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Public Health 101 Healthy People–Healthy Populations

Second Edition

Richard Riegelman, MD, MPH, PhD Professor and Founding Dean

The George Washington University

School of Public Health and Health Services

Washington, DC

Brenda Kirkwood, MPH, DrPH University at Albany, State University of New York

School of Public Health

Albany, NY

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Library of Congress Cataloging-in-Publication Data Riegelman, Richard K., author. Public health 101 : healthy people—healthy populations / Richard Riegelman and Brenda Kirkwood. —Second edition. p. ; cm. Public health one hundred one Includes bibliographical references and index. ISBN 978-1-284-04084-5 (pbk.) I. Kirkwood, Brenda, author. II. Title. III. Title: Public health one hundred one. [DNLM: 1. Public Health. WA 100] RA425 362.1—dc23 2013039072 6048

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To Nancy Alfred Persily, whose enthusiasm for teaching public health to undergraduates inspired Public Health 101:

Healthy People–Healthy Populations.

Dedication

U.S. Capitol Building: © Orhan Cam /ShutterStock, Inc.; Hand w

ashing: © Elena Elisseeva/ShutterStock, Inc.; Seat belt: © justasc/ShutterStock, Inc.; Vaccine: © Leah-Anne Thom

pson/ShutterStock, Inc.

Acknowledgments xv Preface: What Is Public Health 101: Healthy People–Healthy Populations All About? xvii About the Authors xix

Section I Principles of Population Health 1

Chapter 1 Public Health: The Population Health Approach 3 Learning Objectives 3 What Do We Mean by “Public Health”? 4 How Has the Approach of Public Health Changed Over Time? 5 What Is Meant by “Population Health”? 9 What Are the Implications of Each of the Four Components of Public Health? 9 Should We Focus on Everyone or on Vulnerable Groups? 10 What Are the Approaches Available to Protect and Promote Health? 11 What Factors Determine the Occurrence of Disease, Disability, and Death? 11 What Changes in Populations Over Time Can Affect Health? 14 Key Words 17 Discussion Question 18 References 19

Chapter 2 Evidence-Based Public Health 21 Learning Objectives 21 How Can We Describe a Health Problem? 22 How Can Understanding the Distribution of Disease Help Us Generate

Ideas or Hypotheses about the Cause of Disease? 24