Introduction to Public Health Edition 3rd Edition by Elizabeth Parker, MaryLou Fleming 0729542033 9780729542036

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ISBN 10: 0729542033

ISBN 13: 9780729542036

Author: Elizabeth Parker, MaryLou Fleming

This third edition of Introduction to Public Health by Fleming and Parker continues to cement itself as a highlyrespected resource for public health students. This title provides an uptodate and comprehensive overview of the key concepts and principles of public health from a multidisciplinary perspective. This highly anticipated new edition of Introduction to Public Health addresses topical issues, including epidemiology, ethics and evidencebased practice. Parker and Fleming also includes a new focus on infectious diseases and disease presence. The inclusion of the new chapter ‘Public health and social policy’ will help broaden the readers’ understanding of the influence policy has on public health.

Introduction to Public Health Edition 3rd Table of contents:

Section 1

History and definitions of public health

Chapter 1 Defining health and public health

Learning objectives

Introduction

Defining health and ill health

Activity 1.1 Defining ‘health’

Reflection 1.1

Health and illness

General public definitions of ‘health’

A critical perspective

TABLE 1.1 Contemporary definitions of ‘health’

Defining ‘public health’: an art and a science?

Case Study 1.1 A typical morning

Activity 1.2 Daily life and public health

Reflection 1.2

Public health vision and values

Activity 1.3 Future focus of public health

Reflection 1.3

Core functions of public health

TABLE 1.2 Core functions for public health

What do public health practitioners do?

Box 1.1 Roles and Functions for the Public Health Workforce

Activity 1.4 What do you think public health workers do?

The World Health Organization agenda for public health

Box 1.2 Who’s Six-Point Action Plan

Box 1.3 Five Key Action Areas for the Commission on Social Determinants of Health

Public health in the Australian context

Australian Government Department of Health

Box 1.4 Role of the Population Health Division, Australian Government Department of Health

Activity 1.5 Advancing public health—the Australian perspective

Box 1.5 State/Territory Government Functions

Reflection 1.5

State and territory governments

Local government

Activity 1.6 Health in the public arena

Public health issues in the daily press

Non-government organisations, community organisations, professional associations, and public health advocacy groups

The future for public health?

A final word

Review Questions

Useful websites

References

Chapter 2 History and development of public health

Learning objectives

Introduction

The importance of the past in public health

Advancing population health—individual intervention or collective action?

For the sake of the public’s health? The ancient history of public health

Changing definitions of ‘disease’

The colonial era: colonisation and health

Colonisation and health, and a maturing Australia

Box 2.1 Differences between the british state and the australian colony

A general history of public health: evolution and influences

TABLE 2.1 Six major influences on the development of public health in Australia

TABLE 2.2 Phases in the history of public health

Activity 2.1 Provision of basic environmental and sanitary structures

Reflection 2.1

Environment protection

Individualism and State involvement

Activity 2.2 Population health programs at federal and local levels

Therapeutic era

Reflection 2.2

Activity 2.3 Influences on individual health choices

Reflection 2.3

Contemporary notions: ecological public health

FIG. 2.1 Contemporary public health movement.

FIG. 2.2 The relationship between ecology, society and economy.

Applying the models

Case Study 2.1 Alice, a homeless woman

Activity 2.4 Public health interventions

Reflection 2.4

A final word

Review Questions

References

Chapter 3 Contemporary public health policy

Learning objectives

Introduction

What is ‘policy’?

Stages of the policy process

Box 3.1 Stages of the Policy Process

Activity 3.1 Government health policy initiatives

Reflection 3.1

Case Study 3.1 Breast and cervical cancer screening

Case Study 3.2 Needle and syringe programs

Activity 3.2 Values underpinning national public health policies

Reflection 3.2

Types of public policy

Distributive policies

Regulatory policies

Self-regulatory policies

Redistributive policies

Activity 3.3 Types of public health policy

Reflection 3.3

What is policy for?

Politics and policy

Health economics

International developments and their impact on contemporary health policies

Case Study 3.3 The UN’s Global Fund

Activity 3.4 The WHO and Australian public health policies

Reflection 3.4

Health policy and the Australian healthcare system

FIG. 3.1 Proportions of recurrent health expenditure, current prices, by area of expenditure, 2011–12, expressed as a percentageNote: Components do not add to exactly 100% due to rounding.

Activity 3.5 Other important features of Australia’s healthcare system

Reflection 3.5

Management and reform of healthcare

Activity 3.6 Super clinics

Reflection 3.6

National public health priorities—an evolving agenda

Activity 3.7 Unified approaches to health policy

Reflection 3.7

The National HIV/AIDS Strategy

The National Chronic Disease Strategy

Activity 3.8 Priorities and issues of interest

Reflection 3.8

Case Study 3.4 Oral health in Queensland

The role of the Australian Institute of Health and Welfare

A final word

Review Questions

Endnotes

Useful websites

References

Chapter 4 Public health and social policy

Learning objectives

Introduction

Activity 4.1 Unemployment

Reflection 4.1

Health policy: a key foundation of the welfare state

Health policy, social justice and risk

Activity 4.2 Definitions of ‘health’

Reflection 4.2

FIG. 4.1 Public social expenditure as a percentage of gross domestic product (GDP).

Case Study 4.1 Joined-up problems need joined-up solutions

Activity 4.3 Interconnected problems

Reflection 4.3

Activity 4.4 Influence of lobbies

Reflection 4.4

History of Australian health policy—policy design and funding arrangements

Disability, Indigenous health and equity considerations

Social determinants of health and environmental health discourses

A final word

Review Questions

Useful websites

References

Section 2

Determinants of health

Introduction

References

Chapter 5 Epidemiology

Learning objectives

Introduction

Defining epidemiology

Objectives of epidemiological studies

Activity 5.1 Application of epidemiology to public health issues

Reflection 5.1

Measuring the occurrence of exposures of interest and of health outcomes

Case Study 5.1 Measuring exposure and outcome

Case Study 5.2 Counting and reporting cases

Example 5.1 Calculating prevalence

Case Study 5.3 When to use incidence rate

Example 5.2 Incidence of hearing loss among workers in heavy industry

Case Study 5.4 When comparative mortality rates can be misleading

Epidemiological study design

Observational epidemiology

TABLE 5.1 Epidemiological study designs: advantages and disadvantages

FIG. 5.1 Main types of epidemiological study design.

Ecological studies

Cross-sectional studies

Activity 5.2 Inconsistencies between studies

Reflection 5.2

Case-control studies

Case Study 5.5 Recall error and bias

Cohort studies

Case Study 5.6 A longitudinal cohort study

Activity 5.3 Types of observational study

Reflection 5.3

Experimental epidemiology

Randomised controlled trials

Activity 5.4 Randomised controlled trials

Case Study 5.7 RCT challenges

Community trials

Activity 5.5 Study designs

Measures of association

Reflection 5.5

Relative risk

TABLE 5.2 Two-by-two table

TABLE 5.3 The relative risk for coronary heart disease (CHD) mortality

Odds ratios

Sources of error in epidemiological studies

Random error

TABLE 5.4 Two-by-two table for a case-control study

Activity 5.6 Issues around self-reporting

Reflection 5.6

Systematic error

Selection bias

Information bias

Activity 5.7 Evaluating study results

Reflection 5.7

Confounding

Case Study 5.8 Confounding factors

FIG. 5.2 Diagram illustrating the relationship between: (a) exposure X, disease Y, and confounder A; (b) exposure X, disease Y, and non-confounding factor on causal path A.

Why are confounding and error important to an epidemiologist?

Activity 5.8 Alternative explanations

Reflection 5.8

Summing it up

A final word

Review Questions

Acknowledgements

Useful websites

References

Chapter 6 Biological and environmental determinants

Learning objectives

Introduction

A complex web of determinants

TABLE 6.1 Determinants of health

FIG. 6.1 Determinants of health.

Activity 6.1 One Health

Genetics and screening

Activity 6.2 Issues with genetic information

Activity 6.3 Diabetes

Reflection 6.3

Biological and behavioural determinants

Biological determinants

Behavioural determinants

Activity 6.4 Health issues and lifestyle behaviours

Reflection 6.4

Tobacco

Activity 6.5 Tobacco control

Alcohol

Activity 6.6 Alcohol consumption

Injuries

Activity 6.7 Driving campaign

Mental Health

Activity 6.8 National Mental Health Plan roadmap

Diet and Physical Activity

Activity 6.9 National Health Priority Areas and genetic and behavioural factors

Reflection 6.9

Environmental determinants

FIG. 6.2 Human interaction with the environment.

Human interaction with the environment

Ecosystem services

Ecosystem services and human wellbeing

FIG. 6.3 Links between biodiversity, ecosystem services and human wellbeing.

Activity 6.10 Ecosystems

Environmental burden of disease

Case Study 6.1 Ecosystem changes and human health impacts

Reflection 6.10

Activity 6.11 Environmental determinants

Reflection 6.11

Food Quality and Safety

Water Quality

Case Study 6.2 Hepatitis A and oysters

Case Study 6.3 Water fluoridation

Air Pollution

Case Study 6.4 Health impacts of bushfires

Built Environment

Global Climate Change

A final word

Case Study 6.5 Sick building syndrome

Review Questions

Useful websites

References

Chapter 7 Social and emotional determinants of health

Learning objectives

Introduction

Socioeconomic determinants and the health inequalities jigsaw

Activity 7.1 Social gradient of health

Reflection 7.1

Socioeconomic characteristics that influence health

Education

Activity 7.2 Education and health

Reflection 7.2

Income

Activity 7.3 Income and health

Work and employment status

Reflection 7.3

Activity 7.4 Workers’ health status

Reflection 7.4

Place or geographical location

Activity 7.5 Contextual and compositional factors

Reflection 7.5

Gender

Activity 7.6 Health profiles

Reflection 7.6

A public health framework to address the social determinants of health

Reducing health inequalities

FIG. 7.1 Socioeconomic determinants of health.

Upstream Factors

Midstream Factors

Downstream Factors

Activity 7.7 Influence of upstream, midstream and downstream policies

Reflection 7.7

Activity 7.8 Social and psychosocial determinants of health

Case Study 7.1 Leila, a refugee

Reflection 7.8

Social and economic disadvantage and emotional health

Activity 7.9 Social and economic disadvantage

Reflection 7.9

The lifecourse approach

FIG. 7.2 Lifecourse framework.

Activity 7.10 Lifecourse approach to health

Reflection 7.10

Role of social cohesion and social capital

Social cohesion

Social capital

Activity 7.11 Social cohesion, social capital and health

Reflection 7.11

A final word

Review Questions

Endnotes

Useful websites

References

Section 3

Ethics, evidence and practice

Introduction

Reference

Chapter 8 Ethics and public health

Learning objectives

‘Integrity’.

Introduction

Activity 8.1 Ethical practice

Reflection 8.1

Ethical frameworks, theories and concepts

Activity 8.2 Issues around quarantining

Normative ethics in public health

Reflection 8.2

Themes and debates in the development of ethics in public health

Public health law and human rights

Applied ethics

Codes of ethics

Activity 8.3 Principles of ethical practice

Reflection 8.3

Activity 8.4 Application of research ethics to health work

Reflection 8.4

Activity 8.5 PSA Code of ethics

Reflection 8.5

The application of ethics in public health practice

Public Health Research

Case Study 8.1 The Tuskegee Syphilis Study

Activity 8.6 Issues arising from the Tuskegee Syphilis Study

Reflection 8.6

Anthropological Research

Activity 8.7 Ethical issues arising from the Genographic Project

Reflection 8.7

Screening

Activity 8.8 Screening issues

Reflection 8.8

Disease Control

Activity 8.9 Population versus individual rights

Reflection 8.9

Social Networking for Public Health

Health Promotion

Activity 8.10 Privacy versus the public interest

Reflection 8.10

Advocacy

Ethical Relativism

Activity 8.11 Community perceptions of their health priorities

Reflection 8.11

Activity 8.12 Environmental determinants versus individual responsibility

Contemporary and future public health ethics

Reflection 8.12

Activity 8.13 Cultural impacts on health

Reflection 8.13

A final word

Review Questions

Acknowledgement

Endnote

References

Chapter 9 Evidence-based practice

Learning objectives

Introduction

The evolution: evidence-based medicine

Box 9.1 The Cochrane Collaboration

FIG. 9.1 Example of the development of clinical guideline standards.

The nature of evidence, and key concepts of evidence-based practice

Activity 9.1 Appraising the evidence

The nature and scope of knowledge

Reflection 9.1

Activity 9.2 Evaluating evidence

Reflection 9.2

Key concepts of evidence-based practice

Case Study 9.1 Dangers of ‘research utilisation’

Reflection on Case Study 9.1

What is ‘evidence-based practice’?

Box 9.2 What Is an ‘Evidence-Based Practitioner’?

Activity 9.3 Building a case for funding

Reflection 9.3

TABLE 9.1 Hierarchy of evidence

TABLE 9.2 Systematic review process

Putting evidence into practice

Example 9.1 Advising on smoking cessation in pregnancy

Example 9.2 Measuring glycated haemoglobin in diabetes management

Example 9.3 Placing infants to sleep on their back to reduce the risk of SIDS

Why is there a gap between research and practice?

Case Study 9.2 Handwashing in hospitals

Reflection for Case Study 9.2

Example 9.4 Allison

Example 9.5 Bianca

Reflection for Examples 9.4 and 9.5

Organisational structures

Box 9.3 Models of Organisational Culture

Mechanistic versus organic

Role versus task

Club

Learning

Finding the evidence

TABLE 9.3 Techniques to overcome bias in research

TABLE 9.4 Barriers to implementing evidence-based practice

Evidence and policy development

FIG. 9.2 Theoretical framework for transforming knowledge into policy actions.

A final word

Review Questions

Useful websites

References

Chapter 10 Planning and evaluation

Learning objectives

Introduction

Planning and evaluation in public health

Activity 10.1 Types of planning

Reflection 10.1

Models of planning

Identifying needs and priorities

Case Study 10.1 Defining food literacy and needs 2011

Beginning your program plan

Activity 10.2 Types of need

Reflection 10.2

Writing Goals and Objectives

FIG. 10.1 Program logic model.

Writing Strategies

Identifying a Target Group

IDENTIFYING RESOURCES—OR PROGRAM ‘INPUTS’

Activity 10.3 The program logic model

Planning the evaluation methods

Reflection 10.3

Purposes of Evaluation

FIG. 10.2 Framework for program evaluation.

Methods

Activity 10.4 Standards for evaluation

Reflection 10.4

Evaluation designs in practice

Process evaluation to measure program strategies and activities

Activity 10.5 Data collection

Reflection 10.5

Evaluability assessment

Activity 10.6 Pilot-testing a campaign

Reflection 10.6

Activity 10.7 Evaluability assessments

Impact evaluation to measure program objectives

Reflection 10.7

Outcome evaluation to measure program goals

Evaluation designs for impact and outcome evaluation

Activity 10.8 Impact and outcome evaluations

Reflection 10.8

A final word

Case Study 10.2 Evaluation of a diabetes prevention pilot initiative

TABLE 10.1 Planning and evaluation checklist: evaluation and dissemination

Review Questions

Useful websites

References

Section 4

Health protection and promotion

Introduction

Reference

Chapter 11 Disease control and management

Learning objectives

Introduction

Defining chronic condition and chronic disease

FIG. 11.1 Top 10 leading causes of disease burden in DALYs* terms, Australia, 1996.Note: *DALYs—disability-adjusted life years—count equivalent years of ‘healthy’ life lost due to poor health or disability and potential years of life lost due to premature death. COPD—chronic obstructive pulmonary disease.

FIG. 11.2 Behavioural risk factors, biomedical risk factors, and other factors contributing to chronic disease.

Continuum of care/integrated approach to chronic disease

TABLE 11.1 Relationships between various chronic diseases, conditions and risk factors

Chronic disease management programs

Early detection and early treatment

Activity 11.1 Diabetes detection and care

Reflection 11.1

Integration and continuity of prevention and care

Activity 11.2 Chronic condition care programs

Self-management

Case Study 11.1 Example of self-management

Chronic disease prevention and management—some issues

Reflection 11.2

Defining infectious disease

FIG. 11.3 Death rates from infectious diseases in Australia 1922–2007.

Models of infectious disease

Box 11.1 The Old Epidemics

Activity 11.3 An outbreak of ‘Spanish flu’ today

Reflection 11.3

Mechanism of infectious disease

FIG. 11.4 The agent–host–environment triangle model of infectious diseases.

FIG. 11.5 Chain model of infectious diseases.

TABLE 11.2 Examples of the chain model of infection

Infectious disease management

Disease prevention

Societal and Environmental Structures

Immunisation

Box 11.2 HPV and Gardasil®

TABLE 11.3 Vaccine-preventable disease data for the United States

Case Study 11.2 The internet and immunisation

Activity 11.4 Evaluating immunisation information on the internet

Vector Control

Case Study 11.3 Malaria and bed-nets

Reflection 11.4

Case Study 11.4 Dengue risk when Australians travel

Personal Protection

Surveillance, early recognition and early intervention

Infection control

Box 11.3 Tattoos and Body-Piercing

Activity 11.5 Tattoos and body-piercing

Outbreak investigation and contact tracing

Reflection 11.5

Barriers to effectively managing infectious diseases

Case Study 11.5 Outbreak investigation

Box 11.4 The Ongoing Challenge

A final word

Review Questions

Useful websites

References

Chapter 12 Environmental health

Learning objectives

Introduction

What is ‘environmental health’?

Environmental health hazards

FIG. 12.1 Relationships between the fields of public health, environmental health and environmental protection.

Air pollution

Case Study 12.1 China’s Huai River policy

Case Study 12.2 Benefits of the US Clean Air Act

Activity 12.1 Air quality

Safe water

Box 12.1 The Global Water Crisis

Case Study 12.3 Chemical contamination of drinking water

Activity 12.2 Paying for water

Safe food

Example 12.1 The cost of supplying prawns to Scots

Case Study 12.4 International Salmonella outbreak

Activity 12.3 OzFoodNet

The built environment

Case Study 12.5 Urban design, transport and health

The occupational environment

Activity 12.4 Cycle routes

Reflection 12.4

Case Study 12.6 Port Pirie and lead exposure

The global environment

FIG. 12.2 Interrelationships between major types of global environmental change.

Global Climate Change

Case Study 12.7 Ocean acidification

Activity 12.5 Ocean acidification

FIG. 12.3 Predicted increase in global mean surface temperature as a function of CO2 emissions from various lines of evidence. This graph displays historical data from 1860 to 2010, along with predictions from various climate models taking account of differing scenarios. The models predict that by 2100 there will be an increase in the global mean surface temperature of between 1.5°C and 4.5°C, depending on the rate of future CO2 emissions.

Health and Social Impacts of Climate Change

Sustainable environmental health

Box 12.2 The Earth Charter

Activity 12.6 The Earth Charter in practice

Risk assessment and risk perception

TABLE 12.1 Outrage factors for individual risk perception

Activity 12.7 Risk assessment

Example 12.2 Risk perception of ‘experts’ versus the ‘public’

Reflection 12.7

A final word

Review Questions

Useful websites

References

Chapter 13 Disaster preparedness and public health

Learning objectives

Introduction

Defining ‘disasters’

FIG. 13.1 The relative nature of disasters.

Context

Epidemiology

FIG. 13.2 Trends in incidents and deaths.

Health impacts

Principles of disaster management

Case Study 13.1 Evacuating health services

Activity 13.1 Decision to evacuate a hospital

Reflection 13.1

An engaged and prepared community

Risk-Based Approach

All-Hazards Approach

All-Agencies Approach

Familiarity

Comprehensive Approach

Prevention and mitigation

Preparedness and planning

FIG. 13.3 Hierarchy of plans. CBR = Chemical, biological and radiological.

Reflection 13.2 Heatwaves

Response and relief

Recovery, rehabilitation and redevelopment

TABLE 13.1 Example of the eight Cs of response management in practice

Activity 13.3 Managing Fukushima

Reflection 13.3

Systems and structures

FIG. 13.4 Queensland disaster management arrangements.

Activity 13.4 Local disaster health committees

Special considerations

Floods

Pandemics

Mass gatherings

Mental health

Public health considerations

Displaced persons

International aid

Volunteers and donations

Vulnerable populations

Management of exercises

The role of the public health practitioner

Activity 13.5 Disaster health management

Reflection 13.5

A final word

Review Questions

References

Chapter 14 Health promotion

Learning objectives

Introduction

History of health education

The concept of wellness

Evolution and evidence for health promotion

Activity 14.1 Health education and promotion

Reflection 14.1

Principles of health promotion

FIG. 14.1 The Ottawa Charter emblem for health promotion.

TABLE 14.1 WHO Global health promotion conferences

Aboriginal and Torres Strait Islander peoples’ concepts of health promotion

Case Study 14.1 Aboriginal and Torres Strait Islander peoples’ health promotion

Activity 14.2 Reducing alcohol- or drug-related violence

Reflection 14.2

Strategies for health promotion

Case Study 14.2 Tobacco control

FIG. 14.2 Tobacco smoking rates across Australia, 2011–12.

Box 14.1 Australian Tobacco Control Strategies

Reflection 14.3 E-cigarettes

Activity 14.4 Strategies for healthy change

Reflection 14.4

Levels of prevention in public health and health promotion

FIG. 14.3 The relationship between primary, secondary and tertiary levels of prevention.

Health promotion in practice

Settings for health promotion

Why A Settings Approach?

Schools

Communities

FIG. 14.4 The empowerment continuum.

Workplaces

The internet and interactive technologies

Case Study 14.3 TLC Diabetes Project

Activity 14.5 Technology and health promotion

Case Study 14.4 Blogging

Reflection 14.5

Emerging challenges for health promotion

FIG. 14.5 Some possible points of intervention for a new public health approach to diabetes, given the distribution of risk.

Self-management

Activity 14.6 Health promotion strategies

Reflection 14.6

A final word

Review Questions

Useful websites

References

Section 5

Contemporary issues

Introduction

References

Chapter 15 The impact of globalisation on health

Learning objectives

Introduction

Activity 15.1 Globalisation

Reflection 15.1

Global communication

Box 15.1 Defining ‘Globalisation’

National and international air travel

TABLE 15.1 The view of globalisation by country

Activity 15.2 Is globalisation good?

Reflection 15.2

Globalisation in population health

Globalisation of infectious diseases

Activity 15.3 Globalisation and the spread of infectious diseases

Reflection 15.3

Case Study 15.1 Australia’s response to Ebola

Globalisation and chronic diseases

Tobacco Use

TABLE 15.2 Projected global tobacco-caused deaths by 2015—adapted from baseline scenario

Activity 15.4 Tobacco—health and economic issues

Reflection 15.4

Overweight and Obesity

TABLE 15.3 Prevalence of pre-obese (overweight) and obese in the world

TABLE 15.4 Prevalence of overweight and obesity in Chinese children aged 7–17 years old in 2002

TABLE 15.5 Factors contributing to global epidemic of obesity

Activity 15.5 Promoting a healthy diet

Reflection 15.5

Refugee health

The global public health community

TABLE 15.6 The UN Millennium Development Goals

Box 15.2 Major Areas of Commonality Identified in The Oslo Statement

Activity 15.6 Working in developing countries

Reflection 15.6

Activity 15.7 International Society for Prevention of Child Abuse and Neglect

Reflection 15.7

A final word

Review Questions

Acknowledgement

References

Chapter 16 Aboriginal and Torres Strait Islander health

Learning objectives

Introduction

Who are Aboriginal and Torres Strait Islander peoples?

Activity 16.1 Aboriginal pre- and post-colonisation experience

Reflection 16.1

Government policy

The National Aboriginal Health Strategy

Close the Gap

The Northern Territory Intervention

Activity 16.2 Close the Gap and the Intervention

Reflection 16.2

Aboriginal and Torres Strait Islander peoples today

Activity 16.3 Profile and culture of Aboriginal and Torres Strait Islander peoples

Reflection 16.3

Community and gendered health

Aboriginal and Torres Strait Islander women’s health

Activity 16.4 Aboriginal and Torres Strait Islander women’s health

Reflection 16.4

Aboriginal and Torres Strait Islander men’s health

Activity 16.5 Aboriginal and Torres Strait Islander men’s health

Reflection 16.5

Community-controlled health service sector

Activity 16.6 Aboriginal and Torres Strait Islander health services

Reflection 16.6

Research

Activity 16.7 Research with Aboriginal and Torres Strait Islander peoples

Reflection 16.7

Case Study 16.1 The Victorian Aboriginal Community Controlled Health Organisation

Indigenous people in other parts of the world

A final word

Review Questions

References

Chapter 17 Grand challenges for public health

Learning objectives

Introduction

Box 17.1 Ten Great Public Health Achievements—United States, 1900–1999

Box 17.2 Key Achievements Within the Australian Public Health Sector

Grand challenges in the twenty-first century

Activity 17.1 Health challenges for the twenty-first century

Reflection 17.1

Twenty-first-century solutions

TABLE 17.1 Future issues impacting on public health activity in the twenty-first century

Globalisation and health

Dietary imbalance, physical inactivity and sedentary behaviour

Population ageing

Sustainable ecological public health

Emerging and re-emerging infections

Genetics, biotechnology and information technology

The public health workforce: skills for a complex future

Strategic planning for public health: political will and action

Leadership and public health: establishing a research agenda

Box 17.3 Major Public Health Research Challenges

Grand challenges for public health: what is the future?

Activity 17.2 Opportunities to advance future health

Reflection 17.2

A final word

Review Questions

References

Glossary

Glossary

References

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