health Data Flow Component 1/Unit 7bHealth IT Workforce Curriculum Version1.0/Fall Local Health Dept State Health Dept CDC Data sources – labs, clinicians, etc. Identified DataDe-Identified Data Public Use Data