{"id":84,"date":"2017-12-18T18:27:08","date_gmt":"2017-12-18T18:27:08","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/atd-clinton-hsm111\/?post_type=chapter&#038;p=84"},"modified":"2017-12-18T18:27:08","modified_gmt":"2017-12-18T18:27:08","slug":"functions-of-the-public-health-system","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/atd-clinton-hsm111\/chapter\/functions-of-the-public-health-system\/","title":{"raw":"Functions of the Public Health System","rendered":"Functions of the Public Health System"},"content":{"raw":"<h4 align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3512\/Overview%20of%20PH%20objectives.PNG\" alt=\"\" width=\"628\" height=\"179\" \/><\/h4>\r\n<h4>The Public Health System and the 10 Essential Public Health Services<\/h4>\r\n<div>\r\n<div><\/div>\r\n<div id=\"socialMediaShareContainer\" align=\"center\">\r\n<div>\r\n<ul>\r\n \t<li><img class=\"img-responsive atto_image_button_middle\" src=\"https:\/\/www.cdc.gov\/nphpsp\/images\/phs-figure1.gif\" alt=\"Web of connected eggs showing different components of the public health system including, but not limited to, the public health agency, non-profit organizations, nursing homes, community centers, and mental health.\" width=\"577\" height=\"403\" \/><\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<div id=\"contentArea\">\r\n<div>\r\n<p align=\"center\"><strong>\u00a0\u00a0The Public Health System<\/strong><\/p>\r\n\r\n<h3>The Public Health System<\/h3>\r\nPublic health systems are commonly defined as \u201call public, private, and voluntary entities that contribute to the delivery of essential public health services within a jurisdiction.\u201d This concept ensures that all entities\u2019 contributions to the health and well-being of the community or state are recognized in assessing the provision of public health services.\r\n\r\nThe public health system includes\r\n<ul>\r\n \t<li>Public health agencies at state and local levels<\/li>\r\n \t<li>Healthcare providers<\/li>\r\n \t<li>Public safety agencies<\/li>\r\n \t<li>Human service and charity organizations<\/li>\r\n \t<li>Education and youth development organizations<\/li>\r\n \t<li>Recreation and arts-related organizations<\/li>\r\n \t<li>Economic and philanthropic organizations<\/li>\r\n \t<li>Environmental agencies and organizations<\/li>\r\n<\/ul>\r\n<div>\r\n<div>\r\n\r\nPublic Health 101 (<a href=\"https:\/\/www.cdc.gov\/stltpublichealth\/docs\/usph101.pptx\" target=\"_blank\" rel=\"noopener\"><u>PPT<\/u><u>[3.15MB]<\/u><u>(https:\/\/www.cdc.gov\/stltpublichealth\/docs\/usph101.pptx)<\/u><\/a>,\r\nLearn about the components of the US public health system and how they work together to improve the nation's health. You may customize and use this presentation for your own informational and educational purposes.\r\n\r\n<\/div>\r\n<\/div>\r\n<h3>The 10 Essential Public Health Services<\/h3>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_middle\" src=\"https:\/\/www.cdc.gov\/nphpsp\/images\/phs-figure2.gif\" alt=\"Graphic to describe the 10 essential public health services as spokes in a wheel. Essential services are then linked to the 3 core functions of public health: assessment, policy development and assurance.\" width=\"500\" height=\"450\" \/><\/div>\r\n<p align=\"center\"><strong>The 10 Essential Public Health Services<\/strong><\/p>\r\nThe 10 Essential Public Health Services describe the public health activities that all communities should undertake and serve as the framework for the NPHPS instruments. Public health systems should\r\n<ol>\r\n \t<li>Monitor health status to identify and solve community health problems.<\/li>\r\n \t<li>Diagnose and investigate health problems and health hazards in the community.<\/li>\r\n \t<li>Inform, educate, and empower people about health issues.<\/li>\r\n \t<li>Mobilize community partnerships and action to identify and solve health problems.<\/li>\r\n \t<li>Develop policies and plans that support individual and community health efforts.<\/li>\r\n \t<li>Enforce laws and regulations that protect health and ensure safety.<\/li>\r\n \t<li>Link people to needed personal health services and assure the provision of health care when otherwise unavailable.<\/li>\r\n \t<li>Assure competent public and personal health care workforce.<\/li>\r\n \t<li>Evaluate effectiveness, accessibility, and quality of personal and population-based health services.<\/li>\r\n \t<li>Research for new insights and innovative solutions to health problems.<\/li>\r\n<\/ol>\r\n<h3>Philosophy of Public Health<\/h3>\r\n<p id=\"yui_3_17_2_1_1513621316342_68\">Public health is concerned with promoting and protecting the health of populations. Public health action\u00a0 occurs at the international, national, state and local level. Most communities are\u00a0served by health departments whose services include\u00a0the collection and use of epidemiological data for population surveillance of disease.\u00a0Health promotion and the\u00a0protection of\u00a0population health occurs at the global level,\u00a0 World Health Organization (WHO), and at the national level\u00a0under the Centers for Disease Control and Prevention, the Food and Drug Administration, the Environmental Protection Agency and the Consumer Protection Agency as public health agencies.<\/p>\r\nMoral foundations and justifications for public health and the challenges\u00a0faced due to limited resources are the ethical issues\u00a0debated that view public health as\u00a0a social justice, poverty and health disparity concern. Public health policy seeks to balance the greater health outcomes with individual liberties, for example, the immunization debate.\r\n\r\nPublic health has two primary aims, prevention and health promotion. Prevention\u00a0 is action taken to prevent the occurrence of an event or to minimize its effects after it has occurred. Three levels of prevention are described as\r\n<ul>\r\n \t<li>\r\n<div>primary\u00a0prevention - aimed at reducing risk, such as immunization<\/div><\/li>\r\n \t<li>\r\n<div>secondary prevention- aimed at detecting and treating disease at early stages, such as screenings (mammograms)<\/div><\/li>\r\n \t<li>\r\n<div>tertiary prevention - treatment aimed at modifying risk factors of disease, such as cardiac rehabilitation<\/div><\/li>\r\n<\/ul>\r\nHealth promotion refers to strategies that seeks to eliminate or reduce exposures to risk factors of disease\u00a0by modifying human behaviors.\r\n\r\n\u2022Incidence \u2013Number of new cases that develop of a particular disease\/injury\r\n\r\n\u2022Prevalence \u2013Proportion of people who have the disease at a specific point in time\r\n\r\n\u2022Morbidity \u2013The relative incidence of a particular disease\r\n\r\n\u2022Mortality \u2013The number of deaths that occur at a specific time, in a specific group, or from a specific cause\r\n\r\n\u2022Birth rate \u2013Number of live births per one thousand women\r\n\r\n\u2022Fertility rate \u2013Number of live births per one\u00a0thousand women between fifteen\r\n\r\nand forty-four years of age, generally considered a woman's prime childbearing years\r\n\r\n\u2022Infant Mortality \u2013Number of live born infants who die before their first birthday per one thousand live births\r\n\r\n\u2022Life expectancy \u2013Number of additional years of life expected at a specific point in time, such as at birth or at age 45\r\n\r\n\u2022Epidemiology \u2013Study of distribution and causes of health-related states or events in populations\r\n\r\n\u2013Application of the study to control health\r\n\r\n\u2022Epidemiology \u2013Study of distribution and causes of health-related states or events in populations\r\n\r\n\u2022Surveillance \u2013Systematic collection, analysis, interpretation, and dissemination of health data on an ongoing basis\r\n\r\n\u2022Epidemic \u2013Occurrence of more cases of disease than expected in a given area or among a specific group of people over a particular period of time\r\n\r\n\u2022Pandemic \u2013Epidemic occurring in a wide geographical area and usually affecting large part of population\r\n\r\n\u2022Endemic \u2013Constant presence of a disease or infection within a geographic area or population group.\r\n\r\nSource:\u00a0 (CDC Glossary)\r\n<h3 id=\"yui_3_17_2_1_1513621356013_67\">Levels of Public Health<\/h3>\r\n<h4 id=\"yui_3_17_2_1_1513621356013_71\">Three general levels of public health \u2013 local, state, federal<\/h4>\r\n<div>Most \u2013 but not all \u2013 states are associated with a network of local or county health departments<\/div>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph1.PNG\" alt=\"state and local health departments diagram\" width=\"550\" height=\"412\" \/><\/div>\r\nPublic health infrastructure provides communities, states, and the Nation the capacity to prevent disease, promote health, and prepare for and respond to both acute (emergency) threats and chronic (ongoing) challenges to health. Infrastructure is the foundation for planning, delivering, evaluating, and improving public health. All public health services depend on the presence of basic infrastructure. Every public health program\u2014such as immunizations, infectious disease monitoring, cancer and asthma prevention, drinking water quality, injury prevention\u2014requires health professionals who are competent in cross-cutting and technical skills, up-to-date information systems, and public health organizations with the capacity to assess and respond to community health needs. While a strong infrastructure depends on many organizations, public health agencies (health departments) are considered primary players. Federal agencies rely on the presence of solid public health infrastructure at all levels<u><sup>\u00a0\u00a0<\/sup><\/u>to support the implementation of public health programs and policies and to respond to health threats, including those from other countries.\r\n<div>\r\n<div>Public health infrastructure can best be described by what it is and what it does. It includes three key components:<\/div>\r\n<\/div>\r\n<ul>\r\n \t<li>\r\n<div>A capable and qualified workforce<\/div><\/li>\r\n \t<li>\r\n<div>Up-to-date data and information systems<\/div><\/li>\r\n \t<li>\r\n<div>Agencies capable of assessing and responding to public health needs<\/div><\/li>\r\n<\/ul>\r\nPublic health infrastructure provides the necessary foundation for undertaking the basic responsibilities of public health, which have been defined as the 10 Essential Public Health Services:\r\n<p align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph2.PNG\" alt=\"essential services of public health\" width=\"554\" height=\"417\" \/><\/p>\r\n\r\n<ol>\r\n \t<li>\r\n<div><strong>Monitor<\/strong>\u00a0health status to identify and solve community health problems.<\/div><\/li>\r\n \t<li>\r\n<div><strong>Diagnose and investigate<\/strong>\u00a0health problems and health hazards in the community.<\/div><\/li>\r\n \t<li>\r\n<div><strong>Inform<\/strong>,<strong>\u00a0educate<\/strong>,<strong>\u00a0<\/strong>and<strong>\u00a0empower<\/strong>\u00a0people about health issues.<\/div><\/li>\r\n \t<li>\r\n<div><strong>Mobilize<\/strong>\u00a0community partnerships and action to identify and solve health problems.<\/div><\/li>\r\n \t<li>\r\n<div><strong>Develop policies and plans<\/strong>\u00a0that support individual and community health efforts.<\/div><\/li>\r\n \t<li>\r\n<div><strong>Enforce<\/strong>\u00a0laws and regulations that protect health and ensure safety.<\/div><\/li>\r\n \t<li>\r\n<div><strong>Link<\/strong>\u00a0people to needed personal health services and assure the provision of health care when otherwise unavailable.<\/div><\/li>\r\n \t<li>\r\n<div><strong>Ensure<\/strong>\u00a0competent public and personal health care workforces.<\/div><\/li>\r\n \t<li>\r\n<div><strong>Evaluate<\/strong>\u00a0effectiveness, accessibility, and quality of personal and population-based health services.<\/div><\/li>\r\n \t<li>\r\n<div><strong>Research<\/strong>\u00a0for new insights and innovative solutions to health problems.<\/div><\/li>\r\n<\/ol>\r\n<p align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph3.PNG\" alt=\"essential services described\" width=\"558\" height=\"415\" \/><\/p>\r\nChanges in the health system and other factors are prompting new roles for public health agencies, a growing focus on the integration of public health and primary care, a deeper examination of financing options for foundational or core services, and new strategies to deliver services more efficiently and effectively. One such example is cross-jurisdictional sharing, which can range from supporting informal collaborations to sharing defined services such as laboratory testing,\u00a0<sup>\u00a0<\/sup>to more formal changes in structure, such as consolidating public health agencies.\r\n<p align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph4.PNG\" alt=\"federal ph responsiblities\" width=\"554\" height=\"478\" \/><\/p>\r\n<p align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph5.PNG\" alt=\"\" width=\"555\" height=\"421\" \/><\/p>\r\nPublic health data must be accurate, relevant, and timely to inform public health action. National surveys, such as those sent to epidemiologists, laboratories, and health departments, play an important role in understanding the public health infrastructure. National surveillance and reporting systems also play a vital role. Efforts are underway to improve the content of surveys, data collection for major population groups, and timely access to data through public reports and data files. These national surveys and monitoring systems should be sustained, strengthened, and harmonized.\r\n\r\nContinuing to strengthen the evidence base for effective community interventions and for the effective organization, administration, and financing of public health services is critical to the future development of public health infrastructure. Public health services and systems research plays an important role in the development of this evidence base; support should be expanded over the decade, with a strong focus on translating research into practice.\r\n<p align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph6.PNG\" alt=\"\" width=\"551\" height=\"413\" \/><\/p>\r\n<p align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph7.PNG\" alt=\"\" width=\"550\" height=\"412\" \/><\/p>\r\n<p align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph8.PNG\" alt=\"\" width=\"551\" height=\"413\" \/><\/p>\r\n<p align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph9.PNG\" alt=\"\" width=\"552\" height=\"417\" \/><\/p>\r\n<p align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph910.PNG\" alt=\"\" width=\"551\" height=\"415\" \/><\/p>\r\n<p align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph11.PNG\" alt=\"\" width=\"552\" height=\"415\" \/><\/p>\r\n<p align=\"center\"><a href=\"https:\/\/www.healthypeople.gov\/2020\/topics-objectives\/topic\/public-health-infrastructure\" target=\"_blank\" rel=\"noopener\">https:\/\/www.healthypeople.gov\/2020\/topics-objectives\/topic\/public-health-infrastructure<\/a><\/p>\r\n\r\n<div class=\"no-overflow\">\r\n<h3 id=\"yui_3_17_2_1_1513621383692_67\">10 Essential Public Health Services<\/h3>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess1.PNG\" alt=\"\" width=\"560\" height=\"420\" \/><\/div>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess2.PNG\" alt=\"\" width=\"559\" height=\"417\" \/><\/div>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess3.PNG\" alt=\"\" width=\"560\" height=\"417\" \/><\/div>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess4.PNG\" alt=\"\" width=\"558\" height=\"418\" \/><\/div>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess5.PNG\" alt=\"\" width=\"557\" height=\"418\" \/><\/div>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess7.PNG\" alt=\"\" width=\"560\" height=\"421\" \/><\/div>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess6.PNG\" alt=\"\" width=\"556\" height=\"421\" \/><\/div>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess8.PNG\" alt=\"\" width=\"560\" height=\"418\" \/><\/div>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess9.PNG\" alt=\"\" width=\"559\" height=\"419\" \/><\/div>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess10.PNG\" alt=\"\" width=\"561\" height=\"420\" \/><\/div>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess11.PNG\" alt=\"\" width=\"557\" height=\"418\" \/><\/div>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess12.PNG\" alt=\"\" width=\"559\" height=\"421\" \/><\/div>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess13.PNG\" alt=\"\" width=\"559\" height=\"416\" \/><\/div>\r\n<div align=\"center\"><img class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess14.PNG\" alt=\"\" width=\"558\" height=\"419\" \/><\/div>\r\n<\/div>\r\n<h3>Progress in Public Health<\/h3>\r\n<div id=\"yui_3_17_2_1_1513621402897_68\">Public health in the US works in the public interest. Consider the positive impact in daily life attributed to public health policy and action:\u00a0 food safety\/restaurant inspections, fluoridated water, seatbelt use, unleaded gasoline, influenza vaccine programs, trans-fats and other nutritional information, public health response to the most recent disaster.<\/div>\r\n<div><\/div>\r\n<div align=\"center\"><img role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3515\/progress%207.PNG\" alt=\"\" width=\"545\" height=\"411\" \/><\/div>\r\n<div align=\"center\">\u2022Since 1900, the average life expectancy for Americans has increased about 30 years; 25 of those years are attributed to public health initiatives<\/div>\r\n<div align=\"center\">\u20221950 - in anti-tuberculosis efforts, more than 2 million X-ray examinations were made by the Public Health Service<\/div>\r\n<div align=\"center\">\u20221977 - Worldwide eradication of smallpox (as recently as 1958, two million people a year die from smallpox)<\/div>\r\n<div align=\"center\">\u20221990\u2019s \u2013 only 4.4% of US children have elevated blood lead levels (in the 1970\u2019s, 88.2% had elevated blood lead levels)<\/div>\r\n<div align=\"center\">\u2022A combination of medical progress and public health efforts have nearly eliminated deaths from previously-rampant childhood diseases such as<\/div>\r\n<div align=\"center\">\u2013Measles<\/div>\r\n<div align=\"center\">\u2013Diphtheria<\/div>\r\n<div align=\"center\">\u2013Scarlet fever<\/div>\r\n<div align=\"center\">\u2013Whooping cough<\/div>\r\n<div align=\"center\"><img role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3515\/progress%201.PNG\" alt=\"\" width=\"551\" height=\"413\" \/><\/div>\r\n<p align=\"center\"><b><\/b><i><\/i><u><\/u><img role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3515\/progress%202.PNG\" alt=\"\" width=\"549\" height=\"411\" \/><\/p>\r\n<p align=\"left\">In recent years, a series of different public health threats emphasized the context of public health in the US. \u00a0These events required responses from more than one geographic area and more than one agency.<\/p>\r\n<p align=\"left\">\u2022<u>Hurricane Sandy:<\/u>\u00a0hit the US in October 2012; was the largest Atlantic hurricane on record; approx. $71\u00a0<u>B<\/u>illion in damages; affected 24 states, but most severe damage in New Jersey and New York, with sea water flooding streets, tunnels, and subway lines.<\/p>\r\n<p align=\"left\">\u2022<u>Salmonella contamination of peanut butter<\/u>: in 2011, the US Food and Drug Administration (FDA), the CDC, and state and local public health officials investigated a multistate (20) outbreak of salmonella infections linked to peanut butter, of special concern because many children eat peanut butter. The collaborative work identified the origin and shut it down quickly. (Source: FDA)<\/p>\r\n<p align=\"left\">\u2022<u>H1N1 Epidemic<\/u>: the H1N1 flu virus caused a worldwide pandemic in 2009 as a new strain of swine origin.\u00a0 It caused about 17,000 deaths by the start of 2010.<\/p>\r\n<p align=\"left\">\u2022Hurricane Katrina in 2005<\/p>\r\n<p align=\"left\">\u20229\/11 attacks on the US in 2001<\/p>\r\n<p align=\"center\"><img role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3515\/progress%203.PNG\" alt=\"\" width=\"551\" height=\"413\" \/><\/p>\r\n<p align=\"left\">\u2022The second-strongest hurricane ever recorded in the United States, covered most of Gulf of Mexico<\/p>\r\n<p align=\"left\">\u2022The most deaths occurred in New Orleans, Louisiana, which flooded as the levee system catastrophically failed. Eventually 80% of the city and neighboring parishes became flooded, and the floodwaters lingered for weeks.<\/p>\r\n<p align=\"left\">\u2022The worst property damage occurred in coastal areas, such as all the\u00a0 beachfront towns in Mississippi, which were flooded over 90% within hours, with waters reaching 6\u201312\u00a0miles inland (10\u201319\u00a0kilometers) from the beach.<\/p>\r\n<p align=\"left\">\u2022Due to these events, much\u00a0 federal funding and focus was placed on preparedness and emergency response.<\/p>\r\n<p align=\"left\">\u2022However, state and local health departments are still responsible for addressing those population-based health issues in their communities.<\/p>\r\n<p align=\"center\"><img role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3515\/progress%204.PNG\" alt=\"\" width=\"554\" height=\"411\" \/><\/p>\r\n<p align=\"left\">\u2022Two planes crashed into the north and south towers of the World Trade Center in New York.<\/p>\r\n<p align=\"left\">\u2022A third plane crashed into the Pentagon in Washington DC (the headquarters of the US Department of Defense).<\/p>\r\n<p align=\"left\">\u2022The fourth plane crashed into a field in Pennsylvania after the passengers tried to overcome the hijackers.\u00a0 It had originally targeted the US Capitol in Washington DC.<\/p>\r\n<p align=\"left\">\u2022Over 3,000 people were killed during the attacks in New York City and Washington, DC, including more than 400 police officers and firefighters.<\/p>\r\n<p align=\"left\">\u2022The attacks fundamentally changed the attitude toward terrorist attacks in the US and prompted increased planning and funding for preparedness.<\/p>\r\n<p align=\"center\"><img role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3515\/progress%205.PNG\" alt=\"\" width=\"548\" height=\"413\" \/><\/p>\r\n<p align=\"left\">Current life expectancy in 2013 is 78.7 years<\/p>\r\n<p align=\"left\">Life expectancy has been extended (in part) by these achievements:<\/p>\r\n<p align=\"left\"><u>Vaccination<\/u>\u2014There are now 50,000 fewer cases of smallpox than occurred in 1900; 900,000 fewer cases of measles than occurred in 1941; 21,000 fewer cases of polio than occurred in 1951. Programs of population-wide vaccinations\u00a0resulted in the eradication of smallpox; elimination of polio in the Americas; and control of measles, rubella, tetanus, and diphtheria in the US and other parts of the world.<\/p>\r\n<p align=\"left\"><u>Motor<\/u><u>\u00a0<\/u><u>vehicle safety<\/u>\u2014Since 1925, the annual death rate from motor vehicle travel has decreased 90%. Seat belts have saved approximately 85,000 lives; child safety seats have reduced risk of infant death by 69%. Community awareness and DWI (driving while intoxicated) regulations have helped reduce alcohol-related deaths by 32%.<\/p>\r\n<p align=\"left\"><u>Control of infectious diseases<\/u>\u2014Infections (such as typhoid and cholera),\u00a0major causes of illness and death early in the 20th century, have been reduced dramatically by improved sanitation. Also, the discovery of antimicrobial therapy has been critical to successful public health efforts to control infections such as tuberculosis and sexually transmitted diseases.<\/p>\r\n<p align=\"left\"><u>Decline in deaths from coronary heart disease and stroke<\/u>\u2014Deaths from coronary heart disease and stroke have declined due to risk-factor modification, such as smoking cessation and blood pressure control. Since 1972, death rates for coronary heart disease has decreased 51%.<\/p>\r\n<p align=\"left\"><u>Recognition of tobacco use as a health hazard<\/u>\u2014Recognition of tobacco use as a health hazard\u00a0in 1964 has resulted in\u00a0reduced use and reduced exposure to secondhand tobacco smoke.<\/p>\r\n<p align=\"left\"><u>Healthier mothers and babies<\/u>\u2014Healthier mothers and babies\u00a0are a\u00a0result of better hygiene and nutrition, antibiotics, access to health care, technology in maternal and neonatal medicine, and immunizations. Since 1900, infant mortality has decreased more than 90%, and maternal mortality has decreased 99%.<\/p>\r\n<p align=\"center\"><img role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3515\/progress%206.PNG\" alt=\"\" width=\"551\" height=\"412\" \/><\/p>\r\n\r\n<h3>Resources and References<\/h3>\r\nReferences\r\n<div>\u2022Nationally Notifiable Infectious Conditions - United States 2010. (2010). Retrieved December 6, 2011, from Centers for Disease Control and Prevention - Office of Surveillance, Epidemiology, and Laboratory Services website:\u00a0<a href=\"http:\/\/www.cdc.gov\/osels\/ph_surveillance\/nndss\/phs\/infdis2010.htm\"><u>http:\/\/www.cdc.gov\/osels\/ph_surveillance\/nndss\/phs\/infdis2010.htm<\/u><\/a>.<\/div>\r\n<div>\u2022Leading Causes of Death. (2007). Retrieved December 6, 2011, from Centers for Disease Control and Prevention website:\u00a0<a href=\"http:\/\/www.cdc.gov\/nchs\/fastats\/lcod.htm\"><u>http:\/\/www.cdc.gov\/nchs\/fastats\/lcod.htm<\/u><\/a>.<\/div>\r\n<div>\u2022Public Health Achievements in the 20th Century. (1999). Morbidity &amp; Mortality Weekly Report , 48(12), 241-243.<\/div>\r\n<div>\u2022Historical Highlights. (2010). Retrieved December 6, 2011, from US Department of Health &amp; Human Services website:\u00a0<a href=\"http:\/\/www.hhs.gov\/about\/hhshist.html\"><u>http:\/\/www.hhs.gov\/about\/hhshist.html<\/u><\/a>.<\/div>\r\n<div>\u2022Our History - Our Story. (2011). Retrieved December 6, 2011, from Centers for Disease Control and Prevention website:\u00a0<a href=\"http:\/\/www.cdc.gov\/about\/history\/ourstory.htm\"><u>http:\/\/www.cdc.gov\/about\/history\/ourstory.htm<\/u><\/a><\/div>\r\n<\/div>\r\n<\/div>","rendered":"<h4 style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3512\/Overview%20of%20PH%20objectives.PNG\" alt=\"\" width=\"628\" height=\"179\" \/><\/h4>\n<h4>The Public Health System and the 10 Essential Public Health Services<\/h4>\n<div>\n<div><\/div>\n<div id=\"socialMediaShareContainer\" style=\"margin: auto;\">\n<div>\n<ul>\n<li><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_middle\" src=\"https:\/\/www.cdc.gov\/nphpsp\/images\/phs-figure1.gif\" alt=\"Web of connected eggs showing different components of the public health system including, but not limited to, the public health agency, non-profit organizations, nursing homes, community centers, and mental health.\" width=\"577\" height=\"403\" \/><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"contentArea\">\n<div>\n<p style=\"text-align: center;\"><strong>\u00a0\u00a0The Public Health System<\/strong><\/p>\n<h3>The Public Health System<\/h3>\n<p>Public health systems are commonly defined as \u201call public, private, and voluntary entities that contribute to the delivery of essential public health services within a jurisdiction.\u201d This concept ensures that all entities\u2019 contributions to the health and well-being of the community or state are recognized in assessing the provision of public health services.<\/p>\n<p>The public health system includes<\/p>\n<ul>\n<li>Public health agencies at state and local levels<\/li>\n<li>Healthcare providers<\/li>\n<li>Public safety agencies<\/li>\n<li>Human service and charity organizations<\/li>\n<li>Education and youth development organizations<\/li>\n<li>Recreation and arts-related organizations<\/li>\n<li>Economic and philanthropic organizations<\/li>\n<li>Environmental agencies and organizations<\/li>\n<\/ul>\n<div>\n<div>\n<p>Public Health 101 (<a href=\"https:\/\/www.cdc.gov\/stltpublichealth\/docs\/usph101.pptx\" target=\"_blank\" rel=\"noopener\"><u>PPT<\/u><u>[3.15MB]<\/u><u>(https:\/\/www.cdc.gov\/stltpublichealth\/docs\/usph101.pptx)<\/u><\/a>,<br \/>\nLearn about the components of the US public health system and how they work together to improve the nation&#8217;s health. You may customize and use this presentation for your own informational and educational purposes.<\/p>\n<\/div>\n<\/div>\n<h3>The 10 Essential Public Health Services<\/h3>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_middle\" src=\"https:\/\/www.cdc.gov\/nphpsp\/images\/phs-figure2.gif\" alt=\"Graphic to describe the 10 essential public health services as spokes in a wheel. Essential services are then linked to the 3 core functions of public health: assessment, policy development and assurance.\" width=\"500\" height=\"450\" \/><\/div>\n<p style=\"text-align: center;\"><strong>The 10 Essential Public Health Services<\/strong><\/p>\n<p>The 10 Essential Public Health Services describe the public health activities that all communities should undertake and serve as the framework for the NPHPS instruments. Public health systems should<\/p>\n<ol>\n<li>Monitor health status to identify and solve community health problems.<\/li>\n<li>Diagnose and investigate health problems and health hazards in the community.<\/li>\n<li>Inform, educate, and empower people about health issues.<\/li>\n<li>Mobilize community partnerships and action to identify and solve health problems.<\/li>\n<li>Develop policies and plans that support individual and community health efforts.<\/li>\n<li>Enforce laws and regulations that protect health and ensure safety.<\/li>\n<li>Link people to needed personal health services and assure the provision of health care when otherwise unavailable.<\/li>\n<li>Assure competent public and personal health care workforce.<\/li>\n<li>Evaluate effectiveness, accessibility, and quality of personal and population-based health services.<\/li>\n<li>Research for new insights and innovative solutions to health problems.<\/li>\n<\/ol>\n<h3>Philosophy of Public Health<\/h3>\n<p id=\"yui_3_17_2_1_1513621316342_68\">Public health is concerned with promoting and protecting the health of populations. Public health action\u00a0 occurs at the international, national, state and local level. Most communities are\u00a0served by health departments whose services include\u00a0the collection and use of epidemiological data for population surveillance of disease.\u00a0Health promotion and the\u00a0protection of\u00a0population health occurs at the global level,\u00a0 World Health Organization (WHO), and at the national level\u00a0under the Centers for Disease Control and Prevention, the Food and Drug Administration, the Environmental Protection Agency and the Consumer Protection Agency as public health agencies.<\/p>\n<p>Moral foundations and justifications for public health and the challenges\u00a0faced due to limited resources are the ethical issues\u00a0debated that view public health as\u00a0a social justice, poverty and health disparity concern. Public health policy seeks to balance the greater health outcomes with individual liberties, for example, the immunization debate.<\/p>\n<p>Public health has two primary aims, prevention and health promotion. Prevention\u00a0 is action taken to prevent the occurrence of an event or to minimize its effects after it has occurred. Three levels of prevention are described as<\/p>\n<ul>\n<li>\n<div>primary\u00a0prevention &#8211; aimed at reducing risk, such as immunization<\/div>\n<\/li>\n<li>\n<div>secondary prevention- aimed at detecting and treating disease at early stages, such as screenings (mammograms)<\/div>\n<\/li>\n<li>\n<div>tertiary prevention &#8211; treatment aimed at modifying risk factors of disease, such as cardiac rehabilitation<\/div>\n<\/li>\n<\/ul>\n<p>Health promotion refers to strategies that seeks to eliminate or reduce exposures to risk factors of disease\u00a0by modifying human behaviors.<\/p>\n<p>\u2022Incidence \u2013Number of new cases that develop of a particular disease\/injury<\/p>\n<p>\u2022Prevalence \u2013Proportion of people who have the disease at a specific point in time<\/p>\n<p>\u2022Morbidity \u2013The relative incidence of a particular disease<\/p>\n<p>\u2022Mortality \u2013The number of deaths that occur at a specific time, in a specific group, or from a specific cause<\/p>\n<p>\u2022Birth rate \u2013Number of live births per one thousand women<\/p>\n<p>\u2022Fertility rate \u2013Number of live births per one\u00a0thousand women between fifteen<\/p>\n<p>and forty-four years of age, generally considered a woman&#8217;s prime childbearing years<\/p>\n<p>\u2022Infant Mortality \u2013Number of live born infants who die before their first birthday per one thousand live births<\/p>\n<p>\u2022Life expectancy \u2013Number of additional years of life expected at a specific point in time, such as at birth or at age 45<\/p>\n<p>\u2022Epidemiology \u2013Study of distribution and causes of health-related states or events in populations<\/p>\n<p>\u2013Application of the study to control health<\/p>\n<p>\u2022Epidemiology \u2013Study of distribution and causes of health-related states or events in populations<\/p>\n<p>\u2022Surveillance \u2013Systematic collection, analysis, interpretation, and dissemination of health data on an ongoing basis<\/p>\n<p>\u2022Epidemic \u2013Occurrence of more cases of disease than expected in a given area or among a specific group of people over a particular period of time<\/p>\n<p>\u2022Pandemic \u2013Epidemic occurring in a wide geographical area and usually affecting large part of population<\/p>\n<p>\u2022Endemic \u2013Constant presence of a disease or infection within a geographic area or population group.<\/p>\n<p>Source:\u00a0 (CDC Glossary)<\/p>\n<h3 id=\"yui_3_17_2_1_1513621356013_67\">Levels of Public Health<\/h3>\n<h4 id=\"yui_3_17_2_1_1513621356013_71\">Three general levels of public health \u2013 local, state, federal<\/h4>\n<div>Most \u2013 but not all \u2013 states are associated with a network of local or county health departments<\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph1.PNG\" alt=\"state and local health departments diagram\" width=\"550\" height=\"412\" \/><\/div>\n<p>Public health infrastructure provides communities, states, and the Nation the capacity to prevent disease, promote health, and prepare for and respond to both acute (emergency) threats and chronic (ongoing) challenges to health. Infrastructure is the foundation for planning, delivering, evaluating, and improving public health. All public health services depend on the presence of basic infrastructure. Every public health program\u2014such as immunizations, infectious disease monitoring, cancer and asthma prevention, drinking water quality, injury prevention\u2014requires health professionals who are competent in cross-cutting and technical skills, up-to-date information systems, and public health organizations with the capacity to assess and respond to community health needs. While a strong infrastructure depends on many organizations, public health agencies (health departments) are considered primary players. Federal agencies rely on the presence of solid public health infrastructure at all levels<u><sup>\u00a0\u00a0<\/sup><\/u>to support the implementation of public health programs and policies and to respond to health threats, including those from other countries.<\/p>\n<div>\n<div>Public health infrastructure can best be described by what it is and what it does. It includes three key components:<\/div>\n<\/div>\n<ul>\n<li>\n<div>A capable and qualified workforce<\/div>\n<\/li>\n<li>\n<div>Up-to-date data and information systems<\/div>\n<\/li>\n<li>\n<div>Agencies capable of assessing and responding to public health needs<\/div>\n<\/li>\n<\/ul>\n<p>Public health infrastructure provides the necessary foundation for undertaking the basic responsibilities of public health, which have been defined as the 10 Essential Public Health Services:<\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph2.PNG\" alt=\"essential services of public health\" width=\"554\" height=\"417\" \/><\/p>\n<ol>\n<li>\n<div><strong>Monitor<\/strong>\u00a0health status to identify and solve community health problems.<\/div>\n<\/li>\n<li>\n<div><strong>Diagnose and investigate<\/strong>\u00a0health problems and health hazards in the community.<\/div>\n<\/li>\n<li>\n<div><strong>Inform<\/strong>,<strong>\u00a0educate<\/strong>,<strong>\u00a0<\/strong>and<strong>\u00a0empower<\/strong>\u00a0people about health issues.<\/div>\n<\/li>\n<li>\n<div><strong>Mobilize<\/strong>\u00a0community partnerships and action to identify and solve health problems.<\/div>\n<\/li>\n<li>\n<div><strong>Develop policies and plans<\/strong>\u00a0that support individual and community health efforts.<\/div>\n<\/li>\n<li>\n<div><strong>Enforce<\/strong>\u00a0laws and regulations that protect health and ensure safety.<\/div>\n<\/li>\n<li>\n<div><strong>Link<\/strong>\u00a0people to needed personal health services and assure the provision of health care when otherwise unavailable.<\/div>\n<\/li>\n<li>\n<div><strong>Ensure<\/strong>\u00a0competent public and personal health care workforces.<\/div>\n<\/li>\n<li>\n<div><strong>Evaluate<\/strong>\u00a0effectiveness, accessibility, and quality of personal and population-based health services.<\/div>\n<\/li>\n<li>\n<div><strong>Research<\/strong>\u00a0for new insights and innovative solutions to health problems.<\/div>\n<\/li>\n<\/ol>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph3.PNG\" alt=\"essential services described\" width=\"558\" height=\"415\" \/><\/p>\n<p>Changes in the health system and other factors are prompting new roles for public health agencies, a growing focus on the integration of public health and primary care, a deeper examination of financing options for foundational or core services, and new strategies to deliver services more efficiently and effectively. One such example is cross-jurisdictional sharing, which can range from supporting informal collaborations to sharing defined services such as laboratory testing,\u00a0<sup>\u00a0<\/sup>to more formal changes in structure, such as consolidating public health agencies.<\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph4.PNG\" alt=\"federal ph responsiblities\" width=\"554\" height=\"478\" \/><\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph5.PNG\" alt=\"\" width=\"555\" height=\"421\" \/><\/p>\n<p>Public health data must be accurate, relevant, and timely to inform public health action. National surveys, such as those sent to epidemiologists, laboratories, and health departments, play an important role in understanding the public health infrastructure. National surveillance and reporting systems also play a vital role. Efforts are underway to improve the content of surveys, data collection for major population groups, and timely access to data through public reports and data files. These national surveys and monitoring systems should be sustained, strengthened, and harmonized.<\/p>\n<p>Continuing to strengthen the evidence base for effective community interventions and for the effective organization, administration, and financing of public health services is critical to the future development of public health infrastructure. Public health services and systems research plays an important role in the development of this evidence base; support should be expanded over the decade, with a strong focus on translating research into practice.<\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph6.PNG\" alt=\"\" width=\"551\" height=\"413\" \/><\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph7.PNG\" alt=\"\" width=\"550\" height=\"412\" \/><\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph8.PNG\" alt=\"\" width=\"551\" height=\"413\" \/><\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph9.PNG\" alt=\"\" width=\"552\" height=\"417\" \/><\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph910.PNG\" alt=\"\" width=\"551\" height=\"415\" \/><\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3513\/ph11.PNG\" alt=\"\" width=\"552\" height=\"415\" \/><\/p>\n<p style=\"text-align: center;\"><a href=\"https:\/\/www.healthypeople.gov\/2020\/topics-objectives\/topic\/public-health-infrastructure\" target=\"_blank\" rel=\"noopener\">https:\/\/www.healthypeople.gov\/2020\/topics-objectives\/topic\/public-health-infrastructure<\/a><\/p>\n<div class=\"no-overflow\">\n<h3 id=\"yui_3_17_2_1_1513621383692_67\">10 Essential Public Health Services<\/h3>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess1.PNG\" alt=\"\" width=\"560\" height=\"420\" \/><\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess2.PNG\" alt=\"\" width=\"559\" height=\"417\" \/><\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess3.PNG\" alt=\"\" width=\"560\" height=\"417\" \/><\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess4.PNG\" alt=\"\" width=\"558\" height=\"418\" \/><\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess5.PNG\" alt=\"\" width=\"557\" height=\"418\" \/><\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess7.PNG\" alt=\"\" width=\"560\" height=\"421\" \/><\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess6.PNG\" alt=\"\" width=\"556\" height=\"421\" \/><\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess8.PNG\" alt=\"\" width=\"560\" height=\"418\" \/><\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess9.PNG\" alt=\"\" width=\"559\" height=\"419\" \/><\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess10.PNG\" alt=\"\" width=\"561\" height=\"420\" \/><\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess11.PNG\" alt=\"\" width=\"557\" height=\"418\" \/><\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess12.PNG\" alt=\"\" width=\"559\" height=\"421\" \/><\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess13.PNG\" alt=\"\" width=\"559\" height=\"416\" \/><\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" class=\"img-responsive atto_image_button_text-bottom\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3514\/ess14.PNG\" alt=\"\" width=\"558\" height=\"419\" \/><\/div>\n<\/div>\n<h3>Progress in Public Health<\/h3>\n<div id=\"yui_3_17_2_1_1513621402897_68\">Public health in the US works in the public interest. Consider the positive impact in daily life attributed to public health policy and action:\u00a0 food safety\/restaurant inspections, fluoridated water, seatbelt use, unleaded gasoline, influenza vaccine programs, trans-fats and other nutritional information, public health response to the most recent disaster.<\/div>\n<div><\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3515\/progress%207.PNG\" alt=\"\" width=\"545\" height=\"411\" \/><\/div>\n<div style=\"margin: auto;\">\u2022Since 1900, the average life expectancy for Americans has increased about 30 years; 25 of those years are attributed to public health initiatives<\/div>\n<div style=\"margin: auto;\">\u20221950 &#8211; in anti-tuberculosis efforts, more than 2 million X-ray examinations were made by the Public Health Service<\/div>\n<div style=\"margin: auto;\">\u20221977 &#8211; Worldwide eradication of smallpox (as recently as 1958, two million people a year die from smallpox)<\/div>\n<div style=\"margin: auto;\">\u20221990\u2019s \u2013 only 4.4% of US children have elevated blood lead levels (in the 1970\u2019s, 88.2% had elevated blood lead levels)<\/div>\n<div style=\"margin: auto;\">\u2022A combination of medical progress and public health efforts have nearly eliminated deaths from previously-rampant childhood diseases such as<\/div>\n<div style=\"margin: auto;\">\u2013Measles<\/div>\n<div style=\"margin: auto;\">\u2013Diphtheria<\/div>\n<div style=\"margin: auto;\">\u2013Scarlet fever<\/div>\n<div style=\"margin: auto;\">\u2013Whooping cough<\/div>\n<div style=\"margin: auto;\"><img loading=\"lazy\" decoding=\"async\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3515\/progress%201.PNG\" alt=\"\" width=\"551\" height=\"413\" \/><\/div>\n<p style=\"text-align: center;\"><b><\/b><i><\/i><u><\/u><img loading=\"lazy\" decoding=\"async\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3515\/progress%202.PNG\" alt=\"\" width=\"549\" height=\"411\" \/><\/p>\n<p style=\"text-align: left;\">In recent years, a series of different public health threats emphasized the context of public health in the US. \u00a0These events required responses from more than one geographic area and more than one agency.<\/p>\n<p style=\"text-align: left;\">\u2022<u>Hurricane Sandy:<\/u>\u00a0hit the US in October 2012; was the largest Atlantic hurricane on record; approx. $71\u00a0<u>B<\/u>illion in damages; affected 24 states, but most severe damage in New Jersey and New York, with sea water flooding streets, tunnels, and subway lines.<\/p>\n<p style=\"text-align: left;\">\u2022<u>Salmonella contamination of peanut butter<\/u>: in 2011, the US Food and Drug Administration (FDA), the CDC, and state and local public health officials investigated a multistate (20) outbreak of salmonella infections linked to peanut butter, of special concern because many children eat peanut butter. The collaborative work identified the origin and shut it down quickly. (Source: FDA)<\/p>\n<p style=\"text-align: left;\">\u2022<u>H1N1 Epidemic<\/u>: the H1N1 flu virus caused a worldwide pandemic in 2009 as a new strain of swine origin.\u00a0 It caused about 17,000 deaths by the start of 2010.<\/p>\n<p style=\"text-align: left;\">\u2022Hurricane Katrina in 2005<\/p>\n<p style=\"text-align: left;\">\u20229\/11 attacks on the US in 2001<\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3515\/progress%203.PNG\" alt=\"\" width=\"551\" height=\"413\" \/><\/p>\n<p style=\"text-align: left;\">\u2022The second-strongest hurricane ever recorded in the United States, covered most of Gulf of Mexico<\/p>\n<p style=\"text-align: left;\">\u2022The most deaths occurred in New Orleans, Louisiana, which flooded as the levee system catastrophically failed. Eventually 80% of the city and neighboring parishes became flooded, and the floodwaters lingered for weeks.<\/p>\n<p style=\"text-align: left;\">\u2022The worst property damage occurred in coastal areas, such as all the\u00a0 beachfront towns in Mississippi, which were flooded over 90% within hours, with waters reaching 6\u201312\u00a0miles inland (10\u201319\u00a0kilometers) from the beach.<\/p>\n<p style=\"text-align: left;\">\u2022Due to these events, much\u00a0 federal funding and focus was placed on preparedness and emergency response.<\/p>\n<p style=\"text-align: left;\">\u2022However, state and local health departments are still responsible for addressing those population-based health issues in their communities.<\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3515\/progress%204.PNG\" alt=\"\" width=\"554\" height=\"411\" \/><\/p>\n<p style=\"text-align: left;\">\u2022Two planes crashed into the north and south towers of the World Trade Center in New York.<\/p>\n<p style=\"text-align: left;\">\u2022A third plane crashed into the Pentagon in Washington DC (the headquarters of the US Department of Defense).<\/p>\n<p style=\"text-align: left;\">\u2022The fourth plane crashed into a field in Pennsylvania after the passengers tried to overcome the hijackers.\u00a0 It had originally targeted the US Capitol in Washington DC.<\/p>\n<p style=\"text-align: left;\">\u2022Over 3,000 people were killed during the attacks in New York City and Washington, DC, including more than 400 police officers and firefighters.<\/p>\n<p style=\"text-align: left;\">\u2022The attacks fundamentally changed the attitude toward terrorist attacks in the US and prompted increased planning and funding for preparedness.<\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3515\/progress%205.PNG\" alt=\"\" width=\"548\" height=\"413\" \/><\/p>\n<p style=\"text-align: left;\">Current life expectancy in 2013 is 78.7 years<\/p>\n<p style=\"text-align: left;\">Life expectancy has been extended (in part) by these achievements:<\/p>\n<p style=\"text-align: left;\"><u>Vaccination<\/u>\u2014There are now 50,000 fewer cases of smallpox than occurred in 1900; 900,000 fewer cases of measles than occurred in 1941; 21,000 fewer cases of polio than occurred in 1951. Programs of population-wide vaccinations\u00a0resulted in the eradication of smallpox; elimination of polio in the Americas; and control of measles, rubella, tetanus, and diphtheria in the US and other parts of the world.<\/p>\n<p style=\"text-align: left;\"><u>Motor<\/u><u>\u00a0<\/u><u>vehicle safety<\/u>\u2014Since 1925, the annual death rate from motor vehicle travel has decreased 90%. Seat belts have saved approximately 85,000 lives; child safety seats have reduced risk of infant death by 69%. Community awareness and DWI (driving while intoxicated) regulations have helped reduce alcohol-related deaths by 32%.<\/p>\n<p style=\"text-align: left;\"><u>Control of infectious diseases<\/u>\u2014Infections (such as typhoid and cholera),\u00a0major causes of illness and death early in the 20th century, have been reduced dramatically by improved sanitation. Also, the discovery of antimicrobial therapy has been critical to successful public health efforts to control infections such as tuberculosis and sexually transmitted diseases.<\/p>\n<p style=\"text-align: left;\"><u>Decline in deaths from coronary heart disease and stroke<\/u>\u2014Deaths from coronary heart disease and stroke have declined due to risk-factor modification, such as smoking cessation and blood pressure control. Since 1972, death rates for coronary heart disease has decreased 51%.<\/p>\n<p style=\"text-align: left;\"><u>Recognition of tobacco use as a health hazard<\/u>\u2014Recognition of tobacco use as a health hazard\u00a0in 1964 has resulted in\u00a0reduced use and reduced exposure to secondhand tobacco smoke.<\/p>\n<p style=\"text-align: left;\"><u>Healthier mothers and babies<\/u>\u2014Healthier mothers and babies\u00a0are a\u00a0result of better hygiene and nutrition, antibiotics, access to health care, technology in maternal and neonatal medicine, and immunizations. Since 1900, infant mortality has decreased more than 90%, and maternal mortality has decreased 99%.<\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" role=\"presentation\" src=\"https:\/\/clinton.delhi.edu\/pluginfile.php\/30263\/mod_book\/chapter\/3515\/progress%206.PNG\" alt=\"\" width=\"551\" height=\"412\" \/><\/p>\n<h3>Resources and References<\/h3>\n<p>References<\/p>\n<div>\u2022Nationally Notifiable Infectious Conditions &#8211; United States 2010. (2010). Retrieved December 6, 2011, from Centers for Disease Control and Prevention &#8211; Office of Surveillance, Epidemiology, and Laboratory Services website:\u00a0<a href=\"http:\/\/www.cdc.gov\/osels\/ph_surveillance\/nndss\/phs\/infdis2010.htm\"><u>http:\/\/www.cdc.gov\/osels\/ph_surveillance\/nndss\/phs\/infdis2010.htm<\/u><\/a>.<\/div>\n<div>\u2022Leading Causes of Death. (2007). Retrieved December 6, 2011, from Centers for Disease Control and Prevention website:\u00a0<a href=\"http:\/\/www.cdc.gov\/nchs\/fastats\/lcod.htm\"><u>http:\/\/www.cdc.gov\/nchs\/fastats\/lcod.htm<\/u><\/a>.<\/div>\n<div>\u2022Public Health Achievements in the 20th Century. (1999). Morbidity &amp; Mortality Weekly Report , 48(12), 241-243.<\/div>\n<div>\u2022Historical Highlights. (2010). Retrieved December 6, 2011, from US Department of Health &amp; Human Services website:\u00a0<a href=\"http:\/\/www.hhs.gov\/about\/hhshist.html\"><u>http:\/\/www.hhs.gov\/about\/hhshist.html<\/u><\/a>.<\/div>\n<div>\u2022Our History &#8211; Our Story. (2011). Retrieved December 6, 2011, from Centers for Disease Control and Prevention website:\u00a0<a href=\"http:\/\/www.cdc.gov\/about\/history\/ourstory.htm\"><u>http:\/\/www.cdc.gov\/about\/history\/ourstory.htm<\/u><\/a><\/div>\n<\/div>\n<\/div>\n\n\t\t\t <section class=\"citations-section\" role=\"contentinfo\">\n\t\t\t <h3>Candela Citations<\/h3>\n\t\t\t\t\t <div>\n\t\t\t\t\t\t <div id=\"citation-list-84\">\n\t\t\t\t\t\t\t <div class=\"licensing\"><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Shared previously<\/div><ul class=\"citation-list\"><li>OVERVIEW OF PUBLIC HEALTH IN THE UNITED STATES. <strong>Provided by<\/strong>: Clinton Community College . <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/clinton.delhi.edu\/mod\/book\/view.php?id=19651&#038;chapterid=3516\">https:\/\/clinton.delhi.edu\/mod\/book\/view.php?id=19651&#038;chapterid=3516<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><\/ul><\/div>\n\t\t\t\t\t\t <\/div>\n\t\t\t\t\t <\/div>\n\t\t\t <\/section>","protected":false},"author":26254,"menu_order":1,"template":"","meta":{"_candela_citation":"[{\"type\":\"cc\",\"description\":\"OVERVIEW OF PUBLIC HEALTH IN THE UNITED STATES\",\"author\":\"\",\"organization\":\"Clinton Community College \",\"url\":\"https:\/\/clinton.delhi.edu\/mod\/book\/view.php?id=19651&chapterid=3516\",\"project\":\"\",\"license\":\"cc-by\",\"license_terms\":\"\"}]","CANDELA_OUTCOMES_GUID":"","pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-84","chapter","type-chapter","status-publish","hentry"],"part":24,"_links":{"self":[{"href":"https:\/\/courses.lumenlearning.com\/atd-clinton-hsm111\/wp-json\/pressbooks\/v2\/chapters\/84","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/courses.lumenlearning.com\/atd-clinton-hsm111\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/courses.lumenlearning.com\/atd-clinton-hsm111\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/atd-clinton-hsm111\/wp-json\/wp\/v2\/users\/26254"}],"version-history":[{"count":1,"href":"https:\/\/courses.lumenlearning.com\/atd-clinton-hsm111\/wp-json\/pressbooks\/v2\/chapters\/84\/revisions"}],"predecessor-version":[{"id":85,"href":"https:\/\/courses.lumenlearning.com\/atd-clinton-hsm111\/wp-json\/pressbooks\/v2\/chapters\/84\/revisions\/85"}],"part":[{"href":"https:\/\/courses.lumenlearning.com\/atd-clinton-hsm111\/wp-json\/pressbooks\/v2\/parts\/24"}],"metadata":[{"href":"https:\/\/courses.lumenlearning.com\/atd-clinton-hsm111\/wp-json\/pressbooks\/v2\/chapters\/84\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/courses.lumenlearning.com\/atd-clinton-hsm111\/wp-json\/wp\/v2\/media?parent=84"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/atd-clinton-hsm111\/wp-json\/pressbooks\/v2\/chapter-type?post=84"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/atd-clinton-hsm111\/wp-json\/wp\/v2\/contributor?post=84"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/atd-clinton-hsm111\/wp-json\/wp\/v2\/license?post=84"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}