Colorado State The Connection Between Diabetes and Suburban Sprawl Paper Consider the multidisciplinary interactions of biological and social sciences as presented in Chapter 2 of Global Public Health. With this in mind, perform an analysis of the information delivered in this episode about the connection between diabetes and suburban sprawl, as discussed in the text.
Episode One (Links to an external site.)Links to an external site.
https://www.youtube.com/watch?v=7ttyE7ZnupY
Watch the video and look at the suggestions there for improving health in your own community. Once you are satisfied with your review of the episode, write an essay that addresses the following questions:
Begin by summarizing the episode in 100 words or less.
Relate the information from this episode to what you learned in Chapters 1 and 2 of your textbook, Global Public Health. What specific public health disciplines mentioned in Chapter 2 of your textbook are related to the information presented in the video and why?
Critique the information. Do you feel that the information presented is valid and easy to understand?
What information does the episode offer about public health problems? Consider, for example: whether it provides details on how public health can be characterized and measured; and whether it describes common hazards and afflictions affecting modern Americans and American communities.
What information does the episode offer about the nature of communities? Consider whether it provides details on how communities may be altered to improve public health.
What information was missing from the episode? How could the content be improved? What would you like to see in future episodes?
Instructions:
Write a 2- to 3-page paper of about 1,500 words, not including the title and reference pages, which are required.
The paper must be formatted correctly using APA style. Remember, all research material used in your paper must be paraphrased and include an in-text citation.
Be sure you utilize your text appropriately as a reference and cite at least one other credible external reference such as a website or journal article to support your proposed resolution of the case. GLOBAL PUBLIC HEALTH
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Global Public Health
E C O LO G I C A L F O U N DAT I O N S
Franklin White
Lorann Stallones
John Last
1
3
Oxford University Press is a department of the University of Oxford.
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Inquiries concerning reproduction outside the scope of the above should be sent to the
Rights Department, Oxford University Press, at the address above.
You must not circulate this work in any other form
and you must impose this same condition on any acquirer.
Library of Congress Cataloging-in-Publication Data
White, Franklin, 1946Global public health : ecological foundations / Franklin White, Lorann Stallones, John Last.
p. ; cm.
Includes bibliographical references and index.
ISBN 978–0–19–975190–7 (hardback : alk. paper) — ISBN 978–0–19–987699–0 (ebook)
I. Stallones, Lorann. II. Last, John M., 1926- III. Title.
[DNLM: 1. World Health. 2. Ecological and Environmental Processes. 3. Public Health. WA 530.1]
362.1—dc23
2012032257
9 8 7 6 5 4 3 2 1
Printed in the United States of America
on acid-free paper
To our readers: the next generation of public health practitioners, whose decisions
and actions will help secure sound public health capacities for all settings and a
sustainable future globally.
To our families, past and present, for their supportive influence:
Franklin White—my long-deceased father, Professor Frank T.M. White, a
mining and metallurgical engineer and geophysicist with a global outlook, who
was determined to avoid what he saw as the “trap” of developing only within one
culture, whether institution or country; my late mother, Tessie Marian, who built
a loving, stable home for our family in several countries, and who expressed her
appreciation of nature in her paintings; my sister, the late Hilary White-Nunn, a
social worker and community development specialist who tirelessly challenged the
status quo; my children Genevieve, Bernard, and Alexander, for ongoing inspiration
as they shape their own lives in new directions; and my spouse, Debra Nanan, for
her unflinching support and wise counsel, a best friend and worthy colleague.
Lorann Stallones—my father, the late Dr. Reuel A Stallones (“Stony” to his friends
and colleagues), for serving as a mentor, advisor, and phenomenal teacher who
showed me the magic world of public health; my mother, the late Joyce Graves
Walchko, a grassroots activist helping women in Texas locate safe abortion clinics
in Mexico during a dark time when abortions were illegal; and my children, the
late John Byler Nuckols, who was so much like Stony in his love of learning how
everything works and of books, Erin Lorann Nuckols, who is on a path to find a
more sustainable way of preserving our historical buildings and our future through
living a green life, and Jesse Marie Nuckols, who deeply understands how to value and
love all people, especially those with special needs who see the world in unique ways.
John Last—To my family, and in loving memory of Wendy.
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Contents
Preface xiii
1. History, Aims, and Methods of Public Health 1
Definitions of Health 2
A Brief History of Public Health 3
Defining the Magnitude of the Problem 6
Determining the Causes, Risks, Protective Factors, and Population
Affected 8
Safe Environments 9
Occupation and Disease 9
Theories about Cause 10
Develop, Implement, and Evaluate Prevention Programs 12
Sanitation, Hygiene, and Health 12
Enhanced Immunity 14
Nutrition 16
Prudent and Accessible Health Care 18
The Modern History of Public Health 22
Disciplines in Public Health 24
Conclusion 25
2. Ecology and Public Health—The Science Base 26
Biological Environment 26
Physical Environment 29
Social Environment 31
Measuring Health 33
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Contents
Health Information Systems 34
Evidence-Based Public Health 34
Standards of Evidence 34
Aim of Evidence-Based Practice 36
Community-Based Participatory Research 38
Competencies in Public Health 38
Conclusion 40
3. Philosophical and Ethical Foundations of Public Health 54
Ethical Theory 55
Universal Declaration of Human Rights: Article 25 56
Ethical Guidelines 58
Quarantine and Emergency Preparedness 60
Ethics and Environmental Health 62
Environmental Ethics 65
Mandatory or Voluntary Consent for Newborn Screening 66
Public Health Genomics 67
Moral and Political Responsibility for Childhood Obesity 68
Triage in Public Health Emergencies 69
Conclusion 70
4. Community Foundations of Public Health 73
What Are Communities? 73
Why “Community Health”? 74
How Does Community Health Differ from Public Health and
Hospital Services? 76
Nongovernmental Organizations and Voluntarism as a Community Force 77
Community-Based Health Services 78
New Trends in Organizational Forms and Functions—Shifting Sands 81
Community Health as a Vital Ingredient in Health Reform 82
Fundamentals of Community Health—A Synthesis 87
Planning to Involve Communities 88
The Social-Ecological Model of Relationships 89
Involving Communities in Their Health—Selected Case Studies 91
The Importance of Leadership 101
Scaling Up: When Does It Apply, and How Can We Do It? 102
Sustainable Communities 103
Acknowledging Community Development—a Legacy 105
5. Assessing Population Health 106
Demography, Health Situation Analysis, and Public Health Surveillance 106
Role of Demography in Population Health 107
Contents
Population Pyramids 108
Selected Demographic Case Studies 113
Case Study #1: Shifts in Sex Ratios in Asia 113
Case Study #2: Changing Ethnic Composition in the United States 115
Global Demographic and Population Health Resources Online 117
Decoding Global Health Patterns: Population Transition
Theories 118
The Health of Populations: Moving from Assessment to Action 120
Health Situation Analysis 121
Data Sources for Health Situation Analysis 122
Linking Health Situation Analysis to Public Health Action 128
Moving from Assessment to Action—Global Perspective 131
The Millennium Development Goals 131
Public Health Surveillance 134
6. Integrated Approaches to Disease Prevention and Control 144
Overlaps and Interactions Across Disease Groupings 146
Creating Useful Public Health Interventions 148
Epidemiological Transition Theory: Double Burdens and Unfinished
Agendas 150
Natural History of Disease 152
Levels of Prevention 154
Primary Prevention 155
A Case Study of Primary Prevention—Iodine Deficiency Disorders 156
What Ingredients Enabled this Global Elimination Initiative? 158
Secondary Prevention 159
Tertiary Prevention 162
Primordial Prevention 162
Applying Prevention to Public Health Problems: The Haddon Matrix 163
Communicable Diseases 164
Communicable Disease Control 166
Epidemic Theory and Practical Implications 169
Developing Methods of Communicable Disease Control 173
Nutrition and Immunity 178
Noncommunicable Diseases 179
Developing NCD Intervention Options 181
Integrated Approaches 187
Scaling Up Interventions 189
Case Study: Applying Integrated Prevention Principles to Type 2
Diabetes 189
ix
x
Contents
Case Study: Arthritis—An Integrated Approach to Prevention and
Control 192
Chronic Care Management Models 193
Prevention and Control of Mental and Behavioral Disorders 193
Mental and Behavioral Disorders as a Public Health Priority 196
Mental and Behavioral Case Study #1—Problem Gambling 198
Mental and Behavioral Case Study #2—Drug Addiction 199
Integrating Disease Prevention and Control through the Life-Course 201
A Global Perspective on Integrated Health Services 203
Conclusion 204
7. Air, Water, and Food 205
Air 206
Water 209
Waterborne Diseases 215
Vector or Insect-borne Diseases 217
Chemical Contaminants 217
Other Water Contaminants and Injuries 218
Food 219
Food Production 220
Food Safety 220
Sanitary Control of Milk 224
Quality Control in Food Production, Manufacturing, and Preparation 225
Animal Feeding Practices and Disease in Humans 225
Food Security 226
Nutrition 229
Malnutrition 229
Vitamin and Mineral Deficiencies 230
Overnutrition 231
Conclusion 233
8. Public Health Organization and Function in Evolving Health Systems 234
Comparative Health Systems—An Overview 234
Health Sector Reform 239
Role of the Private Sector 241
Organization of Public Health Services within Countries 244
Organization of Public Health Between Countries—International
and Global Health 250
Multilateral Agencies 251
Bilateral Agencies 254
Contents
International Nongovernmental Organizations 255
Other Agencies 256
Strategic Leadership and Management in Public Health Services 256
Results Based Management for Successful Public Health Programs 258
Monitoring and Evaluation as Complementary Disciplines
in Public Health 260
Public Health Goals and Objectives at Societal Level 264
The Issue of Vertical versus Horizontal Program Assistance 268
The Role of Public Health in Reducing the Impacts of Disasters 270
Health Human Resources 272
Conclusion 274
9. Global Ecology and Emerging Health Challenges 275
The Ever-Changing Environment of Planet Earth 275
The Health Impacts of Climate Change 277
What Can Be Done? 281
Human Population Issues 285
Changing Patterns of Health Risk 290
Disaster Risk Reduction 292
The Educated Citizen and Public Health 296
epilogue 299
references 303
index 337
xi
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Preface
the world is undergoing epic transformations and dramatic economic and political power shifts between and within countries. Some nations are experiencing exciting new stages of economic development, while others struggle to avert potential
decline. People everywhere are striving to achieve social justice, improved living
conditions, better health. Yet the prospects for future generations remain unclear
and will depend on the actions of us now living. This is a critical time in the life of
our planet. Will the economic systems fostered by today’s decision makers prove
sustainable? Will our planet be plundered or nurtured?
Will future generations inherit fair or unfair access to health and health care:
health for all or only for a few? A key response to this is to ensure that we have
well-grounded public health systems. An organized society seeks to promote, protect, improve, and restore the health of individuals, groups, and entire populations.
Public health can be all of this: a vision, a discipline, an institution, and a practice. As
a unifying enterprise, it offers many avenues through which practitioners may direct
their energies. Combining social philosophy and values with scientific thought and
advocacy, and working within the mandate received from society, practitioners formulate policies and actions and deliver these through programs, services, institutions,
and related initiatives that emphasize health promotion and disease prevention.
A multidisciplinary field, public health encompasses diverse professional skill
sets that range from epidemiology and the biomedical sciences to the social and
behavioral sciences, nursing, medicine and animal health sciences, engineering, law,
and much more, all engaged together in synergy to advance health from community
to global levels. From this synergy, public health competencies emerge: the ability
xiii
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Preface
to apply those skills within specified roles for the benefit of its common vision of
the highest attainable standard of health for everybody. Among its hallmarks is the
mutual respect held among its practitioners: regardless of their diverse spheres of
orientation, influence or application, public health is a team effort.
A process of renewal has been under way in recent decades, encouraging public health to focus more attention on the underlying determinants of health and
to reengage the field in issues of social justice and environmental sustainability.
Sometimes depicted as the “new public health,” this stream of thought and activism runs prominently through the health promotion movement, suffusing public
health as a whole. Another rallying call is “global health,” which has captured many
an imagination: on the heels of globalization in all forms from trade to culture, this
emphasizes global cooperation for solutions. It differs from “international health,”
which takes its origins from the health situation of developing nations and the
related need for development assistance. More often applied locally than globally,
assistance flowed historically from developed nations (as it still does) but is now augmented by increasing south-south cooperation. These are among the many streams
of thought and action in contemporary public health.
Why ecological foundations? Human interest in ecology originated in the dawn
of prehistory in the struggles of our species coming to grips with its environment.
This instinctive interest has undergone an ethical and scientific revolution as we
discover ourselves and all other species to be threatened by the unsustainable practices of an increasingly man-made world, with its anthropogenic impacts ranging
from local to global pollution and climate change. At its core, the environment
is about the interplay of actions that promote or diminish the sustainability of
life and health, and is best understood in how people live locally, in the control
they have over their mode of living, and the quality of decision making, especially
with regard to the prospects for future generations and for other species. When
we examine our ecological foundations, we refer to both natural and man-made
environments; and now increasingly, we must look to our planet. Public health is
not only about human health, but also about the health of all living beings and of
our planet.
By combining the terms “global public health” and “ecological foundations” we
convey a perspective: that public health principles apply to all countries across the
development spectrum, and that it is a global discipline. It is not sufficient, however,
only to have global comprehension if this means a relatively narrow focus on policy
actions taken only from that level. Health needs to be understood and approached
from the community perspective, from the ground up. Global public health therefore encompasses local public health, especially when one considers the ecological
basis for all health: in effect, there is but “one health.”
Preface
xv
With our best efforts at balance and objectivity, in this book we try to blend what
is valuable from established wisdom with what is new. We attend to facts, giving
credit where due, and refer to authentic experience from the real world. With this
approach, we hope to stimulate a new dialogue about how the different streams of
public health can work more synergistically, and we trust that the next generation of
scholars and professionals will carry this spirit forward.
All future health professionals should find something useful in these pages: some
will discover public health as their vocation; others will broaden to appreciate its
importance, even as they enter other pathways. We do not attempt to be “all things
to all readers”; for those who need more depth in any aspect of public health, there
are more specialized texts. For many readers this book may be a point of departure
from which they will search for more breadth, depth, and experience as they evolve
their perspectives and skills. The ultimate beneficiaries are most people around
the world; their future depends on whether their nations listen to their voices and
respond with health initiatives that meet their needs and help them to find ways of
making sound decisions about their own health. If this book makes a difference in
how health professionals evolve their roles to shape a healthy future for generations,
we will have achieved our purpose.
FW, LS, JL
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Author Biographies
franklin white is a scholar-practitioner whose professional focus is on locally
sustainable solutions for health and social development. He has held posts in Canada
and abroad, notably with the Aga Khan University and the Pan American Health
Organization (PAHO/WHO). Founder of the consulting firm Pacific Health and
Development Sciences Inc., and adjunct professor at the School of Public Health and
Social Policy, University of Victoria, and in Community Health and Epidemiology,
Dalhousie University, he is a past president of the Canadian Public Health
Association and a former chief examiner in Public Health and Preventive Medicine,
Royal College of Physicians and Surgeons of Canada. He is a recipient of the Medal
of Honor, the highest award conferred upon staff officers of PAHO/WHO.
Lorann Stallones is an internationally recognized occupational epidemiologist
with extensive expertise in agricultural safety and health. Professor of epidemiology
at Colorado State University, and director of the Colorado Injury Control Research
Center and of the Institute of Applied Prevention Research, she directs the CSU
Graduate Degree Program in Public Health, Colorado School of Public Health.
She is deputy director, High Plains Intermountain Center for Agricultural Safety
and Health and directs the Occupational Health Psychology training program,
Mountain and Plains Education Research Center. Past president of the American
College of Epidemiology, she is professor laureate in the College of Natural Sciences
at CSU.
John Last is Emeritus Professor of epidemiology and community medicine at the
University of Ottawa. He is the author of Public Health and Human Ecology, founding author of the Dictionary of Public Health, and former editor-in-chief of Public
xvii
xviii Author Biographies
Health and Preventive Medicine (“Maxcy-Rosenau-Last”), and he has written many
book chapters, encyclopedia entries, original articles, and reviews on aspects of public health sciences. His honours and awards include MD honoris causa, Uppasala
University; the Duncan Clarke Award (for contributions to preventive medicine);
and the Abraham Lillienfeld Award for contributions to epidemiology. In 2012 John
Last was admitted as an Officer of the Order of Canada in recognition of lifetime
service in epidemiology and other public health sciences.
Acknowledgments
the authors owe gratitude to countless people with whom we have worked over
the decades in several world regions and numerous countries at different stages of
socioeconomic development.
This includes role models, mentors, colleagues, and students whose encouragement served as inspiration for this book, especially the many frontline practitioners
who grapple daily with the realities of making public health work in diverse settings and whose on-ground experience is simultaneously the source and the proving
ground for many of the ideas and observations presented within these pages.
We are grateful to all who helped in shaping the book itself, particularly those
who advocated the need for a work that would be friendly to a wide range of students that would offer broad educational valu…
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