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]

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]

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. NGOs 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]

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:

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

Obesity Medical condition in which excess body fat harms health

Obesity is a medical condition in which excess body fat has accumulated to an extent that it may have a negative effect on health. People are generally considered obese when their body mass index (BMI), a measurement obtained by dividing a person's weight by the square of the person's height, is over 30 kg/m2; the range 25–30 kg/m2 is defined as overweight. Some East Asian countries use lower values. Obesity increases the likelihood of various diseases and conditions, particularly cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, certain types of cancer, osteoarthritis, and depression.

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.

Weight loss Reduction of the total body mass

Weight loss, in the context of medicine, health, or physical fitness, refers to a reduction of the total body mass, by a mean loss of fluid, body fat, or lean mass. Weight loss can either occur unintentionally because of malnourishment or an underlying disease, or from a conscious effort to improve an actual or perceived overweight or obese state. "Unexplained" weight loss that is not caused by reduction in calorific intake or exercise is called cachexia and may be a symptom of a serious medical condition. Intentional weight loss is commonly referred to as slimming.

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, or prophylaxis, 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.

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 use 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 infections.

A needlestick injury is the penetration of the skin by a hypodermic needle or other sharp object that has been in contact with blood, tissue or other body fluids before the exposure. Even though the acute physiological effects of a needlestick injury are generally negligible, these injuries can lead to transmission of blood-borne diseases, placing those exposed at increased risk of infection from disease causing pathogens, such as the hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Among healthcare workers and laboratory personnel worldwide, more than 25 blood-borne virus infections have been reported to have been caused by needlestick injuries. In addition to needlestick injuries, transmission of these viruses can also occur as a result of contamination of the mucous membranes, such as those of the eyes, with blood or body fluids, but needlestick injuries make up more than 80% of all percutaneous exposure incidents in the United States. Various other occupations are also at increased risk of needlestick injury, including law enforcement, laborers, tattoo artists, food preparers, and agricultural workers.

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.

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. If 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 which are otherwise rare in people who have normal immune function. These late symptoms of infection are referred to as acquired immunodeficiency syndrome (AIDS). This stage is often also associated with unintended weight loss.

Falls in older adults Age-related health problem

Falls in older adults are a significant cause of morbidity and mortality and are a major class of preventable injuries. The cause of falling in old age is often multifactorial and may require a multidisciplinary approach both to treat any injuries sustained and to prevent future falls. Falls include dropping from a standing position or from exposed positions such as those on ladders or stepladders. The severity of injury is generally related to the height of the fall. The state of the ground surface onto which the victim falls is also important, harder surfaces causing more severe injury. Falls can be prevented by ensuring that carpets are tacked down, that objects like electric cords are not in one's path, that hearing and vision are optimized, dizziness is minimized, alcohol intake is moderated and that shoes have low heels or rubber soles.

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 and community-based organizations as public health policies.

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.

Cancer prevention is the practice of taking active measures to decrease the incidence of cancer and mortality. The practice of prevention is dependent upon both individual efforts to improve lifestyle and seek preventive screening, and socioeconomic or public policy related to cancer prevention. Globalized cancer prevention is regarded as a critical objective due to its applicability to large populations, reducing long term effects of cancer by promoting proactive health practices and behaviors, and its perceived cost-effectiveness and viability for all socioeconomic classes.

Peymané Adab is a British physician who is a Professor of Public Health at the University of Birmingham. She leads the Institute of Applied Health Research Chronic Disease Management Team. Adab investigates the epidemiology and management of obesity and chronic obstructive pulmonary disease.

References

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