Public health intervention

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A public health intervention is any effort or policy that attempts to improve mental and physical health on a population level. Public health interventions may be run by a variety of organizations, including governmental health departments and non-governmental organizations (NGOs). Common types of interventions include screening programs, [1] vaccination, [2] food and water supplementation, and health promotion. Common issues that are the subject of public health interventions include obesity, [3] drug, tobacco, and alcohol use, [4] and the spread of infectious disease, e.g. HIV. [5]

Mental health Describes a level of psychological well-being, or an absence of a mental disorder

Mental health is the level of psychological well-being or an absence of mental illness. It is the state of someone who is "functioning at a satisfactory level of emotional and behavioural adjustment". From the perspectives of positive psychology or of holism, mental health may include an individual's ability to enjoy life, and to create a balance between life activities and efforts to achieve psychological resilience. According to the World Health Organization (WHO), mental health includes "subjective well-being, perceived self-efficacy, autonomy, competence, inter-generational dependence, and self-actualization of one's intellectual and emotional potential, among others." The WHO further states that the well-being of an individual is encompassed in the realization of their abilities, coping with normal stresses of life, productive work and contribution to their community. Cultural differences, subjective assessments, and competing professional theories all affect how one defines "mental health".

Health is a state of physical, mental and social well-being in which disease and infirmity are absent.

A health department or health ministry is a part of government which focuses on issues related to the general health of the citizenry. Subnational entities, such as states, counties and cities, often also operate a health department of their own. Health departments perform food inspections and other health related inspections, vaccination programs, free STD and HIV tests, tobacco enforcement and cessation programs, and other medical assistance programs. Health departments also compile statistics about health issues of their area.The role of a health department may vary from one country to the other, but their primary objective is always the same; safeguarding and promoting health. In 1986, several of the world's national health departments met to establish an international guideline by which health departments operate. The meeting was in Ottawa, Ontario, Canada, and hence the guidelines established are known as the Ottawa Charter. The Ottawa Charter was designed to 'achieve Health for All'.

Contents

A policy may meet the criteria of a public health intervention if it prevents disease on both the individual and community level and has a positive impact on public health. [6]

Public health preventing disease, prolonging life and promoting health through organized efforts and informed choices of society and individuals

Public health has been defined as "the science and art of preventing disease, prolonging life and promoting human health through organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the health of a population and the threats it faces is the basis for public health. The public can be as small as a handful of people or as large as a village or an entire city; in the case of a pandemic it may encompass several continents. The concept of health takes into account physical, psychological and social well-being. As such, according to the World Health Organization, it is not merely the absence of disease or infirmity.

Types

Health interventions may be run by a variety of organizations, including health departments and private organizations. Such interventions can operate at various scales, such as on a global, country, or community level. The whole population can be reached via websites, audio/video messages and other mass media, or specific groups can be affected by administrative action, such as increasing the provision of healthy food at schools.

Screening

Screening refers to the practice of testing a set of individuals who meet a certain criteria (such as age, sex, or sexual activity) for a disease or disorder. Many forms of screening are public health interventions. For example, mothers are routinely screened for HIV and Hepatitis B during pregnancy. Detection during pregnancy can prevent maternal transmission of the disease during childbirth. [7]

Vaccination

Vaccination programs are one of the most effective and common types of public health interventions. Typically programs may be in the form of recommendations or run by governmental health departments or nationalised health care systems. For instance, in the U.S., the Center for Disease Contro l decides on a vaccination schedule, and most private health insurers cover these vaccinations. In the UK, the NHS both decides and implements vaccination protocols. NGO s also may be involved in funding or implementing vaccination programs; for instance Bill and Melinda Gates Foundation assists governments in Pakistan, Nigeria and Afghanistan with the administration of polio vaccination. [8]

Centers for Disease Control and Prevention government agency

The Centers for Disease Control and Prevention (CDC) is the leading national public health institute of the United States. The CDC is a United States federal agency under the Department of Health and Human Services and is headquartered in Atlanta, Georgia.

National Health Service publicly funded healthcare systems within the United Kingdom

The National Health Service in the United Kingdom includes NHS England, NHS Scotland, NHS Wales, and the affiliated Health and Social Care (HSC) in Northern Ireland. They were established together in 1948 as one of the major social reforms following the Second World War. The founding principles were that services should be comprehensive, universal and free at the point of delivery. Each service provides a comprehensive range of health services, free at the point of use for people ordinarily resident in the United Kingdom, apart from dental treatment and optical care. The English NHS also requires patients to pay prescription charges with a range of exemptions from these charges.

Non-governmental organization organization that is neither a part of a government nor a conventional for-profit business

Non-governmental organizations - commonly referred to as NGOs, are usually non-profit independent of governments, many are active in humanitarian etc. areas, however, NGOs can also be as lobby groups for corporations, such as the World Economic Forum. NGOs is also sometimes expanded to nongovernmental or nongovernment organizations. They are thus a subgroup of all organizations founded by citizens, which include clubs and other associations that provide services, benefits, and premises only to members. Sometimes the term is used as a synonym of "civil society organization" to refer to any association founded by citizens, but this is not how the term is normally used in the media or everyday language, as recorded by major dictionaries. The explanation of the term by NGO.org is ambivalent. It first says an NGO is any non-profit, voluntary citizens' group which is organized on a local, national or international level, but then goes on to restrict the meaning in the sense used by most English speakers and the media: Task-oriented and driven by people with a common interest, NGOs perform a variety of service and humanitarian functions, bring citizen concerns to Governments, advocate and monitor policies and encourage political participation through provision of information.

Supplementation

Supplementation of food or water of nutrients can reduce vitamin deficiency and other diseases. Supplementation may be required by law or voluntary. Some examples of interventions include:

Food fortification or enrichment is the process of adding micronutrients to food. It can be carried out by food manufacturers, or by governments as a public health policy which aims to reduce the number of people with dietary deficiencies within a population. The predominant diet within a region can lack particular nutrients due to the local soil or from inherent deficiencies within the staple foods; addition of micronutrients to staples and condiments can prevent large-scale deficiency diseases in these cases.

Vitamin deficiency is the condition of a long-term lack of a vitamin. When caused by not enough vitamin intake, it can be classified as a primary deficiency, whereas when due to an underlying disorder such as malabsorption, it is called a secondary deficiency. An underlying disorder may be metabolic – as in a genetic defect for converting tryptophan to niacin – or from lifestyle choices that increase vitamin needs, such as smoking or drinking alcohol. Governments guidelines on vitamin deficiencies advise certain intakes for healthy people, with specific values for women, men, babies, the elderly, and during pregnancy or breastfeeding. Many countries have mandated vitamin food fortification programs to prevent commonly occurring vitamin deficiencies.

Behavioural

Interventions intended to change the behaviour of individuals can be especially challenging. One such form is health promotion, where education and media may be used to promote healthy behaviours, such as eating healthy foods (to prevent obesity), using condoms (to prevent the transmission of STDs), or stopping open defecation in developing countries (see for example in India the campaign Swachh Bharat mission).

The use of laws to criminalise certain behaviours can also be considered a public health intervention, such as mandatory vaccination programs [13] [14] and criminalisation of HIV transmission. [15] [16] [17] However, such measures are typically controversial, particularly in the case of HIV criminalisation where there is evidence it may be counter productive. [15] [16] [17] Laws which tax certain unhealthy products may also be effective, although also not without controversy, and are sometimes called a "sin tax". Examples include the taxation of tobacco products in the U.S. and New Zealand, [18] and sugared drinks in the UK. [19]

Evaluating efficacy

Evaluating and predicting the efficacy of a public health intervention, as well as calculating cost effectiveness, is essential. An intervention should ideally lower morbidity and mortality. Several systematic protocols exist to assist developing such interventions, such as Intervention Mapping. [20]

See also

Related Research Articles

Herd immunity

Herd immunity is a form of indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection, thereby providing a measure of protection for individuals who are not immune. In a population in which a large number of individuals are immune, chains of infection are likely to be disrupted, which stops or slows the spread of disease. The greater the proportion of individuals in a community who are immune, the smaller the probability that those who are not immune will come into contact with an infectious individual.

Type 2 diabetes Type of diabetes mellitus with high blood sugar and insulin resistance

Type 2 diabetes (T2D), formerly known as adult-onset diabetes, is a form of diabetes that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urination, and unexplained weight loss. Symptoms may also include increased hunger, feeling tired, and sores that do not heal. Often symptoms come on slowly. Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations. The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon.

The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs in an attempt to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of multiple drugs that act on different viral targets is known as highly active antiretroviral therapy (HAART). HAART decreases the patient's total burden of HIV, maintains function of the immune system, and prevents opportunistic infections that often lead to death. HAART also prevents the transmission of HIV between serodiscordant same sex and opposite sex partners so long as the HIV-positive partner maintains an undetectable viral load.

Intestinal parasite infection Condition in which a parasite infects the gastro-intestinal tract of humans and other animals

An intestinal parasite infection is a condition in which a parasite infects the gastro-intestinal tract of humans and other animals. Such parasites can live anywhere in the body, but most prefer the intestinal wall.

Orthomolecular medicine is a form of alternative medicine that aims to maintain human health through nutritional supplementation. The concept builds on the idea of an optimal nutritional environment in the body and suggests that diseases reflect deficiencies in this environment. Treatment for disease, according to this view, involves attempts to correct "imbalances or deficiencies based on individual biochemistry" by use of substances such as vitamins, minerals, amino acids, trace elements and fatty acids. The notions behind orthomolecular medicine are not supported by sound medical evidence, and the therapy is not effective; even the validity of calling the orthomolecular approach a form of medicine has been questioned since the 1970s.

Cardiovascular disease class of diseases that involve the heart or blood vessels

Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction. Other CVDs include stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, abnormal heart rhythms, congenital heart disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery disease, thromboembolic disease, and venous thrombosis.

Multivitamin preparation intended to be a dietary supplement with vitamins

A multivitamin is a preparation intended to serve as a dietary supplement with vitamins, dietary minerals, and other nutritional elements. Such preparations are available in the form of tablets, capsules, pastilles, powders, liquids, or injectable formulations. Other than injectable formulations, which are only available and administered under medical supervision, multivitamins are recognized by the Codex Alimentarius Commission as a category of food.

Preventive healthcare Prevent and minimize the occurrence of diseases

Preventive healthcare consists of measures taken for disease prevention. Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices and are dynamic processes which begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention.

Sedentary lifestyle Inactive lifestyle with health risks

A sedentary lifestyle is a type of lifestyle involving little or no physical activity. A person living a sedentary lifestyle is often sitting or lying down while engaged in an activity like reading, socializing, watching television, playing video games, or using a mobile phone/computer for much of the day. A sedentary lifestyle can potentially contribute to ill health and many preventable causes of death.

Global health Health of populations in a global context

Global health is the health of populations in the global context; it has been defined as "the area of study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide". Problems that transcend national borders or have a global political and economic impact are often emphasized. Thus, global health is about worldwide health improvement, reduction of disparities, and protection against global threats that disregard national borders. Global health is not to be confused with international health, which is defined as the branch of public health focusing on developing nations and foreign aid efforts by industrialized countries. Global health can be measured as a function of various global diseases and their prevalence in the world and threat to decrease life in the present day.

Vertically transmitted infection infection caused by pathogens that uses mother-to-child transmission

A vertically transmitted infection is an infection caused by pathogens that uses mother-to-child transmission, that is, transmission directly from the mother to an embryo, fetus, or baby during pregnancy or childbirth. It can occur when the mother gets an infection as an intercurrent disease in pregnancy. Nutritional deficiencies may exacerbate the risks of perinatal infection.

Diseases of poverty are diseases that are more prevalent in low-income populations. They include infectious diseases, as well as diseases related to malnutrition and poor health behaviors. Poverty is one of the major social determinants of health. The World Health Report, 2002 states that diseases of poverty account for 45% of the disease burden in the countries with high poverty rate which are preventable or treatable with existing interventions. Diseases of poverty are often co-morbid and ubiquitous with malnutrition.

HIV/AIDS Spectrum of conditions caused by HIV infection

Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV). Following initial infection, a person may not notice any symptoms or may experience a brief period of influenza-like illness. Typically, this is followed by a prolonged period with no symptoms. As the infection progresses, it interferes more with the immune system, increasing the risk of developing common infections such as tuberculosis, as well as other opportunistic infections, and tumors that rarely affect people who have uncompromised immune systems. These late symptoms of infection are referred to as acquired immunodeficiency syndrome (AIDS). This stage is often also associated with unintended weight loss.

Economic epidemiology is a field at the intersection of epidemiology and economics. Its premise is to incorporate incentives for healthy behavior and their attendant behavioral responses into an epidemiological context to better understand how diseases are transmitted. This framework should help improve policy responses to epidemic diseases by giving policymakers and health-care providers clear tools for thinking about how certain actions can influence the spread of disease transmission.

Sexually transmitted infection Infection transmitted through human sexual behavior

Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs), are infections that are commonly spread by sexual activity, especially vaginal intercourse, anal sex and oral sex. Many times STIs initially do not cause symptoms. This results in a greater risk of passing the disease on to others. Symptoms and signs of disease may include vaginal discharge, penile discharge, ulcers on or around the genitals, and pelvic pain. STIs can be transmitted to an infant before or during childbirth and may result in poor outcomes for the baby. Some STIs may cause problems with the ability to get pregnant.

People living with HIV/AIDS face increased challenges in maintaining proper nutrition. Despite developments in medical treatment, nutrition remains a key component in managing this condition. The challenges that those living with HIV/AIDS face can be the result of the viral infection itself or from the effects of anti-HIV therapy (HAART).

Prevention of HIV/AIDS prevent and minimize the occurrence of HIV and AIDS

HIV prevention refers to practices that aim to prevent the spread of the Human Immunodeficiency Virus (HIV). HIV prevention practices may be undertaken by individuals to protect their own health and the health of those in their community, or may be instituted by governments or other organizations as public health policies.

Infectious diseases within American correctional settings are a concern within the public health sector. The corrections population is susceptible to infectious diseases through, exposure to blood and other bodily fluids, drug injection, poor health care, prison overcrowding, demographics, security issues, lack of community support for rehabilitation programs, and high-risk behaviors. The spread of infectious diseases, such as HIV/AIDS and other sexually transmitted diseases, hepatitis C (HCV), hepatitis B (HBV), and tuberculosis result largely from needle-sharing, drug use, and consensual and nonconsensual sex among prisoners. HIV/AIDS and hepatitis C need specific attention because of the specific public health concerns and issues they raise.

HIV in pregnancy is the presence of HIV in a woman while she is pregnant. HIV in pregnancy is of concern because women with HIV/AIDS may transmit the infection to their child during pregnancy, childbirth and while breastfeeding. However, the risk of mother-to-child transmission of HIV may be reduced by treatment of the HIV infection with antiretroviral therapy (ART). This lifelong therapy may be initiated in women before, during, and after pregnancy. After delivery, children are also given the medication temporarily as a prophylactic measure to reduce the risk of infection. Because HIV may also be spread through breast milk, mothers in the United States who are infected are encouraged to avoid breastfeeding. However, in developing countries such as South Africa, where the risk of death of the infant associated with avoiding exclusive breastfeeding is higher than the risk of contracting HIV, exclusive breastfeeding in a mother who is virally suppressed is encouraged.

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