Public Health: What It Is and How It Works, 2nd Edition
CHAPTER 2: UNDERSTANDING AND MEASURING HEALTH
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After completing this part of the textbook, learners will be able to:
present several different definitions of health
identify at least 4 different categories of factors that influence health
for each of the these categories, identify at least 3 different factors that influence health
identify commonly used categories of measures of health status
for each of these categories, identify at least 3 three different measures
understand how information on factors that influence health and measures of health can be used to develop effective interventions for improving health status
describe major trends in health status for the U.S. over the past 100 years
access and utilize comprehensive and current national data on health status and factors influencing health in the U.S.
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Read Chapter 2 of Public Health: What It Is and How It Works, 2nd edition.
Participate in a class discussion of the "Top 10" lists developed from the first chapter.
After completing this chapter, begin the series of individual exercises for learners listed below. These include computer-based exercises that will introduce you to several Internet web sites relevant to the topics presented in Chapter 2. Many of these sites will be useful later in the course.
Work with your group to complete the group exercises described below. By now, you should have been assigned to a group.
After completing the individual and group exercises, take the self-assessment quiz for Chapter 2.
When you have submitted responses to the learner exercises and your group has submitted its position for the first debate, plan to participate in a class discussion of Chapter 2 debate positions.
For learners interested in going beyond the basics, a list of additional readings is provided. This list emphasizes the most up-to-date materials related to the topics addressed in this part of the course.
Each learner is required to attend a meeting of an official board of health and to provide a brief report on that meeting (no more than 300 words describing the issues raised, interests represented, and roles demonstrated by the board at that meeting). Since most boards of health meet only once a month, it is important that you plan this visit well in advance.
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Each learner will submit a brief response (approximately 100 words) to each of the following discussion questions and exercises.
Is poverty a cause of poor health in a community, or is poor health a cause of poverty? How would different views of this question influence public health policy? You have been asked to review and improve the list of the IOM's proposed indicators for a community health profile (also found in Exhibit 2-3, page 74, of the text). Identify and justify 5 indicators you would add to this list.
Visit the Internet web site of one of the national print media (e.g., Chicago Tribune, New York Times, USA Today, Time Magazine, etc) and use their search features to identify recent stories on public health. Catalog the health problems (both conditions and risks) from that search and compare this to the listing of leading causes and actual causes of death from Table 2-4 (page 57 of the text). Are the types of conditions and risks you encountered in the print media similar to those on Table 2-4? Were some conditions and risks either over- or under-represented in the media in comparison to their relative importance as suggested by these other sources? What are the implications for the role of the media in informing and educating the public regarding public health issues.
Links and Sources of General Information on Public Health
Compare the "Public Health Achievements in Twentieth-Century America" (see Century of Progress in Public Health) presented in Chapter 1 (control of infectious diseases) and Chapter 2 (tobacco use). Which of these accomplishments, in your opinion, has had the greatest impact on the heath status and quality of life of Americans living in the early twenty-first century? Justify your selection.
After reviewing "Public Health Achievements in Twentieth-Century America: Tobacco Use," select a health outcome related to tobacco use and analyze that health problem for its determinants and contributing factors, using the method described in the text. Identify at least two major determinants for the problem that you select. For each determinant, identify at least two direct contributing factors, and for each direct contributing factor, identify at least two indirect contributing factors. At what level of your analysis does tobacco use appear as a risk factor?
Population, poverty, and pollution are sometimes cited as the 3 most important factors influencing global health status today. After examining the World Health Organization (WHO) web site, briefly cite your reasons for agreeing or disagreeing with this assertion.
Develop a "Top 10" list of the most important lessons and themes from this part of the course.
Each group will submit a brief response (300 words or less) to the following exercise:
In addition, each group should begin Public Health Practice Exercise 1. Review the background and instructions for this group exercise; these can be found through the web link above. Completion of this exercise will extend over Chapters 2 through 4 of the textbook.
This is a compendium of additional references and web links to selected sources cited in the readings. Also included are selected materials that have become available since the publication date of the text. All links to case studies, web sites, and other documents can also be found on the "Additional Resources" site.
Centers for Disease Control and Prevention. Years of Healthy Life: Selected States, United States, 1993-1995. MMWR 1998;47(No 1)
Centers for Disease Control and Prevention. State Differences in Reported Healthy Days Among Adults--United States, 1993-1996. MMWR 1998;47(No 12)
Centers for Disease Control and Prevention. Health-Related Quality of Life and Activity Limitation--Eight States, 1995. MMWR 1998;47(No 7)
Dever GEA. Improving Outcomes in Public Health Practice: Strategy and Methods. Gaithersburg MD; Aspen Publishers; 1997.
Durch JS, Bailey LA, Soto MA (Eds). Improving Health in the Community: A Role for Performance Monitoring. Washington DC; National Academy Press; 1997.
Frost K, Frank E, Maibach E. Relative Risk in the News Media: A Quantification of Misrepresentation. AJPH 1997;87:842-845. (Abstract)
Lynch JW, Kaplan GA, Pamuk EP, et al. Income Inequality and Mortality in Metropolitan Areas of the Unites States. AJPH 1998;88:1074-1080. (Abstract)
National Center for Health Statistics. "Health, United States 1999" with Health and Aging Chart Book. Washington DC; DHHS-PHS-CDC-NCHS; 1999. Health, United States 1998 (with Socioeconomic Status and Health Chart Book). Washington DC; DHHS-PHS-CDC-NCHS; 1998. Health, United States 1996-1997 (with Injury Chart Book). Washington DC; DHHS-PHS-CDC-NCHS; 1997. (Note: these are very large files that are not easily viewed or downloaded using modem connections to the Internet. Direct Internet connections work best for these materials!)
US Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health. Washington DC; DHHS-PHS; 2000.
Office of Disease Prevention and Health Promotion USDHHS. Developing Objectives for Healthy People 2010. USDHHS; Washington DC; 1997 (or visit the Healthy People 2000 web site for information on both Healthy People 2000 and Healthy People 2010).
Health Resources and Services Administration. Community Health Status Indicators Project. Rockville MD; USDHHS-HRSA; 2000.
A brief self-assessment quiz is available by clicking on Quiz 2.
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