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Identify a public health measure that has been implemented in Saudi Arabia. Describe its origin and the philosophy behind this measure. Detail how it has affected citizens. In your opinion, has the measure been effective? Why or why not? How could it be improved?
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Chapter 1
Public Health: The
Population Health
Approach
Learning Objectives
• Identify multiple ways that public health affects daily
life.
• Define eras of public health from ancient times to
the present.
• Define the meaning of “population health.”
• Illustrate the uses of health care, traditional public
health, and social interventions in population health.
• Identify a range of determinants of disease.
• Identify ways that populations change over time, and
how this affects health.
Day in the Life (1 of 2)
I woke up this morning, got out of bed, and went to the
bathroom. There, I used the toilet, washed my hands;
brushed and flossed my teeth; drank a glass of water;
and took my blood pressure medicine, cholesterol
medication, and an aspirin. Then I did my exercises and
took a shower.
On the way to the kitchen, I didn’t even notice the
smoke detector I passed or the old ashtrays in the
closet. I took a low-fat yogurt out of the refrigerator
and prepared hot cereal in the microwave oven for my
breakfast.
Day in the Life (2 of 2)
Then I walked out my door into the crisp clean air and
got in my car. I put on my seat belt, saw the light go on
for the airbag, and safely drove to work.
I got to my office, where I paid little attention to the
new defibrillator at the entrance, the “no smoking”
signs, or the absence of asbestos. I arrived safely in my
well-ventilated office and got ready to teach Public
Health 101.
It wasn’t a very eventful morning, but then it’s all in a
morning’s work when it comes to public health.
Questions-to-Ask (1 of 2)
• What do we mean by public health?
• How has the approach of public health changed over
time?
• What is meant by population health?
• What are the implications of each of the four
components of health?
• Should we focus on everyone or on vulnerable
groups?
Questions-to-Ask (2 of 2)
• What do we mean by population health’s focus on
the lifecycle?
• What are the approaches available to protect and
promote health?
• What factors determine the occurrence of disease,
disability, and death?
• What changes in populations over time can affect
health?
What Do We Mean by Public Health?
• An examination of the full range of:
– Environmental, social, and economic determinants of
health—not just those traditionally addressed by public
health and clinical health care
– Interventions to address health issues, including the
structure and function of healthcare delivery systems, plus
the role of public policies that affect health even when
health is not their intended effect
How Has the Approach of Public
Health Changed Over Time?
• Table 1-1 outlines these eras of public health,
identifies their key defining elements, and highlights
important events that symbolize each era.
Table 1.1: Eras of Public Health
(1 of 3)
Data from Awofeso N. What’s new about the “New Public Health”? American
Journal of Public Health. 2004;94(5):705–709.
Table 1.1: Eras of Public Health
(2 of 3)
Data from Awofeso N. What’s new about the “New Public Health”?
American Journal of Public Health. 2004;94(5):705–709.
Table 1.1: Eras of Public Health
(3 of 3)
Data from Awofeso N. What’s new about the “New Public
Health”? American Journal of Public Health. 2004;94(5):705–709.
What is Meant by Population Health?
• A broader concept of public health that stresses
collaboration among traditional public health
professions, healthcare delivery professionals, and a
range of other professions that affect health
• It utilizes an evidence-based approach to analyze
determinants of health and disease and the options
for intervention to preserve and improve health
throughout the lifecycle.
Figure 1.1: The Full Spectrum of
Population Health
Table 1.2: Components of Population
Health
What Are the Implications of Each of
the Four Components of Health? (1 of 3)
• Health issues
– Physical health
– Mental health
– Medical interventions
• Population(s)
– Idea of a global community
– Not confined by geography
What Are the Implications of Each of
the Four Components of Health? (2 of 3)
• Society’s shared health concerns
– Communicable diseases
– Emerging infectious diseases
– Impacts of climate change
– Toxic exposures from the physical environment
– Transportation safety
– Costs of health care
What Are the Implications of Each of
the Four Components of Health? (3 of 3)
• Society’s vulnerable groups
– Mothers and children
– Individuals in high-risk occupations
– The disabled
– The frail elderly
– Individuals without health insurance
– HIV/AIDS patients
– Those with genetic vulnerability
Should We Focus on Everyone or on
Vulnerable Groups?
(1 of 2)
• High-risk approach
– Focuses on those with the highest probability of
developing disease and aims to bring their risk close to the
levels experienced by the rest of the population
Figure 1.2: (A) High Risk
(B) Reducing High Risk
Should We Focus on Everyone or on
Vulnerable Groups?
(2 of 2)
• Improving-the-average approach
– Focuses on the entire population and aims to reduce the
risk for everyone
Figure 1.3: Improving the Average
What Do We Mean by Population Health’s
Focus on the Lifecycle?
• Health risks extend from prenatal to postmortem.
• Age is single most important factor influencing
causes of death and disability.
Table 1.3: Leading Causes of Death and
Disability by Age Groups in the United
States (1 of 3)
Data from Centers for Disease Control and Prevention. National Center for Health
Statistics. Deaths, percent of total deaths, and death rates for the 15 leading causes of
death in 5-year age groups, by race and sex: United States, 2014. Available at
https://www.cdc.gov/nchs/nvss/mortality/lcwk2.htm. Accessed July 23, 2017; Centers
for Disease Control and Prevention. National Center for Injury Prevention and Control. 10
Leading Causes of Death by Age Group, United States—2010. Available at
https://www.cdc.gov/injury/wisqars/pdf/10lcid_all_deaths_by_age_group_2010-a.pdf.
Accessed July 23, 2017; National Institute of Mental Health. Cumulative U.S. DALYs for
the Leading Disease/Disorder Categories by Age (2010). Available at
https://www.nimh.nih.gov/health/statistics/disability/us-leading-disease-disordercategories-by-age.shtml. Accessed July 23, 2017.
Table 1.3: Leading Causes of Death and
Disability by Age Groups in the United
States (1 of 3)
Data from Centers for Disease Control and Prevention. National Center for Health
Statistics. Deaths, percent of total deaths, and death rates for the 15 leading causes of
death in 5-year age groups, by race and sex: United States, 2014. Available at
https://www.cdc.gov/nchs/nvss/mortality/lcwk2.htm. Accessed July 23, 2017; Centers
for Disease Control and Prevention. National Center for Injury Prevention and Control. 10
Leading Causes of Death by Age Group, United States—2010. Available at
https://www.cdc.gov/injury/wisqars/pdf/10lcid_all_deaths_by_age_group_2010-a.pdf.
Accessed July 23, 2017; National Institute of Mental Health. Cumulative U.S. DALYs for
the Leading Disease/Disorder Categories by Age (2010). Available at
https://www.nimh.nih.gov/health/statistics/disability/us-leading-disease-disordercategories-by-age.shtml. Accessed July 23, 2017.
Table 1.3: Leading Causes of Death and
Disability by Age Groups in the United
States (1 of 3)
Data from Centers for Disease Control and Prevention. National Center for Health
Statistics. Deaths, percent of total deaths, and death rates for the 15 leading causes of
death in 5-year age groups, by race and sex: United States, 2014. Available at
https://www.cdc.gov/nchs/nvss/mortality/lcwk2.htm. Accessed July 23, 2017; Centers
for Disease Control and Prevention. National Center for Injury Prevention and Control. 10
Leading Causes of Death by Age Group, United States—2010. Available at
https://www.cdc.gov/injury/wisqars/pdf/10lcid_all_deaths_by_age_group_2010-a.pdf.
Accessed July 23, 2017; National Institute of Mental Health. Cumulative U.S. DALYs for
the Leading Disease/Disorder Categories by Age (2010). Available at
https://www.nimh.nih.gov/health/statistics/disability/us-leading-disease-disordercategories-by-age.shtml. Accessed July 23, 2017.
Table 1-4: Approaches to Public Health
BIG GEMS
• Behavior
• Infection
• Genetics
• Geography
• Environment
• Medical care
• Socioeconomic-cultural
What Changes in Populations Over Time
Can Affect Health?
(1 of 2)
• Demographic transition
– Describes the impact of falling childhood death rates and
extended life spans on the size and the age distribution of
populations
• Epidemiological/public health transition
– Implies that as social and economic development occurs,
different types of diseases become prominent
What Changes in Populations Over Time
Can Affect Health?
(2 of 2)
• Nutritional transition
– Implies that countries frequently move from poorly
balanced diets often deficient in nutrients, proteins, and
calories to a diet of highly processed food, including fats,
sugars, and salt
Identify a public health measure that has been implemented in Saudi Arabia. Describe its origin and the
philosophy behind this measure. Detail how it has affected citizens. In your opinion, has the measure
been effective? Why or why not? How could it be improved?
Embed course material concepts, principles, and theories, which require supporting citations along with at
least 2 scholarly, peer-reviewed references in supporting your answer. These scholarly references can be
found in the Saudi Digital Library by conducting an advanced search. Use APA 7th edition and Saudi
Electronic University academic writing standards.
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