1/27/22Fundamentals of Public HealthHistory: The Black Death - 1300s Europe- First outbreak of medieval plague in Europe, and it killed tens of millions of people, anestimated 30-50% of the European population- This showed the first public health stats!- Even had public health prevention effortsPlague- Had early face masks- Elongated beak with herbs and spices, supposed to prevent the plagueCholera- an acute diarrheal illness caused by infection of the intestine with Vibrio choleraebacteria.- People can get sick when they swallow food or water contaminated with cholerabacteria.- Infection is often mild or without symptoms, but can sometimes be severe andlife-threatening.- John Snow: one of the first epidemiologists- Used stats, scientific method, to figure out the root of the cause- People who were saved by the beer, causality- Weren’t drinking the waterHow have we improved?- Immunizations- Motor-Vehicle safety, workplace safety- Control of Infectious Diseases- Fluoridation of drinking water- Safer and healthier foods- Healthier mothers and babiesPurpose of Public Health- To prevent epidemics and spread of disease- Protect against environmental hazards- Prevent injuries- Promote and encourage healthy behaviors- Respond to disasters and assist communities in recovery- Assure the quality and accessibility of servicesCriteria to Qualify as a Public Health Issue- The concept of prevention: there are conceivable ways to prevent phenomenon- High prevalence of a risk factor or disease- A rapid increase in incidence and prevalence- Cost of the disease- Burden of disease- Has the capability of impacting the population as a whole23 ½ hours- Low fitness is the strongest predictor for death!!- Obese and no exercise? BAD Obese and exercise? GOOD- Almost cancels out the negative affects of being obese- Exercise = best medicine for all-cause mortalityHow did Public Health get started?- London Transport Workers (Busmen) Study: Dr. Jerry Morris, 1950- Natural experiment: bus drivers vs conductors- Revolutionary findings at the time, first link to PA to lower risk of heart disease- San Francisco Longshoremen: Dr. Ralph Paffenbarger- Natural experiment: compared the most active group of cargo handlers to theother longshoremen- More active group had significantly lower coronary artery disease death ratesthan more sedentary colleagues- Harvard Alumni Study- Age-adjusted first heart attack rates, by PA index in a 6-10 year follow-up ofHarvard male alumniBenefits of PA Adults- Lower risk of all-cause mortality- Lower risk of cardiovascular disease mortality- Lower risk of cardiovascular disease (including heart disease and stroke)- Lower risk of hypertension- Lower risk of type 2 diabetes- Lower risk of adverse blood lipid profile- Lower risk of cancers of the bladder,* breast, colon, endometrium,* esophagus,* kidney,*lung,* and stomach*- Improved cognition*- Reduced risk of dementia (including Alzheimer’s disease)*- Help manage existing health conditions*- Improve physical function, QOL, and risk of comorbidities and mortality*- Improved quality of life*- Reduced anxiety*- Reduced risk of depression*- Improved sleep*- Slowed or reduced weight gain- Weight loss, particularly when combined with reduced calorie intake •- Prevention of weight regain following initial weight loss • Improved bone health •Improved physical function • Lower risk of falls (older adults) • Lower risk of fall-relatedinjuries (older adults)*Benefits of PA for Youth- Improved bone health (ages 3 through 17 years) *new for ages 3-5 • Improved weightstatus (ages 3 through 17 years) *new for ages 3-5 • Improved cardiorespiratory andmuscular fitness (ages 6 through 17 years) • Improved cardiometabolic health (ages 6through 17 years) • Improved cognition (ages 6 to 13 years)* • Reduced risk ofdepression (ages 6 to 13 years)Physical Activity GuidelinesAdults- Adults should move more and sit less throughout the day. Some physical activity isbetter than none. Adults who sit less and do any amount of moderate-to-vigorousphysical activity gain some health benefits.- For substantial health benefits, adults should do at least 150 minutes (2 hours and 30minutes) to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hourand 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensityaerobic physical activity, or an equivalent combination of moderate- andvigorous-intensity aerobic activity. Preferably, aerobic activity should be spreadthroughout the week.- Additional health benefits are gained by engaging in physical activity beyond theequivalent of 300 minutes (5 hours) of moderate-intensity physical activity a week.- Adults should also do muscle-strengthening activities of moderate or greater intensityand that involve all major muscle groups on 2 or more days a week, as these activitiesprovide additional health benefits.Older Adults- As part of their weekly physical activity, older adults should do multicomponent physicalactivity that includes balance training as well as aerobic and muscle-strengtheningactivities.- Older adults should determine their level of effort for physical activity relative to theirlevel of fitness.- Older adults with chronic conditions should understand whether and how their conditionsaffect their ability to do regular physical activity safely.- When older adults cannot do 150 minutes of moderate-intensity aerobic activity a weekbecause of chronic conditions, they should be as physically active as their abilities andconditions allow.School-Aged Children and Adolescents- It is important to provide young people opportunities and encouragement to participate inphysical activities that are appropriate for their age, that are enjoyable, and that offervariety.- Children and adolescents ages 6 through 17 years should do 60 minutes (1 hour) ormore of moderate-to-vigorous physical activity daily:- Aerobic: Most of the 60 minutes or more per day should be either moderate- orvigorous-intensity aerobic physical activity and should include vigorous-intensityphysical activity on at least 3 days a week.- Muscle-strengthening: As part of their 60 minutes or more of daily physicalactivity, children and adolescents should include muscle-strengthening physicalactivity on at least 3 days a week.- Bone-strengthening: As part of their 60 minutes or more of daily physical activity,children and adolescents should include bone-strengthening physical activity onat least 3 days a