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Public Health In Oklahoma

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  • Hello. My name is Carmine Jabri. I am a PhD student at Walden University studying Public Health with a concentration in Epidemiology. Today, I will be discussing exactly what Public Health is, some definitions, the history and evolution of Public Health, important public health achievements, issues regarding chronic and infectious disease and the role of genomics in the future of Public Health. I will also be addressing public health issues specifically related to the state of Oklahoma, including the structure and functions of the Oklahoma State Department of Health, local health departments and health issues in Oklahoma. At the end of this presentation, I will open up the discussion for any questions you may have. Lets begin…
  • Franklin Roosevelt said: (Read quote). Some people may wonder, “What exactly is ‘Public Health’?” Public health is (read definition).
  • Core functions of Public Health are: assessment, policy development and assurance. Assessment means to regularly and systematically collect, assemble, analyze and make available information on the health of the community. Policy Development means efforts to serve the public interest in the development of comprehensive public health policies by promoting the use of the scientific knowledge base in decision making about public health and by leading in developing comprehensive public health policies. Assurance means public health efforts to assure citizens that services necessary to achieve agreed upon goals are provided either by encouraging actions by other entities, by requiring such action through regulation, or by providing services directly.
  • Now, I am going to go over some definitions to make you familiar with some common terminology used within the field of public health. (Read definitions on two slides).
  • The following individuals have made a great impact in Public Health. Although this is not a conclusive list of the many individuals who have had a positive impact on the field of public health, these are a few people who stood out to me.
  • There are indications of community health activities in the earliest civilizations. (read slide)… When the Roman empire fell, most public health activities ceased until more modern times.
  • The Code of Hammurabi had laws pertaining to physicians and health practices. 25 million people died of the Plague in Europe alone.
  • Here are some more important historic milestones in public health, leading up to the present.
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  • Current public health problems are the dramatic increase in healthcare costs, environmental concerns such as pollution and global warming. Lifestyle diseases are a HUGE problem as Chronic diseases account for 70% of all deaths in the United States – chronic disease results from lifestyle behaviors like poor nutrition, lack of exercise, etc. Other current problems are Emerging and Re-emerging diseases, Substance Abuse problems, and Terrorism. The Oklahoma State Department of Health formed the Terrorism Preparedness and Response Service, to address the public health and medical implications of a large-scale disaster affecting the state’s population.
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  • (Read the Slide then add): Oklahoma used the assessment to set a baseline for its public health programs; it’s now writing performance measures based in part on the information gathered during that process.
  • (Read Slide) Mary Selecky, Washington State’s health secretary said, “When TB was no longer ravaging communities, the government said it didn’t need to fund the system anymore, but you don’t stop funding a fire department if there are no fires.” 1
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  • Philanthropic Organizations such as the Rockefeller Foundation, Ford Foundation, Robert Wood Johnson Foundation, Henry J. Kaiser Family Foundation, WK Kellogg Foundation, Milbank Memorial Fund, etc. Service and Social such as: Jaycees, Kiwanis Club, Rotary Club, Elks, Lions, Moose, Shriners, American Legion, VFW. Their focus is service to others in their communities Ex: Shriner’s Children’s hospitals and burn centers Religious Organizations Through Volunteering, donations of money, donating space for things like blood donation, alcoholics anonymous, sponsoring food banks and shelters, allowing community health professionals to deliver programs to their congregations. Corporate Involvement : Employee Health Care Benefits Some companies have programs such as smoking cessation, nutrition education, physical fitness, stress management, etc. Many companies going smoke-free in the buildings. Other Governmental Agencies not related to the DHHS, such as: the Department of Agriculture oversees the WIC program, the Department of Labor oversees OSHA/ occupational health.
  • In Oklahoma, there are many Native Americans Tribes, so I wanted to also mention the Indian Health Service. (Read Slide).
  • Each department offers a variety of services, such as immunizations, family planning, maternity education, well-baby clinics, adolescent health clinics, hearing & speech services, child developmental services, environmental health, and the SoonerStart program. 2 They are also responsible for birth and death certificates, licensing for food establishments, medical facilities and tattoo parlors among other things, and some occupational licensing.
  • (Read Slide) The Organizational Chart shows the structure and chain-of-command for the Oklahoma State Department of Health. You, the members of the Board of Health, are at the top of the chart.
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  • The vision and mission of the health department is: (Read Slide)
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  • Some controversies in public health relate to abortion and genetic testing.
  • Epidemiological Study Designs are: Descriptive Study – describe the extent of an outbreak Analytical Study - test hypotheses about relationships between health problems and possible risk factors. Experimental Studies – carried out to identify the cause of disease or determine the effectiveness of a vaccine, therapeutic drug or surgical procedure Case control study: Seeks to identify possible causes of disease by finding differences between the disease cases and a set of controls who are free of the disease. Cohort: A group of individuals having a statistical factor (as age or class membership) in common in a demographic study that is followed over a period of time. Prospective cohort study: Characterized by determination of exposure levels in the present as a baseline, and follow-up for disease occurrence in the future. Retrospective cohort study : Looking back at events that have already taken place, retrospective studies take a group of people who already have a disease and ask them questions about what they did in the past.
  • DATA COLLECTED DIRECTLY BY the OK STATE HEALTH DEPARTMENT: Center for Health Statistics The Vital Records division collects, maintains and issues Birth and Death Certificates. The Health Care Information division is responsible for the development and operation of a method for collecting, processing and disseminating health care data including, but not limited to, quality, expenditure and utilization data. The purpose of the interactive Oklahoma State Department of Health (OSDH) OK2SHARE Service databases is to support the information needs of the Oklahoma State Department of Health and other users such as health officials, educators, and students in improving service delivery, evaluating health care systems, and monitoring the health of the people of Oklahoma. Oklahoma Nursing Home Inspections Database Oklahoma Food Service Inspections Database The preferred method of disease reporting in Oklahoma is through the Public Health Investigation and Disease Detection of Oklahoma (PHIDDO) system. PHIDDO is a real-time, secure, internet-based application that provides a centralized place for reporting diseases and conditions in Oklahoma.
  • Other data sources used are from the Centers for Disease Control and Preparedness, the World Health Organization, the National Institutes of Health, and the U.S. Census Bureau, to name a few.
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  • Infectious agents may be transmitted through either direct or indirect contact. Direct contact occurs when an individual is infected by contact with the reservoir, for example, by touching an infected person, ingesting infected meat, or being bitten by an infected animal or insect. Transmission by direct contact also includes inhaling the infectious agent in droplets emitted by sneezing or coughing and contracting the infectious agent through intimate sexual contact. Some diseases that are transmitted primarily by direct contact with the reservoir include ringworm, AIDS, trichinosis, influenza, rabies, and malaria. Indirect contact occurs when a pathogen can withstand the environment outside its host for a long period of time before infecting another individual. Inanimate objects that are contaminated by direct contact with the reservoir (for example, a tissue used to wipe the nose of an individual who has a cold or a toy that has been handled by a sick child) may be the indirect contact for a susceptible individual. Ingesting food and beverages contaminated by contact with a disease reservoir is another example of disease transmission by indirect contact. The fecal-oral route of transmission, in which sewage-contaminated water is used for drinking, washing, or preparing foods, is a significant form of indirect transmission, especially for gastrointestinal diseases such as cholera, rotavirus infection, cryptosporidiosis, and giardiasis.
  • The preferred method of disease reporting in Oklahoma is through the Public Health Investigation and Disease Detection of Oklahoma (PHIDDO) system. PHIDDO is a real-time, secure, internet-based application that provides a centralized place for reporting diseases and conditions in Oklahoma. Online there are links for information regarding many diseases on the OKSDH website..
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  • Virtually every human ailment, except perhaps trauma, has some basis in our genes. Until recently, doctors were able to take the study of genes, or genetics, into consideration only in cases of birth defects and a limited set of other diseases. Public Health Genomics is an emerging field that assesses the impact of genes and their interaction with behavior, diet and the environment on population health. 1 THE IMPORTANCE OF INTEGRATING GENETICS WITH PUBLIC HEALTH: We can discover the role that genetic factors play in much more complex diseases, such as cancer, diabetes, and cardiovascular disease that constitute the majority of health problems in the United States
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  • Here are the demographics of the COMMUNITIES SERVED by the OKSDH
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  • Some of the major public health challenges in Oklahoma are: (Read Slide)
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  • In conclusion, I attempted to give you a broad overview of public health, its history, and its future. I addressed public health issues specifically related to Oklahoman’s. I hope that you now have a well-rounded knowledge-base regarding Public Health as a result of this presentation. The next few slides are references that I used to help prepare this presentation.
  • Now I will open up the discussion for any questions. (Answer questions) Thank you for your time and attention.
  • Transcript

    • 1. PUBLIC HEALTH: AN OVERVIEW Oklahoma State Department of Health The State of Public Health in Oklahoma CARMINE JABRI May 14, 2008
    • 2. Introduction
      • “ Nothing can be more important to a state than its public health,” Franklin Roosevelt (1934). 1
      • What is Public Health ?
      • Public Health refers to the “health status of a defined group of people and the governmental actions and conditions to promote, protect and preserve their health.” 2
      • 1. Congressional Quarterly, Inc. (2004). Public health costs of complacency. Retrieved on 5/9/08 from: http://www.governing.com/gpp/2004/public.htm
      • 2. McKenzie, J., Pinger, R. & J. Kotecki. (2005). An introduction to community health. Fifth edition. Jones and Bartlett: Sudbury, Massachusetts.
    • 3. Core Functions of Public Health
      • Assessment
      • Policy Development
      • Assurance
      • Minnesota Department of Health. (2008). Public health core functions, essential services and goals. Retrieved on 5/13/08 from: http://www.health.state.mn.us/divs/chs/pdf/gdlinebkgrdall.pdf
    • 4. DEFINITIONS
      • Chronic Disease: A disease or health condition that lasts longer than three months, sometimes for the remainder of one’s life. 3
      • Epidemic: The occurrence in a community or region of cases of an illness (or an outbreak) clearly in excess of expectancy.2
      • Endemic: A disease that is habitually present in a particular geographic region.2
      • Epidemiology: The study of the distribution and determinants of disease frequency in human populations.
      • Genetic testing: Analyzing an individual's genetic material to determine predisposition to a particular health condition or to confirm a diagnosis of genetic disease. Genetic testing is sometimes used interchangeably with genetic screening. Generally, screening refers to a preliminary form of testing, or the assessment of asymptomatic populations. 1
      • Genomics: The study of all of the functions and interactions of all of the genetic material in the genome, including interactions with environmental factors. 1
      • Infectious Disease: An infectious disease is a disease that is caused by the invasion of a host by agents whose activities harm the host's tissues and can be transmitted to other individuals.4
      • 1. Walden University. (2008). Pubh 6002 [week 9 glossary]. Retrieved on 4/30/08 from: http://sylvan.live.ecollege.com/ec/crs/default.learn?CourseID=2898489&Survey=1&47=4655338&ClientNodeID=984640&coursenav=1&bhcp=1
      • 2. Walden University. (2008). Pubh 6002 [week 5 glossary]. Retrieved on 4/30/08 from: http://sylvan.live.ecollege.com/ec/crs/default.learn?CourseID=2898489&Survey=1&47=4655338&ClientNodeID=984640&coursenav=1&bhcp=1
      • 3. McKenzie, J., Pinger, R. & J. Kotecki. (2005). An introduction to community health. Fifth edition. Jones and Bartlett: Sudbury, Massachusetts. p. 585.
      • 4. National Institutes of Allergy and Infectious Diseases. (2008). Emerging and re-emerging infectious diseases..
    • 5. Definitions
      • Incidence: The number of newly diagnosed cases during a specific time period. The incidence is distinct from the prevalence, which refers to the number of cases alive on a certain date. 2
      • Notifiable disease: A disease that by law has to be reported to the appropriate authorities. 2
      • Outbreak: A sudden rise in the incidence of a disease. 2
      • Genomics: The study of all of the functions and interactions of all of the genetic material in the genome, including interactions with environmental factors. 2
      • Public Health: the “health status of a defined group of people and the governmental actions and conditions to promote, protect and preserve their health.” 3
      • Surveillance: The systematic collection of data pertaining to the occurrence of specific diseases, the analysis and interpretation of these data, and the dissemination of consolidated and processed information. 2
      • 1Walden University. (2008). Pubh 6002 [week 5 glossary]. Retrieved on 4/30/08 from:http://sylvan.live.ecollege.com/ec/crs/default.learn?CourseID=2898489&Survey=1&47=4655338&ClientNodeID=984640&coursenav=1&bhcp=1
      • 2. Walden University. (2008). Pubh 6002 [week 5 glossary]. Retrieved on 4/30/08 from: http://sylvan.live.ecollege.com/ec/crs/default.learn?CourseID=2898489&Survey=1&47=4655338&ClientNodeID=984640&coursenav=1&bhcp=1
      • 3. McKenzie, J., Pinger, R. & J. Kotecki. (2005). An introduction to community health. Fifth edition. Jones and Bartlett: Sudbury, Massachusetts.
    • 6. IMPORTANT HISTORIC FIGURES IN PUBLIC HEALTH
      • Dr. Edward Jenner (1796) Process of vaccination as a protection against small pox.
      • Dr. John Snow (1849) Studied cholera epidemic in London, concluded it was caused by drinking water from Broad St. pump. Had pump handle removed and epidemic stopped.
      • Lemuel Shattuck (1850) wrote report for Massachusetts. Recommended establishment of Boards of Health, collection of vital statistics, implementation of sanitary measures, research on diseases, health education, controlling exposure to smoke and alcohol.
      • Louis Pasteur (1862) germ theory of disease
      • Robert Koch (1876) Koch’s Postulates – developed criteria and procedures to establish that a particular microbe and no other causes a particular disease.
      • Major Walter Reed (1900) Announced yellow fever transmitted by mosquitoes
      • Dorothea Dix (1802-1897) Helped establish public mental health hospitals in many states
      • McKenzie, J., Pinger, R. & J. Kotecki. (2005). An introduction to community health. (Fifth edition). Sudbury, Massachusetts: Jones and Bartlett.
    • 7. HISTORICAL BACKGROUND
        • 2000 B.C. Indus Valley- bathrooms and drains in homes, sewers below street level
        • 2700-1500 B.C. – Drainage Systems in Ancient Egypt, more than 700 drugs known to Egyptians.
        • 2100 B.C. – Sumerian clay tablet had written prescriptions for drugs
        • 500 B.C. – A.D.500 – Greeks Supplemented local city wells with water from mountains 10 miles away.
        • Romans built aqueducts, sewer systems, regulation of building construction, refuse removal, street cleaning and repair. They also started hospitals.
      • McKenzie, J., Pinger, R. & J. Kotecki. (2005). An introduction to community health. (Fifth edition). Sudbury, Massachusetts: Jones and Bartlett.
    • 8. Historical Background
      • Earliest written record concerning Public Health: Code of Hammurabi
      • During the Dark Ages, people believed disease was caused by demons or as punishment for sin.
        • Epidemics: Leprosy, 3 epidemics of Plague, Syphilis
      • McKenzie, J., Pinger, R. & J. Kotecki. (2005). An introduction to community health. (Fifth edition). Sudbury, Massachusetts: Jones and Bartlett.
    • 9. Historical Background
      • Advances in Public Health were made by Dr Jenner, Dr. Snow, Lemuel Shattuck, Louis Pasteur, and Robert Koch, among others.
      • The American Public Health Association was founded in 1872.
      • By 1900, 38 states had state health departments.
      • In 1911, the first 2 local health departments were established.
      • The first school of Public Health was in 1918, Johns Hopkins University.
      • In the twentieth century, the leading causes of death were communicable diseases.
        • Two discoveries during WWII, antibiotic penicillin and DDT to kill insects that transmit disease.
        • 1950’s vaccine to prevent Polio
      • McKenzie, J., Pinger, R. & J. Kotecki. (2005). An introduction to community health. (Fifth edition). Sudbury, Massachusetts: Jones and Bartlett.
    • 10. Historical Background
      • 1965 – Medicaid and Medicare bills passed to help the poor and the elderly
      • 1977 – CDC study found that 48% of premature deaths were caused by one’s lifestyle. This lead to the government’s publication:
        • Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention
      • McKenzie, J., Pinger, R. & J. Kotecki. (2005). An introduction to community health. (Fifth edition). Sudbury, Massachusetts: Jones and Bartlett.
    • 11. Public Health Problems in the 2000’s
      • Rise in Healthcare costs
      • Environmental Concerns
      • Lifestyle Diseases
      • Emerging and Re-emerging diseases
      • Substance Abuse problems
      • Terrorism- chemical, nuclear/radiological & biological
    • 12. PUBLIC HEALTH ACHIEVEMENTS
      • The Center for Disease Control and Prevention (CDC) has called vaccination one of the greatest public health achievements of the 20th century. 1
      • 1. Tulsa Health Department. (2008). Childhood immunizations. Retrieved on 5/1/08 from: http://www.tulsa-health.org/personal-health/child-health/immunizations/
    • 13. 10 Great Public Health Achievements
      • Vaccination
      • Motor-vehicle safety
      • Safer workplaces
      • Control of infectious diseases
      • Decline in deaths from coronary heart disease and stroke
      • Safer and healthier foods
      • Healthier mothers and babies
      • Family planning
      • Fluoridation of drinking water
      • Recognition of tobacco use as a health hazard
      • CDC. (1999, April 2). 10 great public health achievements 1900-1999. MMWR. Retrieved on 5/12/08 from: http://www.cdc.gov/MMWR/preview/mmwrhtml/00056796.htm
    • 14. 10 Most Common Causes of Death in Oklahoma (1993-2003)
      • Heart Disease
      • Cancer
      • Stroke
      • Bronchitis/Emphysema/Asthma
      • Unintentional Injury
      • Influenza/Pneumonia
      • Diabetes
      • Suicide
      • Kidney Disease
      • Alzheimer's Disease
      • Oklahoma State Department of Health. (2005). State Health Report. Retrieved on 5/10/08 from: http://www.ok.gov/health/documents/State%20Report.pdf
    • 15. Healthy People 2010
      • What Is Healthy People 2010 ? Healthy People 2010 is a comprehensive set of disease prevention and health promotion objectives for the Nation to achieve over the first decade of the new century. Created by scientists both inside and outside of Government, it identifies a wide range of public health priorities and specific, measurable objectives.
      • Overarching Goals:  
        • 1. Increase quality and years of healthy life
        • 2. Eliminate health disparities
        • Office of Disease Prevention and Health Promotion. (2005). Healthy people 2010. Retrieved on 5/12/08 from : http://www.healthypeople.gov/About/hpfact.htm
    • 16. 10 Essential Public Health Services
      • According to Walden University (2008), “The Essential Services provide a working definition of public health and a guiding framework for the responsibilities of local public health systems:
      • Monitor health status to identify and solve community health problems.
      • Diagnose and investigate health problems and health hazards in the community.
      • Inform, educate, and empower people about health issues.
      • Mobilize community partnerships and action to identify and solve health problems.
      • Develop policies and plans that support individual and community health efforts.
      • Enforce laws and regulations that protect health and ensure safety.
      • Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
      • Assure competent public and personal health care workforce.
      • Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
      • Research for new insights and innovative solutions to health problems.”
      • Walden University. (2008). Pubh 6002 [week 3 glossary]. Retrieved on 4/30/08 from: http://sylvan.live.ecollege.com/ec/crs/default.learn?CourseID=2898489&Survey=1&47=4655338&ClientNodeID=984640&coursenav=1&bhcp=1
    • 17.
      • More than a dozen states are participating in the National Public Health Performance Standards Program, developed by the CDC and other public health partners. The assessment tool sets optimum, not minimum, standards for state and local health agencies based on the 10 essential services outlined nearly a decade ago. 1
      • 1. Congressional Quarterly, Inc. (2004). Public health costs of complacency. Retrieved on 5/9/08 from: http://www.governing.com/gpp/2004/public.htm
    • 18. FUNDING FOR PUBLIC HEALTH
      • Typically top-down funding: money comes from Federal to state to local level.
      • The portion of Oklahoma’s public health budget derived from state general funds has been reduced 24 percent in the past two years. 1
      • 1. Congressional Quarterly, Inc. (2004). Public health costs of complacency. Retrieved on 5/9/08 from: http://www.governing.com/gpp/2004/public.htm
    • 19. Factors that Affect the Health of a Community
      • 1.) Physical Factors
        • Geography
        • Environment
        • Community Size
        • Industrial Development
      • McKenzie, J., Pinger, R. & J. Kotecki. (2005). An introduction to community health. (Fifth edition). Sudbury, Massachusetts: Jones and Bartlett.
    • 20. Factors that Affect the Health of a Community
      • 2. Social and Cultural Factors
        • Beliefs, Traditions and Prejudices
        • Economy
        • Politics
        • Religion
        • Social Norms
        • Socioeconomic Status
    • 21. Factors that Affect the Health of a Community
      • 3. Community Organizing
      • 4. Individual Behavior
    • 22. Who is Responsible for Public Health?
      • International Agencies
        • World Health Organization
      • National Health Agencies
        • For the U.S., it is the Departments of Health and Human Services (DHHS).
      • State Health Agencies
      • Local Public Health Agencies
      • McKenzie, J., Pinger, R. & J. Kotecki. (2005). An introduction to community health. (Fifth edition). Sudbury, Massachusetts: Jones and Bartlett.
    • 23. Who is Responsible for Public Health?
      • Quasi-Governmental Health Organizations
        • American Red Cross
      • Voluntary Health Agencies
        • American Cancer Society, SIDS Alliance, March of Dimes, American Lung Association, American Heart Association, Alzheimer's Association, etc.
    • 24. Who is Responsible for Public Health?
      • Philanthropic Organizations
      • Service and Social
      • Religious Organizations
      • Corporate Involvement
      • Other Governmental Agencies not related to the DHHS
    • 25. Indian Health Service (IHS)
      • Indian Health Service (IHS) is a federal agency within the Department of Health and Human Services.
      • “ The Oklahoma City Area Indian Health Service serves the states of Oklahoma, Kansas, and portions of Texas. Oklahoma is home to more than 39 Tribes and Tribal Organizations, a unique characteristic of the Oklahoma City Area because a large number of Tribes have opted to operate their own health programs including large scale hospitals to the smaller preventive care programs and behavioral health programs. The Area consists of 8 Service Units with federally operated hospitals, clinics and smaller health stations.”
      • HIS. (2008). Oklahoma city area. Retrieved on 5/13/08 from: http://www.ihs.gov/FacilitiesServices/AreaOffices/oklahoma/index.cfm
    • 26. STRUCTURE AND ROLES OF OKLAHOMA STATE AND LOCAL HEALTH DEPARTMENTS
      • Four major service branches, Community Health Services , Family Health Services , Disease & Prevention Services and Protective Health Services , provide technical support and guidance to 68 county health departments as well as guidance and consultation to the two independent city-county health departments in Oklahoma City and Tulsa. 1
      • 1. Oklahoma State Department of Health. (2008). The department. Retrieved on 4/30/08 from: http://www.ok.gov/health/Organization/index.html
      • 2. Oklahoma State Department of Health. (2008). County health departments. Retrieved on 4/30/08 from: http://www.ok.gov/triton/modules/health/map/county_map.php
    • 27. THE PUBLIC HEALTH WORKFORCE
      • Public health professionals are employed in a variety of settings including government federal, state and local public health and human services agencies; community-based and non-profit organizations, public and private health care institutions, and universities.
      • The Organizational Chart for the State Dept of Health is located at: http://www.ok.gov/health/documents/OSDH%20Org-Feb%2008.pdf
      • Minnesota Department of Health. (2007, Dec 18). Description of public health careers. Retrieved on 5/13/08 from: http://www.health.state.mn.us/pathways/description.html
    • 28. OKLAHOMA PUBLIC HEALTH LAWS
      • It takes some navigation around the Oklahoma State Department of Health website to get to laws and regulations.
      • Go to the home page: http://www.ok.gov/health/
      • Then click on Forms, Regulations and Licensing
      • Then click on Regulations
      • Then click on the area you are interested in, for example: Consumer Protection
      • Then you narrow it down even further. I clicked on Retail Foods
      • Then I clicked on Rules for Food Service Establishments, Effective June 25, 2006
      • It finally took me to the regulations, which was at: http://www.ok.gov/health/documents/Retail%20Foods257-2006.pdf
    • 29. MISSION
      • Vision: "Add Years to Life and Life to Years."
      • Mission: To partner with public, private, and voluntary agencies to enable Oklahomans to live increasingly long, healthy, satisfactory lives
    • 30. EDUCATING THE PUBLIC
      • There are many programs aimed at educating the public including disease prevention programs, health and nutrition programs and WIC, among others.
      • The website for the Oklahoma State Department of Health is an excellent resource for educating the public.
    • 31. CONTROVERSIES IN PUBLIC HEALTH
      • ABORTION
      • GENETIC TESTING
    • 32. THE BASIC SCIENCE BEHIND PUBLIC HEALTH
      • EPIDEMIOLOGICAL STUDY DESIGNS
        • Descriptive Study
        • Analytical Study
        • Experimental Studies
        • Case control study
        • Cohort
        • Prospective cohort study
        • Retrospective cohort study
        • Walden University. (2008). Pubh 6002 [week 5 glossary]. Retrieved on 4/30/08 from:http://sylvan.live.ecollege.com/ec/crs/default.learn?CourseID=2898489&Survey=1&47=4655338&ClientNodeID=984640&coursenav=1&bhcp=1
    • 33. DATA SOURCES USED
      • DATA COLLECTED DIRECTLY BY OK STATE HEALTH DEPARTMENT:
      • Center for Health Statistics
        • The Vital Records division collects
        • The Health Care Information division
      • OK2SHARE
      • Oklahoma Nursing Home Inspections Database
      • Oklahoma Food Service Inspections Database
      • Public Health Investigation and Disease Detection of Oklahoma (PHIDDO) system.
      • Oklahoma State Department of Health. (2008). Center for health statistics. Retrieved on 5/13/08 from: http://www.ok.gov/health/Data_and_Statistics/Center_For_Health_Statistics /
    • 34. OTHER DATA SOURCES USED
      • CDC
      • WHO
      • NIH
      • U.S. Census Bureau
    • 35. How is the data used?
      • The data that is gathered by the Oklahoma State Department of Health is used to assess the health of Oklahoman’s, develop policies related to Public Health and plan programs to address those health issues that were brought to attention from the assessment of the data.
    • 36. INFECTIOUS DISEASE
      • DEFINITION: An infectious disease is a disease that is caused by the invasion of a host by agents whose activities harm the host's tissues and can be transmitted to other individuals.
      • TRANSMISSION MODES:
        • Direct Contact
        • Indirect Contact
      • McKenzie, J., Pinger, R. & J. Kotecki. (2005). An introduction to community health. (Fifth edition). Sudbury, Massachusetts: Jones and Bartlett.
    • 37. INFECTIOUS DISEASE PROGRAMS RUN BY OK STATE HEALTH DEPT.
      • The mission of the Acute Disease Service is to control communicable disease through: surveillance for infectious diseases; investigation of disease outbreaks; analysis of data to plan, implement and evaluate disease prevention and control measures; dissemination of pertinent information; education of healthcare professionals and the public; and bioterrorism preparedness.
      • Vaccination programs
    • 38. CHRONIC DISEASE
      • In 2005, 133 million people, almost half of all Americans lived with at least one chronic condition.
      • Chronic diseases account for 70% of all deaths in the United States.
      • The medical care costs of people with chronic diseases account for more than 75% of the nation’s $2 trillion medical care costs.
      • Chronic diseases account for one-third of the years of potential life lost before age 65.
      • CDC (2008). Chronic disease overview. Retrieved on 5/12/08 from:
      • http://www.cdc.gov/nccdphp/overview.htm
    • 39. CHRONIC DISEASE PROGRAMS RUN BY THE OK STATE HEALTH DEPT.
      • Arthritis Prevention and Education Program
      • Asthma Prevention and Control Program
      • Cancer Prevention Programs
      • Diabetes Prevention and Control Programs
      • Heart Disease and Stroke Prevention Program
      • Oklahoma Physical Activity and Nutrition Program (OKPAN)
      • OSDH. (2008) Chronis disease service. Retrieved on 5/13/08 from: http://www.ok.gov/health/Disease,_Prevention,_Preparedness/Chronic_Disease_Service/
    • 40. GENOMICS IN PUBLIC HEALTH
      • Public Health Genomics is an emerging field that assesses the impact of genes and their interaction with behavior, diet and the environment on population health. 1
      • THE IMPORTANCE OF INTEGRATING GENETICS WITH PUBLIC HEALTH
        • National Office of Public Health Genomics. (2008). Welcome to public health genomics. Retrieved on 5/13/08 from: http://www.cdc.gov/genomics/
        • National Human Genome Research Institute. (2007). A brief guide to genomics. Retrieved on 5/13/08 from: http://www.genome.gov/18016863
    • 41. Oklahoma State Genetics Plan
      • 3 Goals:
        • 1.) Genetic Education for healthcare providers and the public
        • 2.) Development of a stable public health genetics infrastructure to assess, implement, monitor and evaluate genetics in Oklahoma.
        • 3.) Screening and genetic testing.
        • Oklahoma State Department of Health. (2008). Genetics and public health – why does oklahoma need a state genetics plan? Retrieved on 5/13/08 from: http://www.ok.gov/health/documents/Why%20does%20Oklahoma%20need%20a%20State%20Genetics%20Plan-%20page26.pdf
    • 42. GENETIC PROGRAMS RUN BY OK STATE HEALTH DEPARTMENT
        • The main program is NEWBORN SCREENINGS
      • Other than that, the OK State Health Dept. focuses on family health histories to uncover possible genetic risk factors for disease. They also offer education regarding genetics.
      • The OKSDH has links to many websites regarding genetic testing and genetic services and many other websites related to genetics.
      • Oklahoma State Department of Health. (2008). Genetics program mission. Retrieved on 5/13/08 from: http://www.ok.gov/health/Child_and_Family_Health/Screening,_Special_Services_and_Sooner_Start/Genetics_Program/index.html
    • 43. PUBLIC HEALTH IN OKLAHOMA
        • Demographics
        • • Population estimates 9.7% increase from 1990 to 2000, 3.6% increase from 2000 to 2005
          • (3,145,576 to 3,450,654)
          • Ranked 28th for growth in country
        • 2000 Census
        • • Hispanic/Latino ethnicity = 5%
        • • Race
          • Whites = 76%
          • Native Americans =8%
          • Blacks =8%
          • Other/Multiple = 8%
        • • Age
          • Under 5 = 7%
          • Over 64 = 13%
          • Median age = 35.5 years
        • • Disability (ages 21 to 64) = 21.5%, national = 19.2%
        • • Individuals below poverty = 14.7%, national = 12.4%
      • Oklahoma State Department of Health. (2005). State Health Report. Retrieved on 5/10/08 from: http://www.ok.gov/health/documents/State%20Report.pdf
    • 44. PUBLIC HEALTH IN OKLAHOMA
      • 9 th FATTEST STATE
        • “ Oklahoma entered the fattest ten for the first time, tying for ninth place.” 1
        • 1 IN 4 OKLAHOMANS ARE OBESE
        • Oklahoma City is ranked the 8 th Fattest City in the U.S. 3
        • WHY?
        • One reason may be the Official Oklahoma State Meal:
        • “ It was formally designated by the Oklahoma legislature in 1988. And it includes: cornbread, sausage and gravy, chicken fried steak, pecan pie, barbecue pork, fried okra and squash, biscuits, grits, corn, strawberries and black-eyed peas.” 2
        • 1. Calorie Lab. (2008). Mississippi once again fattest state. Retrieved on 5/1/08 from: http://calorielab.com/news/2007/08/06/fattest-states-2007/
        • 2. Calorie Lab. (2008). Oklahoma citizen’s diet sabotaged by official state meal of chicken fried steak and pecan pie. Retrieved on 5/1/08 from: http://calorielab.com/news/2008/01/07/oklahoma-citizens-diets-sabotaged-by-official-state-meal-of-chicken-fried-steak-and-pecan-pie/
        • 3. Tulsa World. (2008, Feb. 11). Mens fitness magazine ranks okc among fattest cities. Retrieved on 5/1/08 from: http://www.tulsaworld.com/news/article.aspx?articleID=20080211_1__OKLAH63032
    • 45. MAJOR PUBLIC HEALTH CHALLENGES IN OKLAHOMA
      • Unintentional and Violence Related Injuries are on the rise. For persons aged 1-44, unintentional injuries are the leading cause of death.
      • Tobacco Use in Oklahoma is
        • is 30% higher than the
        • nation on the amount of tobacco
        • consumed per capita (103 packs vs.
        • 79 packs).
        • Oklahoma State Department of Health. (2005). State Health Report. Retrieved on 5/10/08 from:
        • http://www.ok.gov/health/documents/State%20Report.pdf
    • 46. MAJOR PUBLIC HEALTH CHALLENGES IN OKLAHOMA
      • Lack of Physical Activity
      • Teen Pregnancy: Oklahoma has moved up in rank from 13th to 8th in the country.
      • Poverty – almost 15% of Oklahoman’s have an income below the federal poverty level.
      • Cardiovascular Disease
      • Obesity
      • Diabetes
      • Oklahoma State Department of Health. (2005). State Health Report. Retrieved on 5/10/08 from: http://www.ok.gov/health/documents/State%20Report.pdf
    • 47. CONCLUSION
      • PUBLIC HEALTH
        • Past
        • Present
        • Future
        • Public Health in Oklahoma
    • 48. References
      • Calorie Lab. (2008). Mississippi once again fattest state. Retrieved on 5/1/08 from: http://calorielab.com/news/2007/08/06/fattest-states-2007/
      • Calorie Lab. (2008). Oklahoma citizen’s diet sabotaged by official state meal of chicken fried steak and pecan pie. Retrieved on 5/1/08 from: http://calorielab.com/news/2008/01/07/oklahoma-citizens-diets-sabotaged-by-official-state-meal-of-chicken-fried-steak-and-pecan-pie/
      • CDC (2008). Chronic disease overview. Retrieved on 5/12/08 from: http://www.cdc.gov/nccdphp/overview.htm
      • CDC. (1999, April 2). 10 great public health achievements 1900-1999. MMWR. Retrieved on 5/12/08 from: http://www.cdc.gov/MMWR/preview/mmwrhtml/00056796.htm
      • Congressional Quarterly, Inc. (2004). Public health costs of complacency. Retrieved on 5/9/08 from: http://www.governing.com/gpp/2004/public.htm
      • HIS. (2008). Oklahoma city area. Retrieved on 5/13/08 from: http://www.ihs.gov/FacilitiesServices/AreaOffices/oklahoma/index.cfm
      • McKenzie, J., Pinger, R. & J. Kotecki. (2005). An introduction to community health. (Fifth edition). Sudbury, Massachusetts: Jones and Bartlett.
      • Minnesota Department of Health. (2007, Dec 18). Description of public health careers. Retrieved on 5/13/08 from: http://www.health.state.mn.us/pathways/description.html
      • Minnesota Department of Health. (2008). Public health core functions, essential services and goals. Retrieved on 5/13/08 from: http://www.health.state.mn.us/divs/chs/pdf/gdlinebkgrdall.pdf
      • National Office of Public Health Genomics. (2008). Welcome to public health genomics. Retrieved on 5/13/08 from: http://www.cdc.gov/genomics/
      • National Human Genome Research Institute. (2007). A brief guide to genomics. Retrieved on 5/13/08 from: http://www.genome.gov/18016863
    • 49. References
      • Office of Disease Prevention and Health Promotion. (2005). Healthy people 2010. Retrieved on 5/12/08 from: http://www.healthypeople.gov/About/hpfact.htm
      • Oklahoma State Department of Health. (2008) Retrieved on 5/9/08 from: http://www.ok.gov/health/
      • Oklahoma State Department of Health. (2008). Center for health statistics. Retrieved on 5/13/08 from: http:// www.ok.gov/health/Data_and_Statistics/Center_For_Health_Statistics/
      • OSDH. (2008) Chronis disease service. Retrieved on 5/13/08 from: http://www.ok.gov/health/Disease,_Prevention,_Preparedness/Chronic_Disease_Service/
      • Oklahoma State Department of Health. (2008). Genetics and public health – why does oklahoma need a state genetics plan? Retrieved on 5/13/08 from: http://www.ok.gov/health/documents/Why%20does%20Oklahoma%20need%20a%20State%20Genetics%20Plan-%20page26.pdf
      • Oklahoma State Department of Health. (2008). Genetics program mission. Retrieved on 5/13/08 from: http://www.ok.gov/health/Child_and_Family_Health/Screening,_Special_Services_and_Sooner_Start/Genetics_Program/index.html
      • Oklahoma State Department of Health. (2008). The department. Retrieved on 4/30/08 from: http://www.ok.gov/health/Organization/index.html
      • Oklahoma State Department of Health. (2008). County health departments. Retrieved on 4/30/08 from: http://www.ok.gov/triton/modules/health/map/county_map.php
      • Oklahoma State Department of Health. (2005). State Health Report. Retrieved on 5/10/08 from: http://www.ok.gov/health/documents/State%20Report.pdf
    • 50. References
      • Schneider, M. (2006). Introduction to public health . (2 nd ed.). Sudbury, Massachusetts: Jones and Bartlett.
      • Tulsa World. (2008, Feb. 11). Mens fitness magazine ranks okc among fattest cities. Retrieved on 5/1/08 from: http://www.tulsaworld.com/news/article.aspx?articleID=20080211_1__OKLAH63032
      • Walden University. (2008). Pubh 6002 [week 3 glossary]. Retrieved on 4/30/08 from: http://sylvan.live.ecollege.com/ec/crs/default.learn?CourseID=2898489&Survey=1&47=4655338&ClientNodeID=984640&coursenav=1&bhcp=1
      • Walden University. (2008). Pubh 6002 [week 5 glossary]. Retrieved on 4/30/08 from:http://sylvan.live.ecollege.com/ec/crs/default.learn?CourseID=2898489&Survey=1&47=4655338&ClientNodeID=984640&coursenav=1&bhcp=1
      • Walden University. (2008). Pubh 6002 [week 9 glossary]. Retrieved on 4/30/08 from: http://sylvan.live.ecollege.com/ec/crs/default.learn?CourseID=2898489&Survey=1&47=4655338&ClientNodeID=984640&coursenav=1&bhcp=1
    • 51. ANY QUESTIONS?

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