Public health

1. Missouri Department of Health and Senior Services
Center for Local Public Health Services
Missouri’s Public Health System

2. What is Public Health?
• Public health is often confused with
health care.
• A health care provider diagnoses and
treats individual patients.
• Public health professionals develop plans
of action to improve the health status of
the entire population.

3. • Focus of public health has changed over
the years.
• Early efforts directed toward disease
prevention.
• Expanded insurance coverage to most
people has allowed public health to focus
on its principal roles of protecting the
public and promoting health.
Public Health cont.

4. Effective Public Health System
• Assesses and promotes health and safety
• Prevents or minimizes the occurrence of
diseases and injuries
• Plans, prepares and responds to natural and
manmade disasters
• Identifies barriers, and facilitates access to
primary and preventive health care, and
• Enforces public health laws and regulations

5. CDC’s Ten Essential Services
• 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
actions to identify and solve health
problems

6. Essential Services cont.
• 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

7. Essential Services cont.
• Assure a 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

8. Public Health System vs.
the Health System (medicine)
Public Health System
• Primary focus on
population
• Emphasis on disease
prevention and health
promotion that shape a
community’s overall
health profile
Health System
• Primary focus on
individual
• Emphasis on
diagnosis and
treatment

9. Health System
• Hospital delivers the
baby
Public Health System
• Regulates the hospital
to ensure safety

10. Public health is
credited with
adding 25 years to
the life expectancy
of people in the
United States in
this century.
Missouri’s Public Health
System

11. Great Public Health
Achievements
• Vaccinations
• Motor-vehicle safety
• Safer workplaces
• Safer and healthier foods
• Decline in deaths from coronary heart
disease and stroke
United States – 1900-1999

12. • Healthier mothers and babies
• Fluoridation of drinking water
• Recognition of tobacco use as a health
hazard
• Control of infectious diseases
Great Public Health
Achievements cont.
United States – 1900-1999

13. Public health’s disease control efforts
have led to a sharp decline in deaths from
infectious diseases since 1900.
Missouri’s Public Health
System

14. However, as these
infectious diseases
decreased, chronic
diseases increased.
Missouri’s Public Health
System

15. Missouri’s Public Health
System
“Health is worth more
than learning.”
-Thomas Jefferson
(1743 - 1826)
letter to his cousin John
Garland Jefferson,
June 11, 1790

16. Top Five Leading Causes of Death,
Missouri 2005
Cancer
23%
Unintentional
Injuries
5%
Stroke
6%
Chronic lower
respiratory
diseases
6%
Heart Disease
27%
Other
diseases
33%
12,381
3,316
3,063
2,807
17,939
14,818

17. Tobacco Use
23 23 22 23 23 22 23 23 23 23 23 23 23
22
21 21 20
26
25
23
27
25 24
28 29
26 27 27
26 27 27
24 23 23
0
5
10
15
20
25
30
35
1
9
9
0
1
9
9
1
1
9
9
2
1
9
9
3
1
9
9
4
1
9
9
5
1
9
9
6
1
9
9
7
1
9
9
8
1
9
9
9
2
0
0
0
2
0
0
1
2
0
0
2
2
0
0
3
2
0
0
4
2
0
0
5
2
0
0
6
Proportion
(%)
Source: Centers for Disease Control and Prevention (CDC), Behavioral Risk Factor Surveillance System (BRFSS)
U.S.
Missouri
Proportion of Current Smokers Among Adults Aged 18 Years
and Older, Missouri and the U.S., 1990-2006

18. Tobacco Use
Proportion of Current Smokers Among Adults Aged 18 Years
and Older, by Region, Missouri, 2006
Northwest:
23.4%
Kansas City
Area: 20%
Southwest:
23.8%
Northeast: 26.6%
Central: 31.1%
St. Louis Area: 19.8%
Southeast: 29.7%
BOONE
AUDRAIN
HOWARD
CHARITON
SALINE
MORGAN
PETTIS
CARROLL
COLE
COOPER
MILLER
CAMDEN
MONT-GOMERY
GASCONADE
PULASKI
LACLEDE DENT
POLK
GREENE
WEBSTER WRIGHT
DOUGLAS HOWELL
SHANNON
CARTER
WAYNE
MADISON
BOLLINGER
ST.
FRANCOIS
STE.
GENEVIEVE
WASHINGTON
JEFFERSON
PERRY
CAPE
GIRARDEAU
SCOTT
MISSISSIPPI
STODDARD
BUTLER
PEMISCOT
DUNKLIN
ST. LOUIS
ST. CHARLES
LINCOLN
PIKE
MACON
MONROE
JOHNSON
LAFAYETTE
JACKSON
RAY
CLAY
PLATTE
CLINTON
BUCHANAN
ATCHISON NODAWAY
LAWRENCE
JASPER
BARRY
TANEY
WORTH HARRISON MERCER PUTNAM SCHUYLER
SCOTLAND
CLARK
HOLT
ANDREW
GENTRY
DEKALB
GRUNDY
DAVIESS
SULLIVAN
ADAIR
LINN
LIVINGSTON
CALDWELL
KNOX
SHELBY
RANDOLPH
LEWIS
MARION
RALLS
CALLAWAY
CASS
WARREN
FRANKLIN
CRAWFORD
IRON
REYNOLDS
TEXAS
MARIES
NEW
MADRID
RIPLEY
OREGON
DALLAS
HICKORY
BENTON
ST. CLAIR
HENRY
CEDAR
DADE
BARTON
VERNON
BATES
STONE
McDONALD
NEWTON
CHRISTIAN
OZARK
MONITEAU
OSAGE
PHELPS

19. Obesity
12
25
12
27
0
5
10
15
20
25
30
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Proportion
(%)
Source: CDC, BRFSS
Missouri
U.S.
Proportion of Obesity Among Adults Aged 18 Years and
Older, Missouri and the U.S., 1990-2006

20. Obesity
Northwest:
28.6%
Kansas City
Area: 28.3%
Southwest:
26.7%
Northeast: 30.5%
Central: 25.1%
St. Louis Area: 23%
Southeast: 32.6%
Proportion of Obesity Among Adults Aged 18 Years and
Older, by Region, Missouri, 2006
BOONE
AUDRAIN
HOWARD
CHARITON
SALINE
MORGAN
PETTIS
CARROLL
COLE
COOPER
MILLER
CAMDEN
MONT-GOMERY
GASCONADE
PULASKI
LACLEDE DENT
POLK
GREENE
WEBSTER WRIGHT
DOUGLAS HOWELL
SHANNON
CARTER
WAYNE
MADISON
BOLLINGER
ST.
FRANCOIS
STE.
GENEVIEVE
WASHINGTON
JEFFERSON
PERRY
CAPE
GIRARDEAU
SCOTT
MISSISSIPPI
STODDARD
BUTLER
PEMISCOT
DUNKLIN
ST. LOUIS
ST. CHARLES
LINCOLN
PIKE
MACON
MONROE
JOHNSON
LAFAYETTE
JACKSON
RAY
CLAY
PLATTE
CLINTON
BUCHANAN
ATCHISON NODAWAY
LAWRENCE
JASPER
BARRY
TANEY
WORTH HARRISON MERCER PUTNAM SCHUYLER
SCOTLAND
CLARK
HOLT
ANDREW
GENTRY
DEKALB
GRUNDY
DAVIESS
SULLIVAN
ADAIR
LINN
LIVINGSTON
CALDWELL
KNOX
SHELBY
RANDOLPH
LEWIS
MARION
RALLS
CALLAWAY
CASS
WARREN
FRANKLIN
CRAWFORD
IRON
REYNOLDS
TEXAS
MARIES
NEW
MADRID
RIPLEY
OREGON
DALLAS
HICKORY
BENTON
ST. CLAIR
HENRY
CEDAR
DADE
BARTON
VERNON
BATES
STONE
McDONALD
NEWTON
CHRISTIAN
OZARK
MONITEAU
OSAGE
PHELPS

21. Core Public Health General Revenue Funding
Per Capita
$1.71 $1.70
$1.68
$1.57 $1.56 $1.55 $1.53
$1.71
$1.67
$1.62
$1.47
$1.41
$1.36
$1.30
$1.20
$1.30
$1.40
$1.50
$1.60
$1.70
$1.80
2001 2002 2003 2004 2005 2006 2007
Per capita support
Per capita support discounted due to inflation
Fiscal Year

22. 0.79%
3.49%
1.51%
0.00%
-5.93%
0.00%
7.03%
1.76%
0.00%
-0.68%
-8.00%
-6.00%
-4.00%
-2.00%
0.00%
2.00%
4.00%
6.00%
8.00%
FY 2002 FY 2003 FY 2004 FY 2005 FY 2006
Local Public Health Agency revenues raised locally
State Core Public Health General Revenue funding
Local Public Health Agency Revenue Growth
(Local Revenues vs. State Core Public Health GR Funding)

23. Missouri Public Health and You
• In action every day, in every county of the state
• Assures our children are immunized
• Puts plans in place for emergency and disaster
management
• Detects and curtails infectious diseases
• Reduces effects of diseases like diabetes and
asthma
• Monitors drinking water quality, and
• Helps keep restaurant food safe