community midterm

7/27/2019 Community Midterm

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What Is A Public Health Problem? Two Criteria:

1-A condition or situation that is a widespread actual or potential cause of morbidityor mortality.

2-A perception by the public, government, public health authorities that the conditionis a public health problem.

Phases of public health:1-First Phase (1849-1900)

Public health dealt with elimination and control of disease b/c of rapid growth of

industry and crowded and poor working conditions.

2- Second Phase (1880-1930)Population based prevention strategies

Immunizations

Reduction of effects of diseases

3- Third Phase (1930-1975)Treatment of disease through complex medical treatments

Infectious diseases eradicated

Cures for acute health problems

4-Fourth Phase. We are in it now!Technology used in treatment

Longer life expectancy = more health issues

Encourage healthy lifestyle choices (not smoking)

Global issues

Public health: The science and art of preventing disease, prolonging life, and promoting

physical health and efficiency through organized community efforts. (Winslow,1920)

Dental Public health: The science and art of preventing and controlling dental diseases

and promoting dental health through organized community efforts. It is that form of

dental practice that serves the community as a patient rather than the individual. It is

concerned with dental health education of the public, with applied dental research, and

with the administration of group dental care programs, as well as the prevention andcontrol of dental diseases on a community basis.

3 core functions of PH:

Assessment Policy Development Assurance


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Community profile: what it is

Helps determine

the feasibility of a program if there are sufficient resources for the program

Community profile components:

Population Number of households and size Age distribution Household income Marital status Racial/ethnic composition Education Geographic boundaries Political/economic atmosphere Dental/medical resources

Top 10 achievements of PH: list a few

1-Vaccination

2-Motor vehicle safety

3-Workplace safety4-Infectious disease control

5-Reduction in death from CHD and stroke

6-Safer and healthier food

7-Healthier mothers and babies

8-Family planning

9-Fluoridated drinking water

10-Tobacco use recognized as a health hazard

What is Oral health disparity?Explain what it is

-When certain populations or groups experience a higher level of oral diseases

when compared to other groups.

-Non-Hispanic Blacks, American Indians, Hispanics, Alaska natives have the

poorest oral health of all racial groups in U.S.

-Limited knowledge and access to preventive care contribute to disparity.

Insurance

Two types:


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-Indemnity plans-reimbursement plans/fee-for-service plans

-Managed care plans

Three Types:

*Health maintenance organization (HMO)

*Preferred provider organization (PPO)

*Point-of-service plans (POS)

Capitation:

-Provider is paid a fixed amount for each patient enrolled in his/her office

regardless of whether or the patient actually uses the services.

- Providers are paid in several ways: capitation, fee-for-service, or can be salaried

by the plan.

Medicare:

Provides health insurance to those 65 and older, certain people with disability, and

persons with kidney failureDoes not provide coverage for oral health services

Medicaid:

Jointly funded by federal and state

Provides insurance for low income families

Includes children, seniors, blind, disabled

Oral health services mandatory for children

Oral health services optional for adults

Barriers to care: Structural Financial Personal/cultural

Advantages of training non-dental care providers: be able to discuss

Cost less to educate

Would lower cost to deliver care

Could increase production and cut cost for dentist

Increase capacity of dentist to provide quality treatment

Dentist could treat more people at lower cost

Community resources: be familiar of what they are

People power

Money

Time

Facilities

Supplies


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Equipment

Legislative authority

Differences ./.

Cost effectiviness: Cost effective programs deliver enough benefit to justify their cost.

Ex: Community wide water fluoride is consider one the most cost effective

Problem: Political issues may cause water fluoridation to be less

popular than school based fluoride mouth rinse even though it is more cost effective.

Cost benefit ratio: The success rates for similar programs may motivate communities to give

increased priority for the program. An estimated cost benefit ratio is also helpful. This is the

difference between the cost of providing the program versus the cost of not providing the

program.For example: water fluoridation is both cost-effective and cost saving. Although the

exact costbenefit ratio varies depending on the size of a community and method of

fluoridating, the expense associated with providing fluoridated water is much less than the cost

of restorations per person in a nonfluoridated community.

Proactive approach in PH: What does it mean?Health promoting interventions are most effective if they strategically predict, plan and

prevent potential crisis.

In other words: It is better if a program is proactive rather than reactive.

Ex: Promote use of mouth guards, helmets, and seat belts rather than treat preventable

injuries.

STAKEHOLDERS: Who are they? Explain are people who have the potencial to be affected by

a program and can include community and organization decicion makers, sponsors, dentalhealth professionals and community members and taxpayers

Policy makers

Funding agents

Community representatives

Evaluation answers the question: Was the program successful in reducing or eliminating the

identified need or problem?

TYPES OF PROGRAM EVALUATION: be familiar(qualitative or quantitative)

- Formative (process evaluation) Occurs during implementation processPoints out problems with the process

Identifies opportunities for improvement with the process

Helps determine if program is operating as expected.

- Summative (outcome evaluation) Occurs after the interventionResults are compared with goals and objectives to determine

the impact of the program on the communities health.


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Evaluation designs: be familiar

Post program only

Pre-program and post program

Pre-program and post program with a comparison group

Pre-program and post program with a control group

Differences ./. them

Control group: Participants are randomly assigned from same group to target or control

group.

Random-each person has equal chance of being assigned to either group.

Comparison group: Comparison group does not receive the program

Comparison and target group are assessed before and after program

Comparison group must be similar to target group (gender, age,

SES, education) and in similar situation

What is:Primary data: Data collected specifically for use in a program.

Sources: survey/questionnaire, interview, observation, experiment

Secondary data: Data that is already available

Sources: federal, state, and local health agencies, other public

health programs, state dental board.

Pilot test: talk a little bit about

Used in advance to check survey

Helps to insure survey questions are useableWorks out bugs prior to beginning program

Helps determine whether or not questions are being interpreted as they were

intended to be interpreted

Purpose of program evaluation:

Evaluation answers the question: Was the program successful in

reducing or eliminating the identified need or problem?

Did the program accomplish what is designed to do?

How could the program be improved?

Should the program be continued?

Does the program merit funding?

Should the program be expanded?

Helps:

Develop good practice

Make good use of scarce resources

Provide feedback to staff and participants

Shape policy development


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President cabinetDepartment of health and human services (DHHS)------ Office of public

health and science

SMART FORMULA for writing objectives:

S=Specific

M=Measurable

A=Appropriate

R=Realistic/Related

T=Time Bound

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