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.[ citation needed ]

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 Control decides on a vaccination schedule, [8] 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. [9]

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).[ citation needed ]

The use of laws to criminalise certain behaviours can also be considered a public health intervention, such as mandatory vaccination programs [14] [15] and criminalisation of HIV transmission. [16] [17] [18] However, such measures are typically controversial, particularly in the case of HIV criminalisation where there is evidence it may be counter productive. [16] [17] [18] 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, [19] and sugared drinks in the UK. [20]

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. [21]

See also

Related Research Articles

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<span class="mw-page-title-main">Plant-based diet</span> Diet consisting mostly or entirely of plant-based foods

A plant-based diet is a diet consisting mostly or entirely of plant-based foods. Plant-based diets encompass a wide range of dietary patterns that contain low amounts of animal products and high amounts of fiber-rich plant products such as vegetables, fruits, whole grains, legumes, nuts and seeds. They do not need to be vegan or vegetarian, but are defined in terms of low frequency of animal food consumption.

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Vitamin B<sub>12</sub> deficiency Disorder resulting from low blood levels of vitamin B12

Vitamin B12 deficiency, also known as cobalamin deficiency, is the medical condition in which the blood and tissue have a lower than normal level of vitamin B12. Symptoms can vary from none to severe. Mild deficiency may have few or absent symptoms. In moderate deficiency, feeling tired, headaches, soreness of the tongue, mouth ulcers, breathlessness, feeling faint, rapid heartbeat, low blood pressure, pallor, hair loss, decreased ability to think and severe joint pain and the beginning of neurological symptoms, including abnormal sensations such as pins and needles, numbness and tinnitus may occur. Severe deficiency may include symptoms of reduced heart function as well as more severe neurological symptoms, including changes in reflexes, poor muscle function, memory problems, blurred vision, irritability, ataxia, decreased smell and taste, decreased level of consciousness, depression, anxiety, guilt and psychosis. If left untreated, some of these changes can become permanent. Temporary infertility, reversible with treatment, may occur. A late finding type of anemia known as megaloblastic anemia is often but not always present. In exclusively breastfed infants of vegan mothers, undetected and untreated deficiency can lead to poor growth, poor development, and difficulties with movement.

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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).

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 an HIV/AIDS infection in a woman while she is pregnant. There is a risk of HIV transmission from mother to child in three primary situations: pregnancy, childbirth, and while breastfeeding. This topic is important because the risk of viral transmission can be significantly reduced with appropriate medical intervention, and without treatment HIV/AIDS can cause significant illness and death in both the mother and child. This is exemplified by data from The Centers for Disease Control (CDC): In the United States and Puerto Rico between the years of 2014–2017, where prenatal care is generally accessible, there were 10,257 infants in the United States and Puerto Rico who were exposed to a maternal HIV infection in utero who did not become infected and 244 exposed infants who did become infected.

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<span class="mw-page-title-main">Neonatal infection</span> Human disease

Neonatal infections are infections of the neonate (newborn) acquired during prenatal development or within the first four weeks of life. Neonatal infections may be contracted by mother to child transmission, in the birth canal during childbirth, or after birth. Neonatal infections may present soon after delivery, or take several weeks to show symptoms. Some neonatal infections such as HIV, hepatitis B, and malaria do not become apparent until much later. Signs and symptoms of infection may include respiratory distress, temperature instability, irritability, poor feeding, failure to thrive, persistent crying and skin rashes.

The first 1,000 days describes the period from conception to 24 months of age in child development. This is considered a "critical period" in which sufficient nutrition and environmental factors have life-long effects on a child's overall health. While adequate nutrition can be exceptionally beneficial during this critical period, inadequate nutrition may also be detrimental to the child. This is because children establish many of their lifetime epigenetic characteristics in their first 1,000 days. Medical and public health interventions early on in child development during the first 1,000 days may have higher rates of success compared to those achieved outside of this period.

References

  1. ↑ Kim, Hyuncheol Bryant; Lee, Sun-Mi (2017-03-06). "When public health intervention is not successful: Cost sharing, crowd-out, and selection in Korea's National Cancer Screening Program". Journal of Health Economics. 53: 100–116. doi:10.1016/J.JHEALECO.2017.02.006. PMID   28340393.
  2. ↑ Kürüm, Esra; Warren, Joshua L.; Schuck-Paim, Cynthia; Lustig, Roger; Lewnard, Joseph A.; Fuentes, Rodrigo; Bruhn, Christian A. W.; Taylor, Robert J.; Simonsen, Lone (2017-07-31). "Bayesian model averaging with change points to assess the impact of vaccination and public health interventions". Epidemiology. 28 (6): 889–897. doi:10.1097/EDE.0000000000000719. PMC   5617796 . PMID   28767518.
  3. ↑ Bhuyan, Soumitra S.; Chandak, Aastha; Smith, Patti; Carlton, Erik L.; Duncan, Kenric; Gentry, Daniel (2015-08-07). "Integration of public health and primary care: A systematic review of the current literature in primary care physician mediated childhood obesity interventions". Obesity Research and Clinical Practice. 9 (6): 539–552. doi:10.1016/J.ORCP.2015.07.005. PMID   26259684.
  4. ↑ Todd, Adam; Moore, Helen J.; Husband, Andrew K.; Bambra, Clare; Kasim, Adetayo; Sniehotta, Falko F.; Steed, Liz; Summerbell, Carolyn D. (2014-08-22). "Community pharmacy interventions for public health priorities: protocol for a systematic review of community pharmacy-delivered smoking, alcohol and weight management interventions". Systematic Reviews. 3: 93. doi: 10.1186/2046-4053-3-93 . PMC   4145162 . PMID   25145710.
  5. ↑ M, Schrappe; K, Lauterbach (1998-01-01). "Systematic review on the cost-effectiveness of public health interventions for HIV prevention in industrialized countries". AIDS. 12 Suppl A: S231–8. PMID   9633007.
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  8. ↑ "Vaccines". medlineplus.gov. Retrieved 2021-11-19.
  9. ↑ "Polio". Bill & Melinda Gates Foundation. Retrieved 2018-06-09.
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  11. ↑ Honein, Margaret A. (2001-06-20). "Impact of Folic Acid Fortification of the US Food Supply on the Occurrence of Neural Tube Defects". JAMA. 285 (23): 2981–6. doi: 10.1001/jama.285.23.2981 . ISSN   0098-7484. PMID   11410096.
  12. ↑ Frieden, Thomas R. (April 2010). "A Framework for Public Health Action: The Health Impact Pyramid". American Journal of Public Health. 100 (4): 590–595. doi:10.2105/ajph.2009.185652. ISSN   0090-0036. PMC   2836340 . PMID   20167880.
  13. ↑ Hiligsmann, Mickael; Neuprez, Audrey; Buckinx, Fanny; Locquet, Médéa; Reginster, Jean-Yves (December 2017). "A scoping review of the public health impact of vitamin D-fortified dairy products for fracture prevention". Archives of Osteoporosis. 12 (1): 57. doi:10.1007/s11657-017-0352-1. ISSN   1862-3514. PMC   5486688 . PMID   28634891.
  14. ↑ Haverkate, M; D'Ancona, F; Giambi, C; Johansen, K; Lopalco, P L; Cozza, V; Appelgren, E; on behalf of the VENICE project gat, collective (2012-05-31). "Mandatory and recommended vaccination in the EU, Iceland and Norway: results of the VENICE 2010 survey on the ways of implementing national vaccination programmes" (PDF). Eurosurveillance. 17 (22). doi: 10.2807/ese.17.22.20183-en . ISSN   1560-7917. PMID   22687916.
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  18. 1 2 Mykhalovskiy, Eric (2011-09-01). "The problem of "significant risk": Exploring the public health impact of criminalizing HIV non-disclosure". Social Science & Medicine. 73 (5): 668–675. doi:10.1016/j.socscimed.2011.06.051. ISSN   0277-9536. PMID   21835524.
  19. ↑ Wilson, Nick; Blakely, Tony; Tobias, Martin (2006-11-02). "What potential has tobacco control for reducing health inequalities? The New Zealand situation". International Journal for Equity in Health. 5 (1): 14. doi: 10.1186/1475-9276-5-14 . PMC   1654162 . PMID   17081299.
  20. ↑ Briggs, Adam D. M.; Mytton, Oliver T.; Kehlbacher, Ariane; Tiffin, Richard; Rayner, Mike; Scarborough, Peter (2013-10-31). "Overall and income specific effect on prevalence of overweight and obesity of 20% sugar sweetened drink tax in UK: econometric and comparative risk assessment modelling study". BMJ. 347: f6189. doi:10.1136/bmj.f6189. ISSN   1756-1833. PMC   3814405 . PMID   24179043.
  21. ↑ Bartholomew, L. K., Parcel, G. S., Kok, G., Gottlieb, N. H., & Fernández, M.E., 2011. Planning health promotion programs; an Intervention Mapping approach, 3rd Ed. San Francisco, CA: Jossey-Bass.
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