Public health terms

Public Health Terminology, including descriptions of federal agencies that fund public health programs)

Access - Access is the potential for or actual entry of a population into the health system. Entry isdependent upon the wants, resources, and needs that individuals bring to the care-seekingprocess. The ability to obtain wanted or needed services may be influenced by many factors,including travel, distance, waiting time, available financial resources, and availability of aregular source of care. Access also refers to the extent to which a public health service isreadily available to the community’s individuals in need. Accessibility also refers to thecapacity of the agency to provide service in such a way as to reflect and honor the social andcultural characteristics of the community and focuses on agency efforts to reduce barriers toservice utilization.Source: Turnock, BJ. Public Health: What It Is and How It Works. Jones and Bartlett. 2009.
Assurance - As one of the core functions of public health, assurance refers to the process of determiningthat “services necessary to achieve agreed upon goals are provided, either by encouragingactions by other entities (public or private sector), by requiring such action throughregulation, or by providing services directly.”Source: Institute of Medicine, The Future of Public Health. Washington, DC: National Academy Press; 1988.
Behavioral risk factors - Risk factors in this category include behaviors that are believed to cause, or to becontributing factors to most accidents, injuries, disease, and death during youth andadolescence as well as significant morbidity and mortality in later life. This is a categoryrecommended for collection in the Community Health Profile.
Behavioral Risk Factor Surveillance Survey (BRFSS) - The BRFSS is a random telephone survey of state residents aged 18 and older in householdswith telephones. In 2009, the BRFSS began conducting surveys by cellular phone in addition totraditional “landline” telephones. BRFSS was initially developed in the early 1980s by theCenters for Disease Control and Prevention (CDC) in collaboration with state healthdepartments and is currently conducted in all 50 states, the District of Columbia and severalUnited States territories. Through BRFSS, information is collected in a routine, standardizedmanner at the state level on a variety of health behaviors and preventive health practicesrelated to the leading causes of death and disability such as cardiovascular disease, cancer,diabetes and injuries. BRFSS interviews are conducted monthly and data are analyzedannually (on a calendar-year basis).
Benchmarks - Benchmarks are points of reference or a standard against which measurements can becompared. In the context of indicators and public health, a benchmark is an accurate datapoint, which used as a reference for future comparisons (similar to a baseline). Sometimes italso refers to as “best practices” in a particular field. Communities compare themselvesagainst these standards. Many groups use benchmark as a synonym for indicator or target.Source: Norris T, Atkinson A, et al. The Community Indicators Handbook: Measuring Progress toward Healthy andSustainable Communities. San Francisco, CA: Redefining Progress; 1997.
Best practice(s) - The best clinical or administrative practice or approach at the moment, given the situation,the consumer’s or community’s needs and desires, the evidence about what works for thissituation/need/desire, and the resources available. Organizations also often use promisingpractices, which are defined as clinical or administrative practices for which there isconsiderable evidence or expert consensus and which show promise in improving outcomes,but which are not yet proven by the highest or strongest scientific evidence.
Board of Health - A board of health is a legally designated governing entity whose members are appointed orelected to provide advisory functions and/or governing oversight of public health activities,including assessment, assurance, and policy development, for the protection and promotionof health in their community.Source: National Public Health Performance Standards Program, Acronyms, Glossary, and Reference Terms, CDC, 2007.www.cdc.gov/nphpsp/PDF/Glossary.pdf.
CDC - The Centers for Disease Control and Prevention (CDC) is part of the Department of Healthand Human Services. It provides federal leadership and funding in the prevention andcontrol of diseases.
Chronic disease - A disease that has one or more of the following characteristics: it is permanent, leavesresidual disability, is caused by a nonreversible pathological alteration, requires special training of the patient for rehabilitation, or may be expected to require a long period ofsupervision, observation or care.
Communicable disease data - This category includes diseases that are usually transmitted through person-to-personcontact or shared use of contaminated instruments/materials. Many of these diseases canbe prevented through the use of protective measures, such as a high level of vaccinecoverage of vulnerable populations.
Community-based participatory research (CBPR) - A collaborative approach to research that equitably involves all partners in the researchprocess and recognizes the unique strengths that each brings. CBPR begins with a researchtopic of importance to the community, has the aim of combining knowledge with action andachieving social change to improve health outcomes and eliminate health disparities.
Community health assessment (CHA) - Community health assessment calls for regularly and systematically collecting, analyzing, andmaking available information on the health of a community, including statistics on healthstatus, community health needs, epidemiologic and other studies of health problems. Oftenthis can take the form of community needs assessments, which are intended to assist thecommunity in adapting and responding to important health problems and risks. Increasingly,moving beyond problems and deficits toward an analysis of community strengths andresources is becoming recognized as a critical part of understanding a community’s health.Conducting a community health assessment is required for state and county public healthaccreditation as well as for Coordinated Care Organizations (CCOs).
Community health improvement (CHIP) - Focuses on the combined effects of individual and community, physical and socialenvironments, and the policies and interventions used to promote health, prevent disease,and ensure access to quality health care. The ultimate measure of success in any healthimprovement effort is the health status of the target population. Implementing a communityhealth improvement plan is required for state and county public health accreditation as wellas for Coordinated Care Organizations (CCOs).
Community health profile (CHP) - A comprehensive compilation of measures representing multiple categories, or domains,that contributes to a description of health status at a community level and the resourcesavailable to address health needs. Measures within each domain may be tracked over timeto determine trends, to evaluate health interventions or policy decisions, to comparecommunity data with peer, state, national or benchmark measures, and to establishpriorities through an informed community process.
Continuous quality improvement - An ongoing effort to improve the efficiency, effectiveness, quality, or performance ofservices, processes, capacities, outcomes. These efforts can seek “incremental”improvement over time or “breakthrough” improvement all at once. Among the most widelyused tools for continuous improvement is a four-step quality model, the Plan-Do-Check-Act(PDCA) cycle.
Coordinated Care Organizations (CCOs) - A Coordinated care organization, or CCO, is a network of all types of health care providers(physical health care, addictions and mental health care, and dental care providers) whohave agreed to work together in their local communities to serve people who receive healthcare coverage under the Oregon Health Plan (Medicaid). CCOs are focused on preventionand helping people manage chronic conditions, like diabetes. This helps reduce unnecessaryemergency room visits and gives people support to be healthy
Core public health competencies - The core public health competencies encompass the individual skills desirable for thedelivery of Essential Public Health Services. They transcend the boundaries of the specificdisciplines within public health and help to unify the profession. The competencies aredivided into the following eight domains: Analytic Assessment Skills, Basic Public HealthSciences Skills, Cultural Competency Skills, Communication Skills, Community Dimensions ofPractice Skills, Financial Planning and Management Skills, Leadership and Systems ThinkingSkills, Policy Development/Program Planning Skills. Intended levels of mastery, and thereforelearning objectives for public health workers within each competency, will differ dependingupon their backgrounds and job duties.
Cultural competence - A set of skills that result in an individual understanding and appreciating cultural differencesand similarities within, among, and between groups and individuals. This competencerequires that the individual draw on the community-based values, traditions, and customs towork with knowledgeable persons of and from the community in developing targetedinterventions and communications.
Death, illness, and/or injury data - Health status in a community is measured in terms of mortality (rates of death within apopulation) and morbidity (rates of the incidence and prevalence of disease). Mortality maybe represented by crude rates or age-adjusted rates (AAM); by degree of premature death(Years of Productive Life Lost or YPLL); and by cause (disease - cancer and non-cancer orinjury - intentional, unintentional). Morbidity may be represented by age-adjusted (AA)incidence of cancer and chronic disease.
Demographic characteristics - Demographic characteristics of a jurisdiction include measures of total population as well aspercent of total population by age group, gender, race and ethnicity, where these populations and sub-populations are located, and the rate of change in population densityover time, due to births, deaths and migration patterns.
Determinants of health - Direct causes and risk factors which, based on scientific evidence or theory, are thought toinfluence directly the level of a specific health problem. These maybe defined as the“upstream” factors that affect the health status of populations and individuals. Roughlydivided into the social environment (cultural, political, policy, economic systems, socialcapital, etc.), the physical environment (natural and built), and genetic endowment. Thedeterminants of health affect both individual response (behavior and biology) and theprevalence of illness and disease.
Disease - A state of dysfunction of organs or organ systems that can result in diminished quality of life.
Emergency Medical Services (EMS) - Emergency Medical Services focuses on ensuring a functioning emergency care system. Thisincludes licensing paramedics and emergency medical technicians, approving the trainingcurriculum and licensing EMS instructors, ensuring ambulances are safe and well-equipped,and ensuring that every community has access to emergency care-from first respondersthrough to a sophisticated trauma center.
Endemic - Prevalent in or peculiar to a particular locality or people.
Environmental Factor - An environmental factor is an extrinsic factor (e.g., geology, climate, insects, sanitation,health services, etc.) that affects the agent and the opportunity for exposure.
Environmental hazards - Situations or materials that pose a threat to human health and safety in the built or naturalenvironment, as well as to the health and safety of other animals and plants, and to theproper functioning of an ecosystem, habitat, or other natural resource.
Environmental health - The interrelationships between people and their environment that promote human healthand well-being and foster a safe and healthful environment. Environmental health includesall aspects of human health and quality of life that are determined by physical, chemical,biological, social, and psychosocial factors in the environment.
Environmental justice - The fair treatment and meaningful involvement of all people, regardless of race, ethnicity,culture, income or education level for the development, implementation, and enforcement of environmental laws, regulations, and policies. Environmental justice seeks to ensure thatno population is forced to shoulder a disproportionate burden of the negative human healthand environmental impacts of pollution or other environmental hazards.
Epidemic - A group of cases of a specific disease or illness clearly in excess of what one would normallyexpect in a particular geographic area.
Epidemiology - Epidemiology is the study of the distribution and determinants of health-related states orevents in specified populations, and the application of this study to the control of healthproblems. Epidemiology is concerned with the frequencies and types of illnesses and injuriesin groups of people and with the factors that influence their distribution.
Essential Public Health Services - The ten services identified in Public Health in America: monitoring health status; diagnosingand investigating health problems; informing, educating, and empowering people;mobilizing community partnerships; developing policies and plans; enforcing laws andregulations; linking people to needed services; assuring a competent workforce; conductingevaluations; and conducting research. Representatives from federal agencies and nationalorganizations developed the statement made in Public Health in America. This statementincludes two lists, one that describes what public health seeks to accomplish and the secondthat describes how it will carry out its basic responsibilities. The second list, the EssentialServices, provides a list of 10 public health services that define the practice of public health.
Evaluation - Evaluation is a process that attempts to determine as systematically and objectively aspossible the relevance, effectiveness, and impact of activities in the light of their objectives.Evaluation identifies what should or could be done to address a health problem, and how itcan be done.
Foodborne illness - Illness caused by the transfer of disease organisms or toxins from food to humans.
Geographic information system (GIS) - Combines modern computer and supercomputing digital technology with data managementsystems to provide tools for the capture, storage, manipulation, analysis, and visualization ofspatial data. Spatial data contains information, usually in the form of a geographiccoordinate system that gives data location relative to the earth’s surface. These spatialattributes enable previously disparate data sets to be integrated into a digital mappingenvironment.
Health disparities - Health disparities indicate the difference in the incidence, prevalence, mortality, and burdenof diseases and other adverse health conditions that exists among specific populationgroups.
Health Impact Assessment (HIA) - Health impact assessments refers to any combination of qualitative and quantitativemethods used to assess the population health consequences of a policy, project, or programthat does not have health as its primary objective (i.e., assessing the health consequences ofnon-health-sector actions).
Health indicator - A health indicator is a measure that reflects, or indicates, the state of health in a definedpopulation, such as the infant mortality rate.
Health Insurance Portability and Accountability Act of 1996 (HIPAA) - The Health Insurance Portability and Accountability Act of 1996 (HIPAA) consists of twoTitles. Title I protects health insurance coverage for workers and their families when theychange or lose their jobs. Title II requires the Department of Health and Human Services(HHS) to establish national standards for electronic health care transactions and addressesthe security and privacy of health information.
Health Officer - General definition: The name of an officer invested with power to enforce the health laws.The powers and duties of health officers are regulated by local laws.Oregon specific definitions:State public health officer: The Director of the Oregon Health Authority shall appoint aphysician licensed by the Oregon Medical Board and certified by the American Board ofPreventive Medicine who shall serve as the Public Health Officer and be responsible for themedical and paramedical aspects of the health programs within the Oregon HealthAuthority.
Healthy People 2020 - Healthy People provides science-based, 10-year national objectives for improving the healthof all Americans. For three decades, Healthy People has established benchmarks andmonitored progress over time in order to encourage collaborations across sectors; guideindividuals toward making informed health decisions and measure the impact of preventionactivities. (www.healthypeople.gov/2020).
Health Plan Employer Data and Information Set (HEDIS) - The most widely used quality report for managed care health plans. Version 3.0 includes71indicators of performance covering quality measures in addition to performance onaccess, patient satisfaction, membership and utilization, financial efficiency, and health planmanagement.
Health promotion - Health promotion means the process of enabling people to increase control over and toimprove their health.
Health risk - A condition of humans that can be represented in terms of measurable health status orquality-of-life indicators.
Health status - The current state of a given population using a variety of indices, including morbidity,mortality, and available health resources.
Incidence - Incidence (incidence rate) is the number of new events (for example, new cases of a disease)in a defined population, occurring within a specified period of time.
Indicator - In public health terms, an indicator variable helps to measure changes directly or indirectly.It also makes it possible to assess the success of a program’s efforts in achieving its goals. Inmedicine, indicators help to measure changes in the health situation of a given population(e.g., the elderly).
Infant Mortality Rate - A death rate calculated by dividing the number of infant deaths during a calendar year bythe number of live births reported in the same year. It is expressed as the number of infantdeaths per 1,000 live births.
Infectious - Capable of causing infection or disease by entrance of organisms (e.g., bacteria, viruses,protozoan, fungi) into the body, which then grow and multiply. Often used synonymouslywith “communicable”.
Infectious diseases - A disease caused by a living organism. An infectious disease may, or may not, betransmissible from person to person, animal to person, or insect to person.
Infrastructure - The systems, competencies, relationships, and resources that enable performance of publichealth’s core functions and essential services in every community. Categories includehuman, organizational, informational, and fiscal resources.
Injury - Injuries can be classified by the intent or purposefulness of occurrence in two categories,intentional and unintentional injuries. Intentional injuries are ones that are purposelyinflicted and often associated with violence. These include child abuse, domestic violence,sexual assault, aggravated assault, homicide, and suicide. Unintentional injuries include onlythose injuries that occur without intent of harm and are not purposely inflicted.
Injury prevention - Injury prevention strategies focus primarily on environmental design (e.g., road constructionthat permits optimum visibility), product design, human behavior, education and legislativeand regulatory requirements that support environmental and behavioral change.
Intervention - An intervention is the act of interfering with a condition to modify it or with a process tochange its course. A public health intervention can be defined by the fact that it is applied tomany, most, or all members in a community, with the aim of delivering a net benefit to thecommunity or population as well as benefits to individuals. Public health interventionsinclude policies of governments and non-government organizations; laws and regulations;organizational development; community development; education of individuals andcommunities; engineering and technical developments; service development and delivery;and communication, including social marketing.
Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) - A peer review organization which provides the primary review of hospitals and healthcareproviders for the purpose of accreditation. Many insurance companies require providers tohave this accreditation in order to seek third party payment. JCAHO usually surveys orga-nizations once every three years, sending in a medical and administrative team to reviewpolicies, patient records, professional credentialing procedures, governance and qualityimprovement programs.
Local health department - An administrative or service unit of local or state government concerned with health andcarrying some responsibility for the health of a jurisdiction smaller than the state; thegovernmental public health presence at the local level, which may be a locally governedhealth department, a branch of the state health department, a state-created district orregion, a department governed by and serving a multi-county area, or any otherarrangement that has governmental authority and is responsible for public health functionsat the local level.
Local Health Officer - An individual who is hired or appointed by the appointing authority for a local governmentalpublic health agency and who has direct responsibility for the day-to-day operations,management, and direction of the local governmental public health agency. Such individualsare generally called “director,” “administrator,” “commissioner,” “health officer,” or similarterms.
Local public health system (LPHS) - The collection of public, private and voluntary entities, as well as individuals and informalassociations, that contribute to the public’s health within a jurisdiction.
Morbidity - Illness or lack of health caused by disease, disability, or injury.
Mortality - A measure of the incidence of deaths in a population.
Outbreak - An outbreak is the occurrence of more cases of disease than would normally be expected ina specific place or group of people over a given period of time.
Population health - Population health connotes a high level assessment of a group of people. This epidemiologicframework is often in direct opposition to the manner in which the health care system hascared for patients; one individual at a time.“Population” in population health can be defined from several different perspectives:• Population served by an individual provider or payer– Insuring that patients are assigned correctly to primary care provider• Population served by the entire delivery system– Primary care patients• Population residing in the broader community– Geographic area, membership in a category of persons that share specificattributes
Population-based health - Interventions aimed at disease prevention and health promotion that affect an entirepopulation and extend beyond medical treatment by targeting underlying risks, such astobacco, drug, and alcohol use; diet and sedentary lifestyles; and environmental factors.
Prevalence - Prevalence is the proportion of people in a population who have some attribute or conditionat a given point in time or during a specified time period.
Prevention - In public health terms, prevention means actions that reduce exposure or other risks, keeppeople from getting sick, or keep disease from getting worse.
Primary medical care - Clinical preventive services, first contact treatment services and ongoing care for commonlyencountered medical conditions.
Public health (several definitions) - 1) Public health is a set of organized interdisciplinary efforts to protect, promote, and restorethe public’s health. It is the combination of assessment, policy development and assurancethat is directed to the maintenance and improvement of the health of all the people throughcollective or social actions. The mission of public health is to “Promote physical, mental andenvironmental health and prevent disease, injury and disability.”
Public Health Accreditation Board (PHAB) - PHAB is the national accrediting organization for public health departments. A nonprofitorganization, PHAB is dedicated to advancing the continuous quality improvement of Tribal,state, local, and territorial public health departments. PHAB is working to promote andprotect the health of the public by advancing the quality and performance of all publichealth departments in the United States through national public health departmentaccreditation.
Public health director - The person responsible for the total management of the health department. The governingauthority, often the board of health, appoints this person. The public health director isresponsible for the day-to-day operations of the health department and its componentinstitutions, often sets policy or implements policies adopted by the board of health, and isresponsible for fiscal and programmatic matters.
Public health disasters - Severe or catastrophic events that affect the health of a given area or population.
Public health emergency - An occurrence or imminent threat of an illness or health condition, caused by bioterrorism,epidemic or pandemic disease, or novel and highly infectious agent or biological toxin, thatposes a substantial risk of a significant number of human fatalities or incidents of permanentof long term disability. Such illness or health condition includes, but is not limited to, anillness or health condition resulting from a natural disaster.
Public health laboratory - A scientific research facility with the equipment and staff needed to conduct ongoing publichealth assessments and to respond to emergency public health issues.
Public health system - All public, private, and voluntary entities that contribute to the delivery of essential publichealth services within a jurisdiction. These systems are a network of entities with differingroles, relationships, and interactions that contribute to the health and well-being of thecommunity or state.
Public health workforce - All persons engaged during a significant part of the time in work that creates the conditionswithin which people can be healthy. Composed of those who work for official public healthagencies at all levels of government, community-based and voluntary organizations with ahealth promotion focus, the public health-related staff of hospitals and health care systems,and a range of others in private industry, government, and the voluntary sector.
Quality of life - In public health terms, quality of life means the degree to which individuals perceivethemselves as able to function physically, emotionally and socially. In a general sense, it isthat which makes life worth living. In a more quantitative sense, it refers to a person’s timeremaining alive, free of impairment, disability, or handicap.
Quarantine - The compulsory physical separation or confinement of individuals and/or groups, animals, orthe enforced restraint of transport of goods in order to prevent or limit the spread of diseaseor disease vectors.
Rate - A measure of the intensity of the occurrence of an event. For example, the mortality rateequals the number who die in one year divided by the number at risk of dying. Rates usuallyare expressed using a standard denominator such 1,000 or 100,000 people.
Reportable disease(s) - Health conditions that are required through statute, ordinance or administrative rule to bereported to a public health agency when it is diagnosed in an individual.
Risk Assessment - The scientific process of evaluating adverse effects caused by a substance, activity, lifestyle,or natural phenomenon. Risk assessment is the means by which currently availableinformation about public health problems arising in the environment is organized andunderstood.
Risk factor - Personal qualities or societal conditions that lead to the increased probability of a problemor problems developing.
Risk management - The goal of risk management is to direct limited available resources to those areas andstrategies where the greatest amount of risk can be reduced for the least amount ofresources. In that “greatest risk” can be defined in a number of different ways, it is a value-laden process.
Safety-net provider(s) - Individuals and organizations that provide health care to low-income and other vulnerablepopulations, including the uninsured and those covered by Medicaid. Major safety netproviders include public hospitals and community health centers as well as teaching andcommunity hospitals, private physicians, and other providers who deliver a substantialamount of care to these populations.
Sanitary code - A regulation concerned with food safety as well as the design, construction, andmaintenance of environmental facilities conducive to public health, such as water supply andwaste disposal.
Screening - The use of technology and procedures to differentiate those individuals with signs orsymptoms of disease from those less likely to have the disease.
Social capital - Social capital refers to the institutions, relationships, and norms that shape the quality andquantity of a society’s social interactions.
Social norm - Expectations about behavior, thoughts or feelings that are appropriate and sanctionedwithin a particular society. Social norms can play a powerful role in the health status ofindividuals. Socioeconomic characteristics include measures that have been shown to affect healthstatus, such as income, education, and employment, and the proportion of the populationrepresented by various levels of these variables.
State health improvement plan - A state health improvement process is a collaborative effort to identify, analyze, and addresshealth problems in a state; assess applicable data; develop measurable health objectives andindicators; inventory statewide health assets and resources; develop and implementcoordinated strategies; identify accountable entities; and cultivate state public healthsystem “ownership” of the entire process. The results of the state health improvementprocess are contained in a written document, the state health improvement plan.
State Health Officer - The chief health official in each state. The chief health officials of these jurisdictions arededicated to formulating and influencing sound public health policy, and to assuringexcellence in state-based public health practice.
State health profile - A comprehensive compilation of measures organized into a public report that describes thehealth status of the state’s population and the resources available to address health needs.Measures may be tracked over time to identify trends, to evaluate health interventions orpolicy decisions, to compare state data with peer, national or benchmark measures, and toestablish priorities through an informed statewide process.
Surge Capacity - Surge capacity refers to the ability to expand care or service capabilities in response tounanticipated or prolonged demand.
Surveillance - In public health terms, surveillance means the ongoing, systematic collection, analysis, andinterpretation of health data. This activity also involves timely dissemination of the data anduse for public health programs.
Tobacco control - Local, state, and federal activity directed towards reducing the harmful effects of tobaccoproducts. This may involve both education and policy efforts in order to decrease theinitiation of tobacco use and to promote cessation among children and adults.
Underserved populations - Populations with barriers to the health care system include the uninsured, the underinsured,and socially disadvantaged people. Socially disadvantaged people include all people who, forreasons of age, lack of education, poverty, culture, race, language, religion, national origin, physical disability, or mental disability, may encounter barriers to entry into a coordinatedsystem of public health services and clinical care.
Vectors - Used in terms of public health it refers to animals or other living organisms that carry ortransmit diseases (e.g., rats, mosquitoes, foxes).
Vector control - Programs designed to reduce or eliminate a disease-carrying insect or rodent population(e.g., mosquito control programs).
Vital events - Live births, deaths, fetal deaths, marriages, divorces, and induced terminations ofpregnancy, together with any change in civil status that may occur during an individual’slifetime.
Vital statistics - Data derived from certificates and reports of birth, death, fetal death, induced terminationof pregnancy, marriage, (divorce, dissolution of marriage, or annulment) and related reports.
Vulnerable populations - A group of people with certain characteristics that cause them to be at greater risk of havingpoor health outcomes. These characteristics include, but are not limited to, age, culture,disability, education, ethnicity, health insurance, housing status, income, mental health, andrace.
Years of potential life lost (YPLL) - A measure of premature death, or death that occurs before age 75, which is the average lifespan. This measure is useful for assessing the impact of a particular public health problem onthe economy in terms of lost work years and earnings, and on family life in terms of impacton surviving spouses and children. It should be noted that a large percentage of the causesof YPLL are preventable through behavior modification, lifestyle changes, and substanceabuse reduction
Public Health Terminology - (including descriptions of federal agencies that fund public health programs)

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