1. Component 1: Introduction to Health Care and Public Health in the U.S. 1.8: Public Health Part II 1.8c: Public Health and Chronic Diseases and Environmental Health

2. Chronic Diseases The success of public health in combating infectious diseases has led to our current situation, where chronic diseases have taken the stage as the leading causes of death in the US 7 of the 10 leading causes of mortality are chronic diseases, led by the top 4: Heart disease, Cancer, Stroke, and Chronic lower respiratory diseases Component 1/Unit 8cHealth IT Workforce Curriculum Version1.0/Fall 2010 2

3. Leading Causes of Mortality in US, 2007 Data Heart disease: 616,067 Cancer: 562,875 Stroke (cerebrovascular diseases): 135,952 Chronic lower respiratory diseases: 127,924 Accidents (unintentional injuries): 123,706 Alzheimer's disease: 74,632 Diabetes: 71,382 Influenza and Pneumonia: 52,717 Nephritis, nephrotic syndrome, and nephrosis: 46,448 Septicemia: 34,828 Health IT Workforce Curriculum Version1.0/Fall 2010 3 Component 1/Unit 8c 3Health IT Workforce Curriculum Version1.0/Fall 2010

4. Chronic Disease Topics Chronic disease topics include: –Arthritis –Asthma & Allergies –Cancer –Chronic Fatigue Syndrome –Diabetes –Epilepsy –Heart Disease –Hemochromatosis –Hepatitis B –Hepatitis C –Iron Overload –Osteoporosis –Overweight and Obesity –Stroke Component 1/Unit 8cHealth IT Workforce Curriculum Version1.0/Fall 2010 4

5. Chronic Disease: Prevention CDC estimates that 70% of deaths in the US are now caused by chronic diseases Public health focus on behaviour modification Chronic diseases mainly due to four modifiable health risk behaviors –lack of physical activity –poor nutrition –tobacco use –excessive alcohol consumption Component 1/Unit 8cHealth IT Workforce Curriculum Version1.0/Fall 2010 5

6. Chronic Disease - Education Since behaviour modification is the main public health goal, the tools to effect that are – –Education and informational materials For the public For health care practitioners For policymakers –Funding opportunities –Recommendations, best practices, guidelines Component 1/Unit 8cHealth IT Workforce Curriculum Version1.0/Fall 2010 6

7. World Health Organization (WHO) and Chronic Diseases The WHO has developed the “Stepwise Framework” PLANNING –STEP 1: Estimate population need and advocate for action –STEP 2: Formulate and adopt policy –STEP 3: Identify policy implementation ste ps IMPLEMENTATION –Table of 3 steps Component 1/Unit 8cHealth IT Workforce Curriculum Version1.0/Fall 2010 7

8. WHO Stepwise Framework Policy implementation steps Population-wide interventionsInterventions for individuals National LevelSub-National Level Implementation step 1 CORE Interventions that are feasible to implement with existing resources in the short term. Implementation step 2 EXPANDED Interventions that are possible to implement with a realistically projected increase in or reallocation of resources in the medium term. Implementation step 3 DESIRABLE Evidence-based interventions which are beyond the reach of existing resources. www.who.int/chp Component 1/Unit 8cHealth IT Workforce Curriculum Version1.0/Fall 2010 8

9. Environmental Public Health Environmental public health is vital to population health Removal of lead from gasoline and from house paint are two of the numerous triumphs of this field Other critical functions include air and water quality monitoring and education, and hazardous waste management Component 1/Unit 8cHealth IT Workforce Curriculum Version1.0/Fall 2010 9

10. Environmental Topics One way of categorizing environmental topics is by their means of contact with the population, such as - –air quality –food protection –radiation protection –solid waste management –hazardous waste management –water quality –noise control –environmental control of recreational areas –housing quality –vector control Another categorization method is to organize topics by public health program Component 1/Unit 8cHealth IT Workforce Curriculum Version1.0/Fall 2010 10

11. Environmental Programs and Topics –Air Quality –Bioterrorism Agents/Diseases –Chemical Agents –Environmental Hazards and Exposure –Food Safety –Hazardous Substances –Hazardous Waste Sites –Health Disorders and the Environment –Herbicides –Hydrocarbons –Laboratory Measurements in People –Lead –Natural Disasters –Pesticides –Smoking and Tobacco Use –Urban Planning for Healthy Places –Vessel Sanitation and Health –Water Quality Component 1/Unit 8cHealth IT Workforce Curriculum Version1.0/Fall 2010 11 Public Health environmental programs and topics include -

12. Chronic Diseases and Environmental Public Health There is some overlap between chronic diseases and environmental topics. Some examples – –Smoking, asthma, air quality –Cancer, environmental hazards and exposure, chemical agents Similarly, there are overlaps between communicable diseases and environmental topics, such as –Bioterrorism –Water quality and water-related diseases Divisions between different facets of public health can be artificial, created for efficiency of organization. In actuality, relationships between facets of public health are often complex rather than simple Component 1/Unit 8cHealth IT Workforce Curriculum Version1.0/Fall 2010 12