Capitol Tech U Doctoral Presentation - April 2024.pptx
Assignment OverviewCyber is a relatively new word that did not .docx
1. Assignment Overview:
Cyber is a relatively new word that did not gain prominence
until three short decades ago. Since then, words such
as cyberwar, cyber-attack, cyber-crime, cyberterrorism,
and cybersecurity have emerged. In April 2015, Loretta Lynch
became the nation's new attorney general. At the forefront of
the attorney general's security concerns are social media
technology, ISIS systematically exploiting the Internet, and the
threat of cyber-attack. According to Lynch, a cyber-attack by
the Islamic State is perhaps the terror group’s biggest emerging
threat. "Concern that ISIS or any of our foreign enemies might
develop that capacity … is the thing that keeps me and many of
my colleagues in law enforcement up at night,” Lynch told
ABC’s News' Pierre Thomas. Understanding cyber threats
begins with understanding the history of technology.
Assignment Task:
History and advancing technology make it imperative to
examine the cyber significance of the years 1945, 1963, 1969,
1970, 1979, 1983, and 1984 to better understand how these
advancements have historically influenced modern day
cybersecurity.
From your research, discuss how ISIS-type organizations have
exploited advancements in technology. Describe how these
historical influences have affected national security.
Key Concepts in Public Health
Determinants of Health
Contributors: Soumen Sengupta
3. (Ashton and Seymour, 1992).
Key Points
• Health is created by a complicated interaction of different
factors, only some of which can be directly
influenced by individuals.
• Social determinants tend to have a greater impact on
population health status than healthcare ser-
vices.
• Different determinants have a differential influence on
different groups of people: this can contribute
to health inequalities.
• An appreciation of the differential influence of determinants
should be used to develop and deploy a
wider array of public policy activities to promote good health.
Discussion
How different disciplines consider determinants of health is
born of their traditions and values. There are four
schools of thought (Beaglehole, 2004):
• The biomedical view – emphasis on specific causes and
discrete treatments for ill health amongst
individuals.
• The lifestyle view – emphasis on individual responsibility for
lifestyle choices.
• The broad socio-economic approach – emphasis on factors
outside the healthcare sector, especially
economic and social.
5. good health:
• Peace
• Shelter
• Education
• Food
• Income
• A stable ecosystem
• Sustainable resources
• Social justice
• Equity
Consequently, an ambitious proposition has been developed for
prioritising resources ‘upstream’, from ser-
vices targeted at the individual to policy action on the
economic, physical and social determinants of popu-
lation health. Unfortunately, most investment in health still
reflects and reinforces the biomedical worldview
(Hunter, 2003).
Social Determinants of Health
Systems theory states that a system is composed of
interdependent and interrelated parts, with change in
one part producing changes in others (von Bertalanffy, 1968). In
order to explore the impacts of and the po-
tential to influence different determinants it is thus necessary to
appreciate their interrelationships. A number
of conceptual models assist this. The most frequently cited is
the Dahlgren and Whitehead ‘rainbow’ – Figure
3.1 (Dahlgren and Whitehead, 1991).
The extent to which different determinants can be influenced
varies; certainly no individual is likely to exert
direct control over most of them. Furthermore, these
7. Simply put, these social systems are a prod-
uct of individuals and their interactions. Moreover, the choices
that individuals make should not be dismissed.
However, they are a product of the choices available and the
confidence different groups have in exercis-
ing them (i.e. the degree of self-efficacy possessed).
Circumstances and conditions that provide people with
greater control over different facets of their lives (and
consequently nurture a greater sense of self-esteem)
are associated with better health outcomes (Marmot, 2003).
Health Inequalities
Consideration of the differential influences of health
determinants is almost inextricably linked to the question
of why economically or socially disadvantaged groups
consistently experience relatively poorer health status
(Graham and Kelly, 2004). Such disadvantage can manifest in
different forms, e.g. limited aspirations, low
income and discrimination. Critically, such disadvantages tend
to gravitate towards one another, creating vi-
cious circles in which people get trapped.
In the UK, the Black Report (Townsend et al., 1992) identified
the primary reasons for worsening social gra-
dients in mortality and other indicators of ill health as material
deprivation and poverty; and its recommen-
dations highlighted economic and social policy solutions. These
conclusions were reinforced by subsequent
publications, with the Acheson Report (Acheson, 1998) stating
that: ‘the weight of scientific evidence supports
a socio-economic explanation of health inequalities. This traces
the roots of ill health to such determinants
as income, education and employment as well as material
environment and lifestyle.’ While there are clearly
overlaps, the determinants of health are not exactly the same as
9. they need to be part of a multi-dimensional package of
activities.
Cross-References
Understanding health determinants has relevance to all aspects
of public health. In using this textbook, it
would be particularly useful to cross-reference with inequalities
in health (Chapter 5); assessing public health
need (Chapter 21); planning public health initiatives (Chapter
22); health impact assessment (Chapter 24);
and collaborative and partnership working (Chapter 34).
Conclusion
Health at both individual and population levels is the product of
a complicated interaction of different factors.
Health policy is still dominated by a biomedical paradigm, yet
there is a substantial theoretical and evidence
base to support a more comprehensive perspective. It is now
widely understood that the primary determi-
nants of health are the economic, physical and social
environments within which individuals live. Few deter-
minants can be directly influenced by the individual; and most
social determinants have a greater impact on
population health status than healthcare services. Critically,
many determinants have a differential impact on
different groups of people: this can contribute to inequalities in
health. Developing an understanding of the
complex nature of the health determinants is not a merely
theoretical exercise; nor should the recognition of
that complexity act as an excuse for inaction on discrete issues.
Rather this understanding should be used to
develop and deploy a wider array of public policy activities to
promote good health.
13. knowledge base of the occupational group promoting public
health. For example, biomedicine, psychology,
social policy and education all bring different theoretical
interpretations to the subject. It has even been sug-
gested that public health is atheoretical in the sense that
practice has been largely unaffected by the explicit
application of theory (Weed, 2002). Indeed, Wills and Earle
(2007: 129) state it is possible to promote public
health ‘without any knowledge, or understanding, of the theory
that underpins practice’, although they do not
believe this will lead to effective strategies.
This chapter aims to review the value and limitations of the
traditional theory base of public health. It will also
highlight the potential importance of current emerging theories
in public health research and their implications
for promoting effective practice. As public health practitioners
have an obligation to act in the best interests of
the population they are serving, it is vital that all theories
underpinning knowledge and practice are given due
consideration.
Key Points
• Public health theory is a dynamic process.
• Public health theory has been influenced by chronological
eras, distinguished by dominant theories.
• Public health theory has important implications for public
health strategy and application to practice.
Discussion
The development of public health theory is evolutionary in
nature. It has always reflected different chronologi-
cal eras which are defined by their prevailing paradigms,
research methods and preventative practices (Nico-
15. health and public health practitioners were largely
involved in population-wide health improvements (Susser and
Susser, 1996a).
Germ Theory Era
Germ theory was the foremost theory in public health science
from the latter half of the nineteenth century
until at least the mid-twentieth century. Following the discovery
of bacteria, laboratory-based diagnosis, im-
munisation and treatment gradually marginalised miasma
theory. The dominant paradigm moved from being
population-based to being focused on disease pathology and the
treatment of individuals. This analysis be-
came even more ascendant with the growth of the medical-
industrial complex which, as MacDonald (2004:
384) states, ‘cemented the biomedical emphasis on single-
causative agents’ and led to the weakening of
population-based public health with the centralisation of power
and resources in hospital-based services. Epi-
demiology became a derivative activity rather than a creative
science in its own right as it had been earlier.
Chronic Disease Era
By the mid-twentieth century infectious-disease mortality had
started to decline in the industrialised world and
much more consideration was given to other causes of disease.
This led to a corresponding decline in germ
theory and the evolution of a new epidemiological paradigm
which came to be known as the ‘risk factor’ or
‘black box’ paradigm (Susser and Susser, 1996b). The
fundamental premise of this paradigm is that chronic
disease is multi-causal and cannot be explained by a specific
factor. Some of the theory's leading proponents
accepted the need for a multi-professional approach and
17. arrangement)
SAGE Books
Page 3 of 5
SAGE Books - Public Health Theories
ulation health, how they integrate social and biological
explanations, and thus their recommendations for ac-
tion’ (Krieger, 2001: 669). Psychosocial and social production
of disease/political economy of health theories,
place little emphasis on the biological process, whereas the
ecosocial paradigm grants it due recognition.
Ecosocial theory accepts the holistic notion that individual
human beings, societal structures, the environment
and biology are mutually significant in formulating patterns of
health, wellbeing and disease in the total popu-
lation (MacDonald, 2004). This multi-level paradigm offers
inter-disciplinary public health practitioners a way
forward with its new methodologies and practices. Its defining
characteristics are not only the environmental
standpoint but also the social concepts of collaboration and
community participation. Hence, ecosocial theory
can provide a practitioner with the knowledge base to devise
strategies which will impact on the delivery of
effective public health practice.
Case Study
Margaret is the health visitor for an isolated, council-owned,
traveller site which has recently been vandalised
and is in an insanitary condition. She is the key contact for the
traveller families and visits them regularly. One
18. of her clients is Carla, a 26-year-old mother, who lives on
benefits in a caravan. She is overweight, suffers
from depression and smokes at least 40 cigarettes a day. Her
father died at 45 from a heart attack and her
mother has a chronic chest condition. She has four children.
Mary, aged 7, and Danny, aged 6, have not re-
ceived a regular education, while Jade and Thomas, who are
both under 3, are behind in their development.
Furthermore, all the family and many other site dwellers are
suffering from impetigo.
Margaret, drawing on her knowledge of contemporary,
ecosocial, public health theory, calls a multi-agency
meeting, including traveller representatives, to discuss the
public health issues relating to the above circum-
stances. As a result of this consultation, the agencies and the
site community are able to secure financial
support for the upgrading of sanitary facilities and organise
transport to enable the children to attend school.
Furthermore, they succeed in improving access to medical and
social amenities for all site members. By view-
ing health, disease and wellbeing from an ecosocial perspective,
Margaret has formulated an effective public
health strategy at the individual, community and environmental
levels.
Conclusion
Public health theory is constantly evolving and will continue to
play an important part in promoting effective
practice. As outlined above, dominant paradigms have been
superseded as health patterns and technologies
have changed (Susser and Susser, 1996a). In the last decade
there has been a move in the level of analysis
from the individual back towards the population. This has
resulted in new methodologies and practices which
21. Modern Public Health
FionaAdshead, and AllisonThorpe
Definition
Public policy has been defined as ‘the broad framework of ideas
and values within which decisions are taken
and action, or inaction, is pursued by governments in relation to
some issue or problem’ (O'Neill and Peder-
son, 1992). As such, policy generically can be described as a
guiding principle of, not a guarantee for, action.
Public health policy more specifically reflects an increasingly
diverse agenda, developed against a context
of global forces and changing social and political environments.
An active social justice agenda and growing
evidence of the impact of the social determinants of health on
health inequalities and outcomes make more
complex an already crowded picture. In this chapter we will
look at the implications of current policy drivers
in England for public health, with a particular focus on how at a
national level policy directions are often influ-
enced by, and influence, legislative frameworks and policies
which are enacted at a European or global level.
Key Points
• Public health policy is not designed or delivered in isolation
from the social and political context – it
is linked to a wide range of social resources and infrastructures,
social capital, social interaction and
social support.
• Policy boundaries are often blurred – European directives can
both limit autonomy of action at a na-
22. tional level and ensure local activity has a resonance over a
larger population level by setting clear
parameters for action across nation states.
• Modern public health policy and practice has to be able to
respond to economic, demographic and
epidemiological transitions, while still enabling everyday action
on the ground.
• With lifestyle-related diseases rising, people's expectation of
active engagement in promoting and
protecting their own health means that the practice of public
health is becoming increasingly person-
alised. This is reflected in the policy arena.
Discussion
Policy-makers working in the field of public health today face a
very different environment to that which faced
our forebears in the nineteenth century. Then, the primary focus
of public health activity centred on sanita-
tion, slum clearance and the prevention of infectious diseases
(Gorsky, 2007). In our more modern complex
society, we face new challenges. Rising rates of diabetes linked
to obesity, escalating chronic diseases, and
global tobacco control – to name but a small selection of our
concerns – are juxtaposed with an increasingly
articulate, educated consumer society and an increasingly
engaged media and business presence. Unsur-
prisingly, against such a backdrop, it has long been remarked
that for public health ‘boundaries are fiction’
(Terry, 1964).
Determining how best to assure the health of our populations
remains an enormous agenda – and one in
which the whole of society has a shared interest, with roles for
24. The recent smoke-free legislation, which came into effect on 1
July 2007 in England, provides a tangible
demonstration of the relationship between politics, policy
development, the individual and the evidence. De-
spite evidence that second-hand smoke was a determinant of ill
health, there was considerable resistance to
the idea of taking a comprehensive legislative approach to the
issue, largely centred around the human rights
of smokers. The eventual policy decision to allow an open vote
on how to progress the legislation was the
culmination of a long campaign, which drew upon:
• policy-driven public consultations;
• high levels of popular and professional support;
• an extensive evidence base;
• examples of local-level action which was considerably ahead
of the proposed national policy direc-
tion;
• international and, in the case of Scotland and Ireland, more
local examples of the success of enacting
national legislation in other countries, with Scotland, for
example, demonstrating a drop in symptoms
in bar workers from 79 per cent to 53 per cent within one month
of implementation (Menzies et al.,
2006).
The combination of these factors raised the level of debate, and
ultimately influenced politicians to vote for
the more radical and visionary legislation which was eventually
enacted. This reinforces the need to recog-
nise that public health policy cannot be designed or delivered in
isolation from the social and political context:
political decisions have to reflect a balance between the
25. evidence and public opinion regarding what is right
– and both affordable and sustainable – for society at the given
point in time. The journey there, and the full
engagement which characterised it, critically determines the
success of the outcome.
However, the success of the policy direction does not lie solely
in the enactment of the legislation, but will
be measured by its cumulative effect on the health of the
population. In this case, enactment of the legisla-
tion is only one manifestation of the policy direction. Alongside
this policy-makers are working to build on this
historic milestone, through effective enforcement, policing and
publicity, to encourage people to take advan-
tage of health improvement initiatives, such as smoking
cessation services, which will spare thousands more
lives, and through consultations to raise the age of sale, to
ensure that more people are spared the misery of
watching their families and friends suffer with preventable
smoke-related illnesses (DH, 2007a).
This recognition of the need to take a more personalised
approach to health underpinned the Choosing Health
White Paper, reflecting a policy commitment to a broader social
contract between the state and individuals,
with choice and civic action being key elements of this contract.
In effect, it recognised that public health pol-
icy needs both to provide a direction for and support action in
relation to our key health priorities. In practice
this means that policies must facilitate partnership across
society, with joined up action at governmental, na-
tional, regional and local levels, and enable those who have an
ability to contribute to do so. In practice, this
means that policy direction must be supported by the
appropriate levers to drive delivery:
27. • Applying policy consistently across nation states sets clear
parameters for action and enables local
action to have a stronger resonance across a wider population.
Legislation provides one route to en-
sure this, but legislation alone will not deliver behavioural
change.
• Working with the population, targeting our efforts
appropriately, ensures that the effects of our policy
will be instrumental in informing a culture that is motivated,
progressive, ambitious and constantly
striving to improve services: not for the sake of it or to satisfy
‘managers’, but for the benefit of ser-
vice users.
But, as the case study demonstrated, it is not an ‘either/or’
scenario. Policy-makers today working in the field
of public health face a complex agenda – but they also have a
unique range of opportunities. It is up to the
population as a whole to ensure that we maximise their
potential.
Further Reading
FrenchJ. and BlairS. C., (2006) ‘From snake oil salesmen to
trusted policy advisors. The development of
a strategic approach to the application of social marketing in
England’, Social Marketing Quarterly, 12(3):
29–40. http://dx.doi.org/10.1080/15245000600848892
HM Treasury (2002) Securing our Future: Taking a Long Term
View. London: HM Treasury.
O'Neill, M. and Pederson, A., (1992) ‘Building a methods
bridge between policy analysis and healthy public
policy’, Canadian Journal of Public Health, 83(32): 25–30.
World Health Organisation. (2006) WHO Framework
Convention on Tobacco Control. Retrieved January
21, 2007, from
29. https://www.youtube.com/watch?v=7ttyE7ZnupY
Consider the multidisciplinary interactions of biological and
social sciences as presented in Chapters 2 and 3 of Key
Concepts of Public Health. With this in mind, perform an
episode analysis of the information delivered in this episode
about the connection between diabetes and suburban sprawl, as
discussed in the text.
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:
1. Begin by summarizing the episode in 100 words or less.
2. Relate the information from this episode to what you learned
in Chapters 2 and 3 of your textbook, Key Concepts in Public
Health. What specific public health disciplines mentioned in
these chapters of your textbook are related to the information
presented in the video and why?
3. Critique the information. Do you feel that the information
presented is valid and easy to understand?
4. 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.
5. 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.
6. What information was missing from the episode? How could
the content be improved? What would you like to see in future
episodes?
· Write a 2-page paper, 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
30. 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.