This document provides an overview of public health concepts for nursing students. It defines key terms like health, illness, sickness, and disease. It also outlines the core functions of public health programs according to the WHO, including leadership, research, policymaking, and health monitoring. Additionally, it discusses public health applications in healthcare systems and differentiates between health indicators and determinants. Major global public health programs and strategies are also summarized, such as vaccination initiatives and efforts to address issues like obesity and smoking.

1. Ministry of Higher Education and Scientific Research
University of Kufa / College of Nursing
Development of Teaching and Undergraduate
Training Center
Prepared by:
Hussein M. A. Al-Tameemi
M.Sc. Community Health Nursing
University of Kufa / College of Nursing
2017
hessinm.altemimi@uokufa.edu.iq
Public Health

2. Public Health:
Aim of the Lecture:
The student will be able to understand the conceptof public health and its
importance.
Behavioral objectives:
At the end of this lecture the student should be able to:
 To argue the essential terms related to health.
 To define public health term.
 To identify core functions of public health programs
 To discuss public health applications in health care.
 To differentiate between health indicators and health determinants.
 To outline worldwide Public health programs and strategies.
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Introduction:
The dimensions of health can encompass "a state of complete physical,
mental and social well-being and not merely the absence of disease or
infirmity," as defined by the World Health Organization. Public health
incorporates the interdisciplinary approaches of epidemiology, biostatistics and
health services. Environmental health, community health, behavioral health,
health economics, public policy, insurance medicine, mental health and
occupational safety and health are other important subfields.
The focus of public health intervention is to improve health and quality of
life through prevention and treatment of disease and other physical and mental
health conditions.
For example, research has shown that the simple act of hand washing with
soap can prevent many contagious diseases. In other cases, treating a disease or
controlling a pathogen can be vital to preventing its spread to others, either during
an outbreak of infectious disease or through contamination of food or water
supplies.
There is a great disparityin access to health care and public health initiatives
between developed nations and developing nations. In the developing world, public
health infrastructures are still forming.

3. Fundamental health related terms:
Health: state of complete physical, mental and social well-being and not
merely the absence of disease or infirmity.
Illness:refers to the subjective sense of feeling unwell that often motivates
a patient to consult a physician. Illness does not define a specific pathology, but
refers to a person’s subjective experience of it, such as discomfort, tiredness, or
general malaise.
Sickness: refers to socially and culturally held conceptions of health
conditions; these may influence how the patient reacts, as in the dread of cancer
or the stigma of mental illness.
Disease: implies a focus on pathological processes that may or may not
produce symptoms and that result in a patient’s illness. For example, a patient
complains of tiredness and malaise, his illness as he experiences it. He consults a
doctor about it, because he believes that he might have a sickness. The doctor
might attribute the patient’s symptoms to a thyroid condition (a disease).
Definition of Public Health:
Public health refers to "the science and art ofpreventing disease, prolonging
life and promoting human health through organized efforts and informed choices
of society, organizations, public and private, communities and individuals."
The World Health Organization (WHO) identifies core functions
of public health programs including:
1. Providing leadership on matters critical to health and engaging in
partnerships where joint action is needed;
2. Shaping a research agenda and stimulating the generation, translation and
dissemination of valuable knowledge;
3. Setting norms and standards and promoting and monitoring their
implementation;
4. Articulating ethical and evidence-based policy options;
5. Monitoring the health situation and assessing health trends.
Public Health applications in health care:
As well as seeking to improve population health through the implementation
of specific population-level interventions, public health contributes to medical
care by identifying and assessing population needs for health care services,
including:
 Assessing current services and evaluating whether they are meeting the
objectives of the health care system

4.  Ascertaining requirements as expressed by health professionals, the public and
other stakeholders
 Identifying the most appropriate interventions
 Considering the effect on resources for proposed interventions and assessing
their cost-effectiveness
 Supporting decision making in health care and planning health services
including any necessary changes.
 Informing, educating, and empowering people about health issues
The determinants of health:
Many factors combine together to affect the health of individuals and
communities. Whether people are healthy or not, is determined by their
circumstances and environment. The determinants of health includes:
1. The social and economic environment,
2. The physical environment, and
3. The person’s individual characteristics and behaviours.
The context of people’s lives determine their health, and so blaming
individuals for having poor health or crediting them for good health is
inappropriate. Individuals are unlikely to be able to control directly many of
the determinants of health. These determinants—or things that make people
healthy or not—include the above factors, and many others:
4. Income and social status - higher income and social status are linked to
better health. The greater the gap between the richest and poorestpeople, the
greater the differences in health.
5. Education – low education levels are linked with poor health, more stress
and lower self-confidence.
6. Physical environment – safe water and clean air, healthy workplaces, safe
houses, communities and roads all contribute to good health. Employment
and working conditions – people in employment are healthier, particularly
those who have more control over their working conditions.
7. Social support networks – greater support from families, friends and
communities is linked to better health. Culture - customs and traditions, and
the beliefs of the family and community all affect health.
8. Genetics - inheritance plays a part in determining lifespan, healthiness and
the likelihood ofdeveloping certain illnesses. Personalbehaviour and coping
skills – balanced eating, keeping active, smoking, drinking, and how we deal
with life’s stresses and challenges all affect health.
9. Health services - access and use of services that prevent and treat disease
influences health

5. 10. Gender - Men and women suffer from different types of diseases at
different ages.
Health indicators:
Health indicators are measureable characteristics of a population, which
researchers use as supporting evidence for describing the health of a population.
A common example of a health indicator is life expectancy.
Typically, researchers will use a survey methodology to gather information about
certain people, use statistics in an attempt to generalize the information collected to the entire
population, and then use the statistical analysis to make a statement about the health of the
population.
Health indicators commonly used to guide public health policy.
List of health indicators:
Health indicators are required in order to measure the health status of people and
communities.
1) Mortality indicators.
2) Morbidity indicators.
3) Health status (conditions).
4) Disability indicators.
5) Nutritional indicators.
6) Social and mental health indicators.
7) Health system indicators.
Public health programs and strategies:
Most governments recognize the importance of public health programs in
reducing the incidence of disease, disability, and the effects of aging and other
physical and mental health conditions, although public health generally receives
significantly less government funding compared with medicine.
Public health programs that providing vaccinations have made strides in
promoting health, including the eradication of smallpox, a disease that plagued
humanity for thousands of years.
Public health surveillance has led to the identification and prioritization of
many public health issues facing the world today, including HIV/AIDS, diabetes,
waterborne diseases, zoonotic diseases, and antibiotic resistance leading to the
reemergence of infectious diseases such as tuberculosis.
Public health communications programs and vaccination programs are
examples of common public health measures. Many public health programs are
increasingly dedicating attention and resources to the issue of obesity, with
objectives to address the underlying causes including healthy diet and physical
exercise. Another public health program is the control of tobacco smoking. Changing

6. smoking behavior requires long-term strategies, unlike the fight against
communicable diseases, which usually takes a shorter period for effects to be
observed.
The Questions:
1. Define the public health?
2. Distinguish between terms of illness, sickness, and disease?
3. Enumerate the essential functions of public health programs?
4. Discuss public health applications in health care?
5. Compare between the health indicators and health determinants?
6. Summarize the global Public health programs and strategies?
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March 10, 2017, from https://www.cdcfoundation.org/content/what-public-
health
Last, J. M. (2007). A Dictionary of Public Health (1st ed.). Oxford, UK: Oxford
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Nash, L. L. (2007). Inescapable Ecologies: A History of Environment, Disease,
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The Association of Faculties of Medicine of Canada (AFMC). (2017). AFMC
Primer on Population Health. The Association of Faculties of Medicine of
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WHO. (2017). The determinants of health. Retrieved March 10, 2017, from
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Wilkinson, R. G., & Marmot, M. (2003). Social determinantsof health:the solid
facts. World Health Organization. Retrieved from
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Wkipedia. (2017). Public Health. Retrieved March 10, 2017, from
https://en.wikipedia.org/wiki/Public_health#cite_note-2