(2016)

Berthold, T., Editor

San Francisco, C.A.: Jossey-Bass
Copyright © 2000-2017 by John Wiley & Sons, Inc., or related companies. All rights reserved.

Chapter Three
An Introduction to Public
Health
Reflection of Last Session
 What did you learn?

 Share what you discovered when Googling “Community

Health Worker”

 CHW Core Competencies

 Interdisciplinary focus of the profession

 How are developments in CHW training, education, and

credentialing shaping the CHW field?
What You Will Learn
 Define health and public health and explain how the field of
public health is different from the field of medicine
 Explain how the field of public health analyzes the causes of
illness and health of populations and emphasized the social
determinants of health
 Explain why public health is concerned with health
inequalities
 Discuss the relationship between promoting social justice and
promoting public health
What You Will Learn

 Describe the ecological model of public health and apply it to

specific public health issues
 Discuss public health’s emphasis on prevention
 Explain the spectrum of prevention and provide examples for
each of the six levels
Words to Know
 Prevalence
 Chronic Disease
 Populations
 Ecological Model of Health

 Environmental Justice  Primary Prevention

 Epidemiology  Secondary Prevention

 Health Co-benefit  Social Determinants of Health

 Infant Mortality  Spectrum of Prevention

 Infectious Disease  Tertiary Prevention

 Life Expectancy
Definition of Health

There are many definitions of health. The most widely used

definition is the one from the World Health Organization
(WHO).

The WHO defines Health as “ the complete state of physical,

mental, and social well-being, not just the absence of disease.”
Definition of Public Health

In 2015 the WHO defined public health as follows:

“Public health refers to all organized measures (either

public or private) to prevent disease, promote health,
and prolong life among the population as a whole. Its
activities aim to provide conditions in which people can
be healthy and focus on entire populations, not on
individual patients or diseases. Thus public health is
concerned with the total system and not only the
eradication of a particular disease.”
Definition of Public Health

There are several key concepts to the definition of public health.

Public health:
Emphasizes prevention
Is population based – concern with large groups of people or
populations
Is an interdisciplinary field – builds on and applies a range of
sciences such as biology anatomy, psychology, sociology, and
anthropology.
Uses the science of epidemiology – the study of the health and
illness of populations.
Definition of Public Health

There are several key concepts to the definition of public health.

Public health:
Is concerned with social justice and health inequalities – when
one group of peoples experience significantly higher rates of
illness and death than others
Emphasizes the social determinants of health – economic,
social, and political policies and dynamics that influence
whether or not people have access to resources and
opportunities essential to good health.
The Practice of Public Health

Public health is practiced by diverse individuals, groups, and

organizations, including:
 International and intergovernmental organizations

 Local, state, tribal, and national government agencies

 Public and private clinics and hospitals

 Colleges and universities

 Small and large private or nongovernmental organizations

 Individuals, groups, and associations

Core Functions of Public
Health

 Assessment – focuses on understanding health-

related issues before taking action
 Policy development – how we address a problem
and promote a better outcome
 Assurance – making sure that a policy, program, or
service is implemented properly
 Ecological Models
Ecological Model of Health

Public health uses

Nation & Society
the Ecological
Model of Health
to understand and Neighborhoods & Community

promote health.
Friends & Family

individual
Image from CDC’s Public Health101 http://www.cdc.gov/nphpsp/essentialservices.html
Public Health Information and
Analysis
 Existing government data

 Analysis of death rates or mortality rates

 Infant mortality rates – the number of children born alive

who die before the age of one

 Life expectancy rates – estimated number of years that

people will live.

 Statistical research methods to gather health information

from a sample (a smaller but representative number) of
the population.
Public Health and Health
Inequalities
Health inequalities are not due to genetics or other biological
differences between populations.
They are the consequences of the way that society is organized
around access to basic resources, rights and opportunities that all
people require to live long healthy lives.
To change health inequalities means changing policies that effect
people’s access to basic resources such as housing, food,
education, employment, health care, safety, and human rights.
Social Justice and Public
Health
The most powerful strategy for promoting public health is to
advocate for changes in public policies that will provide equal
access to resources, rights and opportunities that are basic for
health (education, housing, nutrition, safety, civil rights, quality
health care, employment).

Social justice is the equal access to these basic human resources,

rights and opportunities.
Public Health and Prevention

Primary prevention – preventing the development of a disease or

condition from occurring.
Secondary prevention – early diagnosis and treatment of a
disease or condition before they become symptomatic (show
signs).
Tertiary prevention – provide services that aid in delaying further
progress, alleviate symptoms, prevent complications, and delay
death to those already living with a symptomatic disease or
condition.
The Spectrum of Prevention

1. Strengthen individual knowledge and skills

2. Promoting community education
3. Educating providers
4. Fostering coalitions and networks
5. Changing organizational practices
6. Influencing policy and legislation
Practice
• Do a search! Discover some decisions
your local government has made in the
past year that affect the health of the
community you live in. Find some stories
in the media about health inequality and
bring them to the next session.

• Complete Chapter 3 HW & DB in

Blackboard

• Read Chapter 4
Resources:
Image on slide 2
digital-drugs-binaural-beats by digitalbob8 is licensed under CC BY 2.0

Image on slide 3 and 4

Bring Light Bulb is available in the public domain under CC0 Public Domain

Image on slides 6 and 7

Who-logo by FIHIHF2013 is licensed under a CC BY-SA 3.0

Image on slides 8 and 11-12

United States Public Health Service (seal) is available in the public domain

Video on slide 10
What is Public Health? by Global Health with Greg Martin is licensed under a Standard YouTube License

Image on slides 14
Public Health System is from the Public Health Practice Program Office, Centers for Disease Control and Prevention ,
National Public Health Performance Standards Program, User Guide (first edition), 2002. (Current version available at
www.cdc.gov/nphpsp)

Image on slide 16
Inequation is available in the public domain.

Image on slide 21
Vandalised by KylaBorg is licensed under CC BY 2.0
Acknowledgements:
Adapted from the Foundations for Community Health Workers, 2 nd Edition (Berthold) with
permission from Wiley Publishing by the
Institute of Workforce Innovation of the Metropolitan Community College Kansas City and the
Workforce Solutions Group of St. Louis Community College.

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