Transcript Foundations of Public Health PH-200 Fall 2009 Week 10 Integrating Diverse Foundations of Public Health Into Solutions and Sustainable Infrastructures.

Foundations of Public Health
PH-200 Fall 2009
Week 10
Integrating Diverse Foundations of Public Health Into Solutions and
Sustainable Infrastructures
Outline
• 9:30 AM – 9:45 AM : Questions and Review
• 9:45 AM – 11:00 AM : Integrating and Translating
Theoretical Foundations of Public Health
• 11:00 AM – 11:15 AM : Recess
• 11:15 AM – 12:15 PM : Proposal Summaries
– The Unfulfilled Promise of Public Health
• 12:15 PM – 12:30 PM : Summary
Pop-quiz
• What is the relationship between “demographic transition” and
“epidemiologic transition?”
• Discuss notable exceptions to the traditional epidemiological
transition model.
• Research challenges in public health are embedded in the gap
between “what is” and “what ought to be.” But what “ought to
be” is subject to a variety of ethical considerations. Discuss
your understanding of public health ethics.
Integrative Models in Public Health
• Ecological Model: The health of populations and individuals is
influenced by the interaction of biological, environmental, and
behavioral factors. The Institute of Medicine recommends the use
of the ecological model as the basis for public health education and
interventions (IoM, 2003).
• Some Schools of Public Health, such as the University of California
at Berkeley (UC Berkeley), are using this model as the basis for
teaching, research, and community interventions to improve
health. The model is the cornerstone of Berkeley’s recently
developed strategic plan, along with a commitment to associated
interdisciplinary action and social justice to improve public health.
Ecological Model (UC Berkeley)
Ecological
Perspective
Interdisciplinary
Approach
Biology
Goal: Improve
Human
Health
Behavior
Diversity,
Human Rights,
Social Justice
Environment
Movement from
Publication to
Public Action
Healthy People 2010
• Healthy People 2010: Established a national
goal of eliminating health disparities by 2010.
It recommends that organizations and
communities design, implement, and
evaluate interventions using a framework that
incorporates elements of the ecological
model and also includes policy and health
care factors.
Healthy People 2010 Model
Determinants of Health
Policies and Interventions
Behavior
Physical
Environment
Individual
Biology
Access to Quality Health Care
Social
Environment
Hierarchical Models: How useful are they?
For research? For practice? For education?
Social and Economic
Policies
Culture
Organizational
Connections
(Communities)
Socioeconomic
Psychosocial - Behavioral
Genetics
Human Biology
Pathological
Biomarkers
Health and
Development
Life course
Sample Program Logic Model
ACTIVITIES
Providing
referral
info &
hotline
Providing
parent
education &
training
SHORT-TERM
OBJECTIVES
Improved
knowledge of
supports &
services for
healthy
pregnancy &
infant/child
development
Increased use
of other
supports &
services
OBJECTIVES
LONG-TERM
Improved
maternal
health
Providing
personal,
practical
support to
parents
Providing
professionally
led support
groups for
parents
Providing
counseling
to parents
Improved parenting
knowledge and
practices (pre- &
postnatal care,
nutrition, child
development,
parenting skills,
health/safety)
Increased
parenting
capacity
Improved
infant health
& well-being
Providing
parent
screening &
assessment
Increased
feelings of
family &
social
support
Program and System Supports
Early Childhood
Development,
Learning & Care
Pregnancy, Birth, and Infancy --- Parenting & Family Support
Providing
child
screening &
assessment
Improved
identification of
at-risk parents,
infants and
children (PPD,
P4,
developmental
delay, etc).
Creating,
disseminating
child
development
resource
materials
Provide small
learning
groups for
children
Increased service
provider
knowledge of
pregnancy & child
development
supports &
services/gaps
Increased
child
stimulation
& interaction
Improved
emotional
functioning &
well being of
children
Training of,
consulting
with, service
providers
Evaluating
provincial NP
services &
community
impact
Increased SP
knowledge & skills
of pregnancy &
child development
best practices &
interventions
Developing &
implementing
service
coordination
policies,
protocols
Developing
networks of
service
providers
Increased
capacity to
assess program
planning &
effectiveness
Improved
school
readiness
Increased service
provider, parent, &
community
awareness of the
importance of the
early years
Enhancing &
expanding core
programming
GOALS
For all children to be healthy, safe, and
secure within strong families and
communities
Promotional
advocacy
campaigns
Increased parent
& community
awareness of
pregnancy &
child
development
services
Increased entry
into appropriate
supports &
services
Increased
accessibility of
pregnancy & child
development
intervention
programming
Increased
child
prosocial
behaviours
Increased
commitment,
support,
programming for
EY services
Promote Healthy Pregnancy & the Birth of
Healthy Babies
Organizing
community
events
Increased
service
provider
collaboration
Increased
coordination &
integration of
services in
community
Improved child
health &
physical wellbeing
Ongoing
parental
awareness
media
campaigns
Promote children’s optimal development and
readiness to learn, so that they may reach
their fullest potential
Increased
general
awareness of
the importance
of parenting
Increased
community
participation in
EY & prevention
activities
Link to Map
•
“Ecological” Model : Patz et al. Environmental Health Perspectives Volume 112, Number 10, July 2004
Course Summary
– OBJECTIVES:
– The graduate “foundations” course is designed for incoming graduate students
in professional public health degrees, taking into consideration diverse
academic backgrounds and skills.
– The course provides an opportunity for students to investigate the
fundamental determinants and the complex set of intermediate factors that
underpin health and disease status in different populations at various scales of
analysis.
– After completing the course, students should be knowledgeable about the
diversity of conceptual and methodological approaches and academic
disciplines which inform public health research and practice.
– The course content highlights core competencies and cross‐cutting themes
essential for successful public health intervention programs
Course Organization
– During the first segment, students are introduced to how public health
is practiced at the international, nation, regional, and local levels, with
presentations drawing from “Milestones in Public Health” a project
that highlights historical developments on 10 major causes of
morbidity and mortality in human populations
(http://www.pfizerpublichealth.com/podcasts.aspx) .
– Each student is expected to build on these presentations to develop a
scholarly review of current burden of disease at the regional or global
level, using concrete examples of how public health core disciplines
and cross‐cutting themes are made to work for identifying and solving
problems at those scales of analyses.
– For this review, students are expected to consult, for example, the
World Health Organization’s project on the Global Burden of Disease
(http://www.who.int/topics/global_burden_of_disease/en/).
Organization..continued
• The second requirement is for each student to develop a public health
problem‐solving proposal that builds upon our exploration of the
theoretical foundations necessitating transdisciplinary approaches in
the natural and social sciences and administrative functions in public
health.
• These theoretical linkages, following exposure to how public health
practice is organized in the world, will hopefully prepare students to
explore more deeply within the curriculum organized around the core
disciplines of biostatistics, epidemiology, environmental health sciences,
social and behavioral sciences, and health policy and management.
• The final examination will be based on lecture materials.
Schedule of Topics
• Week 1 – Introduction and orientation to the core and cross-cutting,
interdisciplinary approaches in public health.
•
Milestone: Eradication of Smallpox
Week 2
• The real causes of death and disability: The “Global Burden of Disease”
project.
• Essential Resource: World Health Organization’s
(http://www.who.int/topics/global_burden_of_disease/en/)
• Milestone: Automotive Safety
Week 3
(Public Health and Law Symposium)
• Integrative public health research and practice at the national level
– Centers for Disease Control and Prevention
– Essential Resource: (http://www.cdc.gov/)
• Milestone: Environmental Health
Week 4
• Integrative public health research and practice at the regional level
– California Department of Health Services
– Essential Resource:(http://www.dhs.ca.gov/)
• Milestone: Infectious Disease Control
Week 5
• Integrative public health research and practice at the local level.
– Essential Resource; Orange County Health Care Agency
(http://www.ochealthinfo.com/)
• Milestone: Cancer
Week 6
• Week 6 – Scholarly Review
– Student Presentations
• Milestone: Cardiovascular Disease
Week 7
• Theoretical foundations of the transdisciplinary approaches in public
health research and practice – The natural sciences.
• Milestone: Safer and Healthier Foods
Week 8
• Theoretical foundations of the transdisciplinary approach in public
health research and practice – The social and behavioral sciences
• Milestone: Maternal and Child Health
Maternal Mortality
Old and New Challenges to M&C H
• Since ~ 1982, U.S. Maternal Mortality has reached a plateau
at 7 – 8 maternal deaths per 100,000 live births.
• Twenty countries have reduced their maternal mortality
rates below U.S. levels.
• Legalization of induced abortions led to 89% reduction in
deaths from septic processes between 1950 and 1973.
• Insurance coverage of pre-natal care
Infant mortality
Per 1,000
live births
Infant Mortality Challenges
•
•
•
•
•
•
100 years ago, 1/6 live births
Today, < 1/100 live births in the U.S.
Low birth-weight
Vaccination / Autism
Sudden Infant Death Syndrome (Ethnic disparities)
Chinese experience with one-child per family, and
gender selection.
• Genetic Counseling
• “Family Planning” and government support at the
global level.
Population-Level Intervention
• Multivitamins and birth defects
• (Folic acid/Spinal bifida)
Recommended Daily Intake (Folic Acid)
Men
Women
(19+)
(19+)
Pregnancy
Breast feeding
400 µg
400 µg
600 µg
500 µg
1 µg of food folate = 0.6 µg folic acid from supplements and fortified foods
Week 10
• Theoretical foundations of the transdisciplinary approach in public
health research and practice – Public health administration and
intervention program implementation.
• Milestone: Oral Health
Cancrum oris (Noma)
Week 10
• Discussion of Proposals.
• Milestone: Addiction
• Milestone: Public Health Infrastructure
Pop Quiz
• What, in your opinion, are the grand challenges for maternal
and child health in the world today?
• Why is Dentistry a separate profession from Medicine? Is this
a “good” or “bad” arrangement for public health?
– Where do you stand on the issue of “mandatory” public water
fluoridation? Compare California and Michigan.
– Where do you stand on the issue of dental mercury amalgams?
• Vancouver City established supervised injection sites (Insites)
for drug addicts. Where do you stand on this policy?
Week 11
• Final Examination
– Lecture contents
– This room at 10:00 AM on December 11th.
Proposal Writing
• Scholars Grants in Public Health
http://www.promisingminds.com/AwardDetails.aspx?ProgramID=204&PrevGrant=1
• Program Description
– These awards are meant to support the career development of junior faculty in public health.
This educational grants is nationally competitive, and chosen by an independent Academic
Advisory Board of recognized leaders in public health.
– Up to $130,000, paid over two years, will be awarded to individuals who are pursuing
community-based, public health practice research intended to foster academic science and
knowledge of public health, and collaborative partnerships between accredited schools or
programs of public health and state and local departments of public health. The proposed
research should support the needs of a state or local public health organization. The research
should focus on public health practice issues likely to have a demonstrable impact on community
health and/or the public health system.
– Award funding is primarily intended for salary support. The applicant must demonstrate that at
least 75% of his or her professional time will be devoted to research. Proposals involving headto-head clinical trials or veterinary health will not be considered. Interdisciplinary and
translational research proposals are encouraged.
Research Proposals
• Due in the DropBox, Friday 11th December
2009
Grading Criteria
– Topical Review Article (4000 words) = 40%
• (and exercises)
– Proposal Development = 40%
• (and exercises)
– Final Examination = 20%
Proposal Idea Presentations
Student#
35927958
40528603
67003581
43842064
43848856
91176816
Name
ARJIAN, ARDA M.
BAILEY, MORGAN MICHAEL
CARREON, DAISY CALPO
DIXIT, AMRUTA
HAI, XIANGSHU
HAYASHI, HITOMI DOLLY
Email
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
Major
PUBHLTH
ENGRENV
SOCIOL
PUBHLTH
PUBHLTH
PUBHLTH
23492990
HAYASHI, TOMOMI SAMANTHA
[email protected]
PUBHLTH
79844927
94921771
94128406
78008353
75967473
54128979
57081413
57289688
HEINZ, THOMAS RANDAL
HINGA, BRIANA MARIE
HOANG, ERIC
JAAFARI, TAHEREH
JOO, HEE JIN
NGUYEN, ANN M.
RAMDEO, RAJIV
SHIAH, STEVEN
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
PUBHLTH
EDMAPHD
PUBHLTH
P H POL
PUBHLTH
PUBHLTH
PUBHLTH
PUBHLTH
49247240
SIMBULAN, MARIA STEPHANIE PONCE
[email protected]
PUBHLTH
63885204
70084376
60329476
TRUONG, KIMBERLY KAY
VAISENBERG, LIAT
VU, JOHN THUAN DUY
[email protected]
[email protected]
[email protected]
PUBHLTH
PUBHLTH
PUBHLTH
79223884
WANG, LAWRENCE CHRISTIE
[email protected]
PUBHLTH