2: Evidence-Based Public Health
- Page ID
- 189719
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)We often use the term “evidence-based practice” in public health to refer to policies, programs, or healthcare services. A lot of people have what seem to be great ideas for solving health problems, but how do we know if these ideas will really work? This is especially important when it comes to funding with government grants, which are taxpayer dollars - we need to make sure that we’re not just throwing money at random ideas and hoping they are effective. The following pages will explore how we use evidence-based practices in public health.
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- 2.1: What Does “Evidence-Based Practice” Mean?
- This page underscores the significance of evidence-based public health by using epidemiological data to guide decision-making. It advocates for the systematic collection and evaluation of both objective and subjective evidence to shape public health initiatives. The content stresses careful interpretation of research and acknowledges variability in effectiveness across communities.
- 2.2: Burden of Disease and Epidemiology
- This page addresses the complexities of identifying critical diseases for public health and resource allocation through the burden of disease concept, encompassing disability and mortality. It highlights epidemiology as essential for evaluating disease distribution and risk factors, emphasizing a shift from infectious to chronic diseases and behavioral health. Readers are prepared for various tools and techniques utilized in epidemiological studies.
- 2.3: Vital Statistics
- This page discusses how epidemiologists utilize vital statistics, such as birth and death rates, to evaluate public health. Key concepts include natality, fertility, morbidity, and mortality rates, which aid in resource allocation and health focus. Age-adjusted mortality rates facilitate accurate comparisons, while understanding incidence and prevalence rates is crucial for assessing disease burden.
- 2.4: Health Disparities and Inequalities
- This page discusses health disparities rooted in systemic racism and socioeconomic factors, emphasizing their effects on racial and ethnic minoritized groups. It highlights the need for policy changes to promote health equity, referencing studies that demonstrate discrimination's harmful health impacts and the connection between residential segregation and environmental hazards.
- 2.5: Types of Population Studies
- This page explores essential study types in public health for identifying health disparities and guiding interventions, including population comparison, observational, and experimental studies. It highlights how population studies assess health outcomes among different groups, while observational studies gather data passively. Experimental studies, often in the form of clinical trials, evaluate intervention effectiveness.
- 2.6: Observational Studies
- This page explores different observational studies in public health research, including ecological, cross-sectional, cohort, and case-control studies. Ecological studies examine disease prevalence without establishing causation, while cross-sectional studies assess risks at a specific point in time. Cohort studies follow risk factors over time, and case-control studies analyze existing groups for associations, acknowledging potential biases.
- 2.7: Experimental Studies
- This page discusses experimental research methods, particularly focusing on interventions and randomized controlled trials (RCTs) used to evaluate health programs or drugs. It outlines a typical study design involving a pre-test, intervention, and post-test to analyze outcomes, emphasizing the significance of control groups for accurate comparisons.
- 2.8: Etiology and Contributory Cause
- This page discusses the concept of etiology, focusing on the causes of disease and the criteria needed to establish causality. It outlines various study designs, such as case-control and cohort studies, to infer contributory causes. When a clear cause is lacking, evidence is assessed through factors like strength of association, dose-response relationships, consistency, and biological plausibility. This framework is crucial for determining the effectiveness of public health interventions.
- 2.9: Program Planning
- This page outlines the importance of evidence-based health interventions, emphasizing the need for adaptation to community specifics rather than mere replication. Successful program planning involves assessing community needs, utilizing resources, and ensuring evaluation methods are in place, often requiring a clear planning process for funding.