Dr. jhonnifer abarao public health systems

PUBLIC
HEALTH
SYSTEM
BY: Dr. Jhonnifer Arellano Abarao, DHCM, MAN, RN, USRN
Doctor of Health Care Management
October 2,

O B J ECT IV ES
At the end of the discussion, students should be able to:
• Define Public Health
• Define Public Health System
• Discuss the Sub-branches of Public Health Systems
• Define some Terminologies used in Public Health
• Discuss the History of Public Health in the Philippines and
in the International
• Describe the Health Care Delivery System in the Philipines

the science and art of preventing disease, prolonging
life, and promoting health and efficiency through
organized community efforts for the sanitation of the
environment, the control of community infections, the
education of the individual in personal health, the
organization of medical and nursing services for the
early diagnosis and preventive treatment of disease,
and the development of the social machinery which
will ensure to every individual on the community a
standard of living adequate for the maintenance or
improvement of health.
defined by C.E.A. Winslow

states that public health is the practice of
preventing disease and promoting good
health within groups of people, from small
communities to entire countries. They further
state that it includes health professionals
from many fields working together with the
common purpose of protecting the health of
a population.
defined by American Public Health Association

Public health systems are commonly defined as “all
public, private, and voluntary entities that contribute
to the delivery of essential public health services
within a jurisdiction.” Public health systems can also
be described as a network of entities with differing
roles, relationships, and interactions. All these
entities contribute to the public’s health and
wellbeing throughout the community. The
governmental public health department is a major
player in the public health system, but they do not
provide the full spectrum of essential public health
services alone.

Total Number of Cases
SUB-
BRANCHES
OF PUBLIC
HEALTH
SYSTEMS

Sub-branches of Public Health
System
1
Environmental
Health
2
Community
Health
3
Epidemiology
4
Global
Health
5
Health
Policy and
Management

Environmental
Health
Environmental health refers to
the specialty of public health that
focuses on the natural and man-
made environments that affect
human health. Environmental
health specialists investigate and
analyze environmental qualities
that may influence human health.
They develop, promote and
enforce environmentally related
guidelines, policies, laws and
regulations in order to create and
sustain healthy living
environments for people.

Community health workers assist the
communities they serve by providing
education and facilitating services for
better health and improved quality of
life. They conduct outreach programs
that engage the community concerning
health access and education.
Community Health

Epidemiologists investigate the
patterns and causes of diseases and
injuries in a community or
demographic of people. They do this
in order to reduce the risk and
occurrence of negative health
outcomes via research, community
education and health policy
advocacy. Epidemiologists may
collect and analyze data and results
through the use of observations,
interviews and surveys. They may
collect blood or other fluid samples in
order to find causes of health
problems.
EPIDEMIOLOGY
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Global health is defined by
the National Institutes of
Health as study, research
and practice that widens
the scope of public health
into a global perspective for
people worldwide.
GLOBAL
HEALTH

The specialty of health policy
includes careers like public health
researcher, healthcare policy analyst
and health services manager. Health
policy professionals play roles as
researchers and advocates in the
world of health. They may act as
liaisons between public health
professionals or organizations and
government agencies
HEALTH POLICY
AND
MANAGEMENT

HISTORY OF
PUBLIC HEALTH
IN THE
PHILIPPINES

PRE-AMERICAN
OCCUPATION
The Americans did not establish public health in
a vacuum. When Spain came to introduce
occidental civilization in the country, they had
withal to make use of the type of hygiene and
preventive medicine then understood and
practiced in the Iberian peninsula. They
undeliberately prepared the grounds on which
the Americans later launched the public health
program and it would be unpardonable to ignore
their contributions. Public health work during
the Spanish regime inauspiciously began at the
portera of the old Franciscan convent in
Intramuros where a friar Fr. Juan Clemente put
up a dispensary in 1577 for treating the
indigents in Manila.

PRE-AMERICAN
OCCUPATION
Public health work during the Spanish regime
inauspiciously began at the portera of the old
Franciscan convent in Intramuros where a friar
Fr. Juan Clemente put up a dispensary in 1577
for treating the indigents in Manila.
--Eventually became the San Juan de Dios
Hospital (1659)

PRE-AMERICAN
OCCUPATION
When the Americans occupied the Philippines,
there were already in operation:
Five General Hospitals
* The San Juan de Dios Hospital (1659)
* Chinese General Hospital ( 1891 )
* Hospicio de San Jose in Cavite (1611 )
* Casa de la Caridad in Cebu
* Infirmaries de Sta. Cruz in Laguna (1870)
Four Contagious Hospitals
* San Lazaro Hospital (1577)
* Hospital de Palestina in Camarines Sur
* Hospital de Leprosos in Cebu
* Hospital de Argencina in Manila for smallpox
and cholera

PRE-AMERICAN
OCCUPATION
Two Military Hospitals
* Hospital Militar de Manila Hospital
*Militar de Zamboanga
Two Naval Hospitals
* Hospital dela Marie in Canacao, Cavite
*Hospital de Basilan in Basilan

AMERICAN MILITARY
GOVERNMENT
(1895-1907)
DR. GUY EDI
the first commissioner appointed
when a Board of Health established

These activities were
undertaken during this period
that underscores concerns the
control of epidemics and fight
against communicable
diseases:
• establishment of garbage
crematory (1899)
• first sanitary ordinance and rat
control (1901)
• confirmation of the theory that
plague in man comes from
infected rats (1905)

• established technologically that
contaminated water and unclean
vegetables are important factors in
the control of amoebic dysentery
while Anopheles minimus was first
pointed out as the vector of malaria
(1904)
• opening of the College of Medicine
U.P. with Preventive Medicine as
one the departments ( 1907)
• cholera vaccine was first tried (1 905) followed
by compulsory vaccination of school children
• opening of the leper colony in Culion and
compulsory detection oflepers (1 906)
founding of the Manila Medical Society and
the Philippine Island Medical Association
(1 902 & 1 903).

BUREAU OF SCIENCE
established in 1905 to work in close
collaboration with the Philippine
General Hospital and the
University of the Philippines to
give outstanding importance to
public health.

PHILIPPINE
ASSEMBLY
(1 9 0 7 -1 9 1 6 )
- a step towards Filipinization.
- most of the executive departmcnts were
placed under Filipinos, the Bureau of Health
remained under American administration.
- The public health program started to take
off.

1 9 0 8 -1 9 1 0
• first institution of the search for germ
carriers
• the new waterworks in Manila was
inaugurated
• start of anti-tuberculosis campaign with
P35,OOO appropriation from the
government
• conduct of first sanitary survey of rural
community
• opening of Pasteur Prophylaxis treatment
against rabies
• recognizing that Beri-beri as associated
with eating white polished rice

1 9 1 1 -1 9 1 3
• First demonstrated the eradication of
beri-beri among Philippine scouts by
means of simple change in the diet.
• initial use of anti-typhoid vaccine
• use of hypochlorite of lime for the first
time for treating Manila water supply
• initial study on vitamin deficiency as
cause of beri-beri which ultimately
culminated in the isolate of Vitamin
Biothiamine
• first use of dry vaccine against smallpox
with successful results with potency for
two months versus one week of
glycerinated lymph vaccine

1 9 1 4
• manufacture and free distribution of tiki-
tiki for treatment of beri-beri
• inauguration of first "clean up week"

By 1921, the Republicans regained control
of the White House and Governor General
Leonard Wood, a physician, an
administrator, a sanitarian and a
humanitarian assumed office. Governor
Wood had a militaristic orientation. He re-
energized the health service and
encouraged effective supervision.
Department of Public Instructiona
- where education and health programs
located, still remained under an American
leadership
There's a rise in crude death rate and
infant mortality. there's an increase of
deaths from smallpox, cholera, beri-beri,
and tuberculosis.

Governor-General Leonard Wood
- a physician, an administrator, a
sanitarian and a humanitarian assumed
office
- had a militaristic orientation
- re-energized the health service and
encouraged effective supervision
- had a profound effect on the public
health service
semi-militarized Philippine Health Service
was transformed into a Bureau of Health
and together with the Bureau of Public
Welfare formed the Office of the
Commission of Health and Welfare
(Reorganization Act of 1932).

- a Committee was appointed to study the
cause and prevalence of typhoid fever.
- value and vitamin distribution of many
Philippine foods were studied. This is part
of the drive for better nutrition.
- Schick test was first used on a large scale
to determine the susceptibility of Filipino
children to diphtheria
- campaign against hookworm was
launched. Anti-dysentery vaccine as first
tried locally.
- Mechanism of transmission through
Aedes Egypt of dengue fever was studied
successfully.

- B.S. in Education, major in health
education was offered in U.P.
- Law was enacted to establish civil
registry. Tuberculosis Commission was
created.
- Free Emergency Medical Treatment for
Laborers was offered.
- Reorganization Act - consol idating public
health and welfare ac?tivities under the
Commission of Health and Welfare was
promulgated.

THE
COMMONWEALTH
1936-1942
U.P. School of Public Health was established for
the training of public health leaders.
The health of laborers was addressed and the
sanitation of the environment pursued.
President Quezon gave attention to public health as attested
by a gradual increase given to health appropriation. An
additional PI9,ISO,OOO was made for specific projects for
the construction of additional leprosaria, of provincial
hospitals, for the construction and rehabilitation of the
Philippine General Hospital, and for the drilling of artesian
wells, waterworks, public market and slaughter houses.

THE
COMMONWEALTH
1936-1942
Department of Health and Welfare - created
last 1939 with Dr. Jose Fabella as the first
secretary.
Bureau of Census and Statistics - created in
1940; therefore vital statistics was transferred
from the Bureau of Health to this new Bureau.
President Quezon gave attention to public health as attested
by a gradual increase given to health appropriation. An
additional PI9,ISO,OOO was made for specific projects for
the construction of additional leprosaria, of provincial
hospitals, for the construction and rehabilitation of the
Philippine General Hospital, and for the drilling of artesian
wells, waterworks, public market and slaughter houses.

THE
COMMONWEALTH
1936-1942
Maternal and Child Health, School Health,
Health Education of the public, Public Health
Nursing, Public Health Dentistry, Hospital and
Laboratory services were all strengthened.
By the end of 1939, the state of health was fairly
satisfactory. Only one case of smallpox and no
cholera case was reported.

POST WORLD WAR II
TO
MARTIAL LAW
1946-1972

- research on DDT saw dust as a larvacide and DDT residual spraying of horses in the
control of malaria.
- construction of the National Chest Center, establishment of a control case registry
for TB. Mass case finding surveys and mass BCG immunization for TB control.
- the Bataan Enriched Rich Project which amply demonstrated the efficacy of
enriched rice in the eradication of beri-beri and iron deficiency anemia.
- introduction of one - infection method for gonorrhea with penicillin which
established a routine procedure in all VD clinic.
- creation of a Central Health Laboratory of Philippine under the newly organized
Department of Health.
- reorganization of government offices in 1 947 resulting in the transfer from the Dept.
of Health and Public Welfare of the Bureau of Public Welfare to assume the name of
Social Welfare Administration, and the creation of the Bureau of Hospitals and
Quarantine under the Dept. of Health.
- creation of the Institute of Nutrition - 1 948 which was charged with the duty
of unifying, centralizing and coordinating all nutrition research and activities.

- Implementation of the Restructured Health Care Delivery system where the three
levels of care was evolved - the primary, the secondary and the tertiary.
- The adoption of PHC as an approach to health development in the Philippines
which was eventually launched nationwide on Sept. I I, 1 981 .
- Operation Timbang - a nationwide nutrition program providing
supple?mentary food for infants and school feeding programs.
- The Integrated Provincial Health Office (IPHO) - this merged public health and
hospital services at the provincial level and the various health units, personnel
and financial resources of the different health programs were integrated.
- The Oral Rehydration Therapy for the National Control of Diarrheal Disease
became one of the major thrust of the DOH
- Community-Based Health Programs - started in 1 973, the vision was to train
lay people and utilize local and indigenous resources for preventive and
curative health care instead of Western-oriented system
- Public Health Research - Breakthroughs in public health are generally based
and supported by research. The Martial law years can be credited with

- Creation of the Nutrition Council of the Philippines in 1 974 began to
address the problem of malnutrition
- Research Institute for Tropical Medicine (RITM) was inaugurated on 23
April 1 981 as the research arm of the Department of Health in infectious
and tropical diseases
- The PCHRD (Philippine Council for Health Research and Development
was created in 1 982. Its mandate is to lead, direct and coordinate
science and technology activities in health and nutrition.

-The Milk Code Exec. Order 51
- In 1987, the International Safe Motherhood Initiative was launched to reduce
maternal deaths.
- Start of the National Epidemic Surveillance System in 1988
- The National Drug Policy together with the Generic Act of 1988 to ensure
the availability of safe, effective and affordable quality drug
- RA 7170 - Organ Donation Act of 1991 - Legalizing donation of all or parts of
the body after death for specified purposes.
- The Magna Carta of Public Health workers, RA 7305, dated March 1992
which seeks to promote and improve the social and economic well being of
public health workers.
- onslaught of HIV/AIDS emerged

INTERNATIONAL
HISTORY OF
PUBLIC HEALTH

- epidemics such as the plague, cholera, and smallpox evoked sporadic public
efforts to protect citizens in the face of a dread disease.
- public effort was made to contain the epidemic spread of specific disease
through isolation of the ill and quarantine of travelers
- in the late seventeenth century, several European cities appointed public
authorities to adopt and enforce isolation and quarantine measures

- Several American port cities adopted rules for trade quarantine and
isolation of the sick.
- In 1 701 Massachusetts passed laws for isolation of smallpox patients
and for ship quarantine as needed.
- several cities, including Boston, Philadelphia, New York, and Baltimore,
had established permanent councils to enforce quarantine and isolation
rules.
- cities began to establish voluntary general hospitals for the physically
ill and public institutions for the care of the mentally ill.
- The first American voluntary hospitals were established in Philadelphia
in 1 752 and in New York in 1 771 . The first public mental hospital was
established in Williamsburg, Virginia in 1 773.

THE
NINETEENTH
CENTURY
"THE GREAT SANITARY
AWAKENING"

- the identification of filth as both a cause of disease and a vehicle of transmission
and the ensuing embrace of cleanliness—was a central component of nineteenth-
century social reforms. Sanitation changed the way society thought about health.
Illness came to be seen as an indicator of poor social and environmental
conditions, as well as poor moral and spiritual conditions. Sanitation also changed
the way society thought about public responsibility for citizen's health. Protecting
health became a social responsibility. Disease control continued to focus on
epidemics, but the manner of controlling turned from quarantine and isolation of
the individual to cleaning up and improving the common environment.

THE
DEVELOPMENT OF
PUBLIC ACTIVITIES IN
HEALTH

- a London lawyer and secretary of the Poor Law
Commission in 1838
- one of the most recognized names in the
sanitary reform movement.
- conducted studies of the life and health of the
London working class in 1838 and that of the
entire country in 1842
- documented that the average age at death for
the gentry was 36 years; for the tradesmen, 22
years; and for the laborers, only 16 years.
EDWIN
CHADWICK

- Chadwick proposed what came to be known as
the "sanitary idea." His remedy was based on the
assumption that diseases are caused by foul air
from the decomposition of waste. To remove
disease, therefore, it was necessary to build a
drainage network to remove sewage and waste.
Further, Chadwick proposed that a national board
of health, local boards in each district, and district
medical officers be appointed to accomplish this
goal.
EDWIN
CHADWICK

LATE NINETEENTH
CENTURY:
ENTER
BACTERIOLOGY

- Many major contagious diseases were brought under control through science
applied to public health.
- Louis Pasteur, a French chemist, proved in 1877 that anthrax is caused by
bacteria. By 1884, he had developed artificial immunization against the
disease.
- discoveries of bacteriologic agents of disease were made in European and
American laboratories for such contagious diseases as tuberculosis,
diphtheria, typhoid, and yellow fever.
- The identification of bacteria and the development of interventions such as
immunization and water purification techniques provided a means of
controlling the spread of disease and even of preventing disease.
- Public health measures continued to be focused predominantly on specific
contagious diseases, but the means of controlling these diseases changed
dramatically.

EARLY TWENTIETH
CENTURY: THE MOVE
TOWARD PERSONAL
CARE

- the role of the state and local public health departments expanded greatly.
Although disease control was based on bacteriology
- Identification and treatment of individual cases of disease were the next
natural steps.
- Massachusetts passed a law requiring reporting of individual cases of 16
different diseases.
- Registration and analysis of disease showed that the highest rates of
morbidity still occurred among children and the poor.
- New York and Baltimore health departments began offering home visits by
public health nurses.
- School health clinics were set up in Boston in 1894, New York in 1903, Rhode
Island in 1906, and many other cities in subsequent years
- Numerous local health agencies set up clinics to deal with tuberculosis and
infant mortality.

THE GROWTH OF
FEDERAL ACTIVITIES
IN HEALTH

- In 1906, Congress passed the Food and Drug Act, which initiated controls on the
manufacture, labeling, and sale of food.
- Congress enacted the Chamberlain-Kahn Act, which established the U.S.
Interdepartmental Social Hygiene Board, a comprehensive venereal disease
control program for the military, and provided funds for quarantine of
infected civilians
- The Sheppard-Towner Act of 1922 established the Federal Board of
Maternity and Infant Hygiene, provided administrative funds to the Children's
Bureau, and provided funds to states to establish programs in maternal and
child health. This act was the first to establish direct federal funding of
personal health services. In order to receive federal funds, states were
required to develop a plan for providing nursing, home care, health
education, and obstetric care to mothers in the state

THE LATE TWENTIETH
CENTURY: A CRISIS IN
CARE AND FINANCING

- By the 1970s, the financial impact of the expansion in public health activities
of the 1930s through the 1960s, including new public roles in the financing of
medical care, began to be apparent.
- The Health Maintenance Act of 1973, promoting health maintenance
organizations as a less costly means of health care, and the National Health
Planning and Resources Development Act of 1974, setting up a certification
system for new health services, are examples of this effort.
- Medicaid was altered to give greater leeway to the states in the design and
implementation of the program, although the federal share of Medicaid
financing was not changed. Changes also have been made in Medicare
payment policies to restrain the increase in costs, especially for hospital care.
- New health problems have continued to surface. AIDS, a previously
unknown contagious disease, is reaching epidemic proportions. Greater
numbers of hazardous by-products of industry are being produced and
disposed of in the environment.

HEALTHCARE
DELIVERY
SYSTEM IN THE
PHILIPPINES

HEALTHCARE
DELIVERY SYSTEM
- the network of health facilities and personnel
which carries outthe task of rendering health care
to the people.

PHILIPPINE
HEALTHCARE
SYSTEM
- is a complex set of organizations interacting to
provide an arrayof health services

HEALTH CARE SYSTEM
MODELS
PRIVATE
ENTERPRISE
HEALTHCARE
1
SOCIAL
SECURITY
HEALTH MODEL
PUBLICLY
FUNDED
HEALTHCARE
MODEL
SOCIAL
HEALTH
INSURANCE
2 3 4

PRIVATE ENTERPRISE
HEALTHCARE MODEL
- Purely private enter rise health care systems are
comparatively rare.
• Where they exist, it is usually for a comparatively
well-off subpopulation in a poorer country with a
poorer standard of health care²for instance, private
clinics for a small, wealthy expatriate population in
an otherwise poor country.

SOCIAL SECURITY
HEALTH MODEL
- refers to social welfare service concerned with social
protection, or protection against socially recognized
conditions, including poverty, old age, disability,
unemployment and others.
- social insurance, where people receive benefits or
services in recognition of contributions to an
insurance scheme. These services typically include
provision for retirement pensions, disability
insurance, survivor benefits and unemployment
insurance.

PUBLICLY FUNDED
HEALTHCARE MODEL
- Health care that is financed entirely or in majority
part by citizens' tax payments instead of through
private payments made to insurance companies or
directly to health care providers

SOCIAL HEALTH
INSURANCE
- where the whole population or most of the
population is a member of a sickness insurance
company
- (SHI) is a method for financing health care costs
through a social insurance program based on the
collection of funds contributed by individuals,
employers, and sometimes government subsidies
- characterized by the presence of sickness funds
which usually receive a proportional contribution of
their members' wages.
- With this insurance contributions these funds pay
medical costs of their members

The components of the health care
delivery system as mandate of the
Department of Health (DOH) is to be
responsible for the following:
• formulation and development of national health
policies, guidelines, standards and manual of
operations for health services and programs;
• issuance of rules and regulations, licenses and
accreditations; promulgation of national health
standards, goals, priorities and indicators;
• development of special health programs and
projects and advocacy for legislation on health
policies and programs.

The primary function of the
Department of Health is the
promotion, protection,
preservation or restoration of the
health of the people through the
provision and delivery of health
services and through the
regulation and encouragement of
providers of health goods and
services.

THREE
LEVELS OF
HEALTH
WORKERS IN
THE
PHILIPPINES
VILLAGE OR GRASSROOTS
HEALTH WORKERS
INTERMEDIATE LEVEL OF
HEALTH WORKERS
FIRST LINE HOSPITAL
PERSONNEL

VILLAGE OR
GRASSROOTS
HEALTH
WORKERS
- are the first contacts of the community
and initial links of health care.
-They provide simple curative and
preventive health care measures
promoting healthy environment
- These are the barangay health worker,
volunteers or traditional birth attendants
or hilot.

INTERMEDIATE LEVEL
OF HEALTH WORKERS
- represents the first source of professional health care
- They attend to health problems beyond the competence of
village workers and provide support to front-line health workers
in terms of supervision, training, supplies, and services.
- These are the medical practitioners, nurses and midwives.

- provide backup health services for cases that require hospitalization
and establish close contact with intermediate level health workers or
village health workers.
- These are the physicians with specialty, nurses, dentist, pharmacists,
and other health professionals.
FIRST LINE HOSPITAL
PERSONNEL

LEVELS OF
HEALTHCARE
FACILITIES

PRIMARY LEVEL
are the rural health units, their sub-
centers, chest clinics, malaria
eradication units, and
schistosomiasis control units
operated by the DOH; puericulture
centers operated by League of
Puericulture Centers; tuberculosis
clinics and hospitals of the Philippine
Tuberculosis.

SECONDARY LEVEL
- are the smaller, non-
departmentalized hospitals including
emergency and regional hospitals.
- Services offered to patients with
symptomatic stages of disease,
which require moderately specialized
knowledge and technical resources
for adequate treatment.

TERTIARY LEVEL
- are the highly technological and
sophisticated services offered by
medical centers and large hospitals.
These are the specialized national
hospitals.
- Services rendered at this level are
for clients afflicted with diseases
which seriously threaten their health
and which require highly technical
and specialized knowledge, facilities
and personnel to treat effectively

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NURSING
INFORMATICS
is the specialty that integrates nursing
science, computer science, and information
science in identifying, collecting, proces sing,
and managing data and information to
support nursing practice, administration,
educa tion, research and the expansion of
nursing knowledge

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APPLICATION OF
NURSING
INFORMATICS
- Nursing Informatics can be applied to all
areas of nursing practice, which include;
clinical practice, administration, education,
and research.

Application of Nursing
Informatics
NURSING CLINICAL
PRACTICE (POINT-OF-
CARE SYSTEMS AND
CLINICAL
INFORMATION
SYSTEMS)
NURSING
ADMINISTRATION
(HEALTH CARE
INFORMATION
SYSTEMS)
NURSING
EDUCATION AND
RESEARCH

TERMINOLOGIES
USED IN
PUBLIC HEALTH

• ASSESSMENT
defined as collecting, analyzing, and
using data to educate and mobilize
communities, develop priorities, garner
resources, and plan actions to improve
public health.
4. BENCHMARKS
are points of reference or a standard
against which measurements can be
compared.
2. ASSURANCE
one of the core functions of public health,
assurance refers to the process of
determining that “services necessary to
achieve agreed upon goals are provided,
either by encouraging actions by other
entities (public or private sector)
3. BEHAVIORAL RISK FACTORS
behaviors that are believed to cause, or
to be contributing factors to most
accidents, injuries, disease, and death
during youth and adolescence

5. BOARD OF HEALTH
a legally designated governing entity
whose members are appointed or
elected to provide advisory functions
and/or governing oversight of public
health activities, including assessment,
assurance, and policy development, for
the protection and promotion of health
in their community.
8. COMMUNITY BASED
PARTICIPATORY RESEARCH
research that equitably involves all
partners in the research process and
recognizes the unique strengths that
each brings.
6. CDC
Centers for Disease Control and
Prevention (CDC) is part of the
Department of Health and Human
Services. It provides federal leadership
and funding in the prevention and control
of diseases.
7. COMMUNICABLE DISEASE
DATA
diseases that are usually transmitted
through person-to-person contact or
shared use of contaminated
instruments/materials.

9. CULTURAL COMPETENCE
A set of skills that result in an individual
understanding and appreciating cultural
differences and similarities within,
among, and between groups and
individuals.
12. DEMOGRAPHIC
CHARACTERISTICS
measures of total population as well
as percent of total population by age
group, gender, race and ethnicity.
10. COMMUNITY HEALTH
IMPROVEMENT
Focuses on the combined effects of
individual and community, physical and
social environments, and the policies and
interventions used to promote health,
prevent disease, and ensure access to
quality health care
11. DEATH, ILLNESS, AND/OR
INJURY DATA
measured in terms of mortality (rates of
death within a population) and morbidity
(rates of the incidence and prevalence of
disease).

13. DETERMINANTS OF HEALTH
Direct causes and risk factors which,
based on scientific evidence or theory,
are thought to influence directly the
level of a specific health problem.
16. ENVIRONMENTAL HAZARDS
Situations or materials that pose a
threat to human health and safety in
the built or natural environment, as
well as to the health and safety of
other animals and plants, and to the
proper functioning of an ecosystem,
habitat, or other natural resource.
14. DISEASE
A state of dysfunction of organs or
organ systems that can result in
diminished quality of life
15. ENDEMIC
Prevalent in or peculiar to a particular
locality or people

17. EPIDEMIC
A group of cases of a specific disease
or illness clearly in excess of what one
would normally expect in a particular
geographic area.
20. GEOGRAPHICAL
INFORMATION SYSTEM
Combines modern computer and
supercomputing digital technology
with data management systems to
provide tools for the capture,
storage, manipulation, analysis, and
visualization of spatial data.
18. EPIDEMIOLOGY
the study of the distribution and
determinants of health-related states
or events in specified populations,
and the application of this study to
the control of health problems.
19. FOODBORNE ILLNESS
Illness caused by the transfer of disease
organisms or toxins from food to
humans.

21. HEALTH DISPARITIES
indicate the difference in the incidence,
prevalence, mortality, and burden of
diseases and other adverse health
conditions that exists among specific
population groups.
24. INFECTIOUS
infection or disease by entrance of
organisms (e.g., bacteria, viruses,
protozoan, fungi) into the body,
which then grow and multiply.
22. HEALTH INDICATOR
a measure that reflects, or indicates,
the state of health in a defined
population, such as the infant
mortality rate.
23. INFANT MORTALITY RATE
A death rate calculated by dividing the
number of infant deaths during a
calendar year by the number of live
births reported in the same year. It is
expressed as the number of infant
deaths per 1,000 live births.

25. INFECTIOUS DISEASE
A disease caused by a living organism.
28. LOCAL HEALTH DEPARTMENT
An administrative or service unit of
local or state government concerned
with health and carrying some
responsibility for the health of a
jurisdiction smaller than the state
26. INJURY
Injuries can be classified by the
intent or purposefulness of
occurrence in two categories,
intentional and unintentional injuries.
27. JOINT COMMISSION ON THE
ACCREDITATION OF
HEALTHCARE ORGANIZATIONS
(JCAHO)
A peer review organization which
provides the primary review of hospitals
and healthcare providers for the purpose
of accreditation.

29. LOCAL HEALTH OFFICER
An individual who is hired or appointed
by the appointing authority for a local
governmental public health agency and
who has direct responsibility for the
day-to-day operations, management,
and direction of the local governmental
public health agency
32. OUTBREAK
An outbreak is the occurrence of
more cases of disease than would
normally be expected in a specific
place or group of people over a
given period of time.
30. MORBIDITY
Illness or lack of health caused by
disease, disability, or injury.
31. MORTALITY
A measure of the incidence of deaths in
a population.

33. POPULATION HEALTH
connotes a high level assessment of a
group of people. This epidemiologic
framework is often in direct opposition
to the manner in which the health care
system has cared for patients
36. PUBLIC HEALTH
ACCREDITATION BOARD
the national accrediting organization
for public health departments.
34. PREVALENCE
is the proportion of people in a
population who have some attribute
or condition at a given point in time
or during a specified time period.
35. PREVENTION
means actions that reduce exposure or
other risks, keep people from getting
sick, or keep disease from getting worse.

37. PUBLIC HEALTH DISASTERS
Severe or catastrophic events that
affect the health of a given area or
population
40. PUBLIC HEALTH WORKFORCE
All persons engaged during a
significant part of the time in work
that creates the conditions within
which people can be healthy.
38. PUBLIC HEALTH EMERGENCY
An occurrence or imminent threat of
an illness or health condition,
caused by bioterrorism, epidemic or
pandemic disease, or novel and
highly infectious agent or biological
toxin, that poses a substantial risk of
a significant number of human
fatalities or incidents of permanent
of long term disability.
39. PUBLIC HEALTH SYSTEM
All public, private, and voluntary entities
that contribute to the delivery of essential
public health services within a
jurisdiction.

41. QUALITY OF LIFE
In public health terms, quality of life
means the degree to which individuals
perceive themselves as able to function
physically, emotionally and socially.
44. RISK ASSESSMENT
The scientific process of evaluating
adverse effects caused by a
substance, activity, lifestyle, or
natural phenomenon.
42. QUARANTINE
The compulsory physical separation
or confinement of individuals and/or
groups, animals, or the enforced
restraint of transport of goods in
order to prevent or limit the spread of
disease or disease vectors.
43. REPORTABLE DISEASE
Health conditions that are required
through statute, ordinance or
administrative rule to be reported to a
public health agency when it is
diagnosed in an individual.

45. RISK FACTOR
Personal qualities or societal conditions
that lead to the increased probability of
a problem or problems developing.
48. SOCIAL NORM
Expectations about behavior,
thoughts or feelings that are
appropriate and sanctioned within a
particular society.
46. RISK MANAGEMENT
The goal of risk management is to
direct limited available resources to
those areas and strategies where
the greatest amount of risk can be
reduced for the least amount of
resources.
47. SANITARY CODE
A regulation concerned with food safety
as well as the design, construction, and
maintenance of environmental facilities
conducive to public health, such as water
supply and waste disposal.

49. SURGE CAPACITY
refers to the ability to expand care or
service capabilities in response to
unanticipated or prolonged demand.
52. UNDESERVED POPULATIONS
Populations with barriers to the
health care system include the
uninsured, the underinsured, and
socially disadvantaged people
50. SURVEILLANCE
means the ongoing, systematic
collection, analysis, and
interpretation of health data. This
activity also involves timely
dissemination of the data and use for
public health programs.
51. TOBACCO CONTROL
an activity directed towards reducing the
harmful effects of tobacco products. This
may involve both education and policy
efforts in order to decrease the initiation
of tobacco use and to promote cessation
among children and adults.

53. VECTORS
Used in terms of public health it refers
to animals or other living organisms
that carry or transmit diseases (e.g.,
rats, mosquitoes, foxes).
56. VITAL STATISTICS
Data derived from certificates and
reports of birth, death, fetal death,
induced termination of pregnancy,
marriage, (divorce, dissolution of
marriage, or annulment) and related
reports.
54. VECTOR CONTROL
Programs designed to reduce or
eliminate a disease-carrying insect
or rodent population
55. VITAL EVENTS
Live births, deaths, fetal deaths,
marriages, divorces, and induced
terminations of pregnancy, together with
any change in civil status that may occur
during an individual’s lifetime.

57. VULNERABLE POPULATION
A group of people with certain
characteristics that cause them to
be at greater risk of having poor
health outcomes.
58. YEARS OF POTENTIAL LIFE
LOST
A measure of premature death, or
death that occurs before age 75,
which is the average life span. This
measure is useful for assessing the
impact of a particular public health
problem on the economy in terms of
lost work years and earnings, and
on family life in terms of impact on
surviving spouses and children.

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