think1.htm

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<h2><a name="publichealthrole">Public Health Role</h2>
<p>
The role of public health is central in population health.  Public health has traditionally been distinguished from clinical medicine in that its focus is on the entire population - not the individual patient.1

Most members of the public health community have been trained in some aspects of <a href="javascript:open_window('http://www-nehc.med.navy.mil/epidemiology.htm')">epidemiology</a>
, which is the science dealing with health in populations.  Population health issues are much broader than investigations dealing with communicable disease epidemics.
<p>
<h5><i> Lee P.  "The Role of Public Health in Population Health", The Physician Executive, Sep-Oct 97, pp 25-29.</i></h5>
<p>
<hr size="3" noshade>
<p>
<h2><a name="oshaepaperspective">OSHA/EPA Perspective</h2>
<p>
Standards developed by OSHA and the EPA are based on the potential effects on a population.  Safety and/or health issues - these federal agencies must demonstrate an effect on a population with a commensurate improvement and cost savings after the standard becomes effective.  Think about a unique population, such as specialized workers like welders, or local residents within the same geographic area, or a discrete subset such as all women of reproductive age.  Obstacles toward optimal health of these population groups is approached in a similar manner:  recognize the hazardous chemical or stressor; identify a pathway of exposure; link these to a medical or untoward effect; and propose an intervention that improves the collective health of the subject population group.
<p>
Public health professionals from a variety of disciplines work to anticipate, identify, evaluate, and control hazards in workplaces and in the environment in general.  Epidemiologists, industrial hygienists, audiologists, occupational health physicians and nurses, environmental health officers, radiation health professionals, entomologists, etc. all have a role in improving the health of the populations served.
<p>
<hr size="3" noshade>
<p>
<h2><a name="balancingthinkingdoing">Balancing Thinking and Doing</h2>
<p>
All of us have a mix of things we do in our everyday jobs.  Things like thinking, planning, background work, program development, answering phones, e-mail, and correspondence, investigating outbreaks, providing consultative assistance and inspection services, immunization support, direct patient services, and the like.  There are literally dozens, if not hundreds, of different tasks any one of us may be asked to do in the course of a given day.  In a broad way, they can all be sorted into two general categories:  1)  thinking and planning activities; and 2)  direct customer service activities.  Sure, there is certain to be some overlap, but, these two categories seem to capture both ends of the spectrum
<p>
We probably spend our total working hours doing some combination of planning and direct customer service activities.  For many organizations, headquarters staff may find they do more of the planning activities than direct customer support (say about an 80%/20% split), while field offices may function the other way (80% direct customer support and 20% planning).  There is no "correct" ratio; the point is to realize that although planning and subsequent customer service may be discrete activities, they are fundamentally related.  And they are both very important.  Doing either type activity outside the context of the other really doesn't add value for the organization as a whole.
<p>
For example, providing numerous direct customer service tasks in a setting where what you are doing has not been thoroughly planned and integrated system-wide is often frustrating, and perhaps even counterproductive.  Likewise, planning that doesn't eventually relate downstream to providing something of real value to real customers is perhaps wasted energy also.  The skill is to successfully and seamlessly integrate the two functions:  planning that relates to and delineates real world customer service activities.
<p>
Most of the problems we deal with that seem like isolated events really represent just the tip of the iceberg, so to speak.  One issue, one customer, one problem - they often represent a population of similar issues, a population of similar customers, a population of similar problems.  So, following the motto: " Think Populations …. See Individuals " prompts us to look at things collectively.  Plan for handling the population of issues, for serving the population of customers, for solving the population of like problems.  Only when you have a well conceived and thought out process or solution that addresses the population issues are you ready to directly interact with individual customers and provide them with exemplary service.
<p>
<hr size="3" noshade>
<p>
<h2><a name="challenges">Challenges</h2>
<p>
An excerpt from the Navy Environmental Health Center command philosophy states:  "…What all of us at NEHC have in common, across our many specialties and activities, is the population-based foundation of preventive medicine.  It is that common foundation that provides us with the unparalleled opportunities to use our expertise in some new ways to make even greater and broader contributions to Navy Medicine…."
<p>
A challenge is to bring this message --"Think Populations …. See Individuals"-- to practical reality across all of Navy Medicine.  The curative focus of organized American medicine has perfected the skill of taking care of people on an individual level.  Now, under a managed care concept, we are being asked to think of, and plan for, the health of a collection of patients (our defined population).  Blending individual-focused clinical practice with population-based planning is a formidable task.  The public health community has crucial experience dealing with health issues from a population perspective; we are being asked to expand our skills and interests into assisting the MTFs as they struggle to learn how to manage population health while still providing compassionate care at the individual patient level.

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<h5><center><a href="index.htm"> Return to NEHC Homepage</a></center></h5>
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<ADDRESS>Navy Environmental Health Center, Norfolk VA.  Questions or Problems
contact  <a href="mailto:webmaster@nehc.med.navy.mil"><i>The NEHC Webmasters</i></a>
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GILS Registration #DOD-TBD-000098<br>
Author:  HMC J. A. Shuck; Code: PM<br>
Webmaster: D. Savage, Code: OD<br>
Date of last revision: 18 December 1998<br>
Approved by: Mr. John Fabre, CIO; DSN: 253-5454
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<!--Author: HMC J. A. Shuck, Code: PM-->
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	<SCRIPT LANGUAGE="JavaScript">
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	function open_window()
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	<body background="images/worldbg.jpg" onClick="epidemiology("http://www-nehc.med.navy.mil/epidemiology.htm")";>
	<IMG SRC="images/nehc1.gif" align=right ALT="nehc logo" width="250" height="250">
	<h2><a name="publichealthrole">Public Health Role</h2>
	<p>
	The role of public health is central in population health. Public health has traditionally been distinguished from clinical medicine in that its focus is on the entire population - not the individual patient.1

	Most members of the public health community have been trained in some aspects of <a href="javascript:open_window('http://www-nehc.med.navy.mil/epidemiology.htm')">epidemiology</a>
	, which is the science dealing with health in populations. Population health issues are much broader than investigations dealing with communicable disease epidemics.
	<p>
	<h5><i> Lee P. "The Role of Public Health in Population Health", The Physician Executive, Sep-Oct 97, pp 25-29.</i></h5>
	<p>
	<hr size="3" noshade>
	<p>
	<h2><a name="oshaepaperspective">OSHA/EPA Perspective</h2>
	<p>
	Standards developed by OSHA and the EPA are based on the potential effects on a population. Safety and/or health issues - these federal agencies must demonstrate an effect on a population with a commensurate improvement and cost savings after the standard becomes effective. Think about a unique population, such as specialized workers like welders, or local residents within the same geographic area, or a discrete subset such as all women of reproductive age. Obstacles toward optimal health of these population groups is approached in a similar manner: recognize the hazardous chemical or stressor; identify a pathway of exposure; link these to a medical or untoward effect; and propose an intervention that improves the collective health of the subject population group.
	<p>
	Public health professionals from a variety of disciplines work to anticipate, identify, evaluate, and control hazards in workplaces and in the environment in general. Epidemiologists, industrial hygienists, audiologists, occupational health physicians and nurses, environmental health officers, radiation health professionals, entomologists, etc. all have a role in improving the health of the populations served.
	<p>
	<hr size="3" noshade>
	<p>
	<h2><a name="balancingthinkingdoing">Balancing Thinking and Doing</h2>
	<p>
	All of us have a mix of things we do in our everyday jobs. Things like thinking, planning, background work, program development, answering phones, e-mail, and correspondence, investigating outbreaks, providing consultative assistance and inspection services, immunization support, direct patient services, and the like. There are literally dozens, if not hundreds, of different tasks any one of us may be asked to do in the course of a given day. In a broad way, they can all be sorted into two general categories: 1) thinking and planning activities; and 2) direct customer service activities. Sure, there is certain to be some overlap, but, these two categories seem to capture both ends of the spectrum
	<p>
	We probably spend our total working hours doing some combination of planning and direct customer service activities. For many organizations, headquarters staff may find they do more of the planning activities than direct customer support (say about an 80%/20% split), while field offices may function the other way (80% direct customer support and 20% planning). There is no "correct" ratio; the point is to realize that although planning and subsequent customer service may be discrete activities, they are fundamentally related. And they are both very important. Doing either type activity outside the context of the other really doesn't add value for the organization as a whole.
	<p>
	For example, providing numerous direct customer service tasks in a setting where what you are doing has not been thoroughly planned and integrated system-wide is often frustrating, and perhaps even counterproductive. Likewise, planning that doesn't eventually relate downstream to providing something of real value to real customers is perhaps wasted energy also. The skill is to successfully and seamlessly integrate the two functions: planning that relates to and delineates real world customer service activities.
	<p>
	Most of the problems we deal with that seem like isolated events really represent just the tip of the iceberg, so to speak. One issue, one customer, one problem - they often represent a population of similar issues, a population of similar customers, a population of similar problems. So, following the motto: " Think Populations …. See Individuals " prompts us to look at things collectively. Plan for handling the population of issues, for serving the population of customers, for solving the population of like problems. Only when you have a well conceived and thought out process or solution that addresses the population issues are you ready to directly interact with individual customers and provide them with exemplary service.
	<p>
	<hr size="3" noshade>
	<p>
	<h2><a name="challenges">Challenges</h2>
	<p>
	An excerpt from the Navy Environmental Health Center command philosophy states: "…What all of us at NEHC have in common, across our many specialties and activities, is the population-based foundation of preventive medicine. It is that common foundation that provides us with the unparalleled opportunities to use our expertise in some new ways to make even greater and broader contributions to Navy Medicine…."
	<p>
	A challenge is to bring this message --"Think Populations …. See Individuals"-- to practical reality across all of Navy Medicine. The curative focus of organized American medicine has perfected the skill of taking care of people on an individual level. Now, under a managed care concept, we are being asked to think of, and plan for, the health of a collection of patients (our defined population). Blending individual-focused clinical practice with population-based planning is a formidable task. The public health community has crucial experience dealing with health issues from a population perspective; we are being asked to expand our skills and interests into assisting the MTFs as they struggle to learn how to manage population health while still providing compassionate care at the individual patient level.

	<p>

	<p>

	<center><img src="images/hr-thin.gif" alt="Thin Line"></center>

	<p>
	<h5><center><a href="index.htm"> Return to NEHC Homepage</a></center></h5>
	<p>
	<h5>
	<center>
	<ADDRESS>Navy Environmental Health Center, Norfolk VA. Questions or Problems
	contact <a href="mailto:webmaster@nehc.med.navy.mil"><i>The NEHC Webmasters</i></a>
	</ADDRESS>
	</center>
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	<h5><i>
	<blockquote><font size=2>
	GILS Registration #DOD-TBD-000098<br>
	Author: HMC J. A. Shuck; Code: PM<br>
	Webmaster: D. Savage, Code: OD<br>
	Date of last revision: 18 December 1998<br>
	Approved by: Mr. John Fabre, CIO; DSN: 253-5454
	</font></blockquote>
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	<!--Author: HMC J. A. Shuck, Code: PM-->
	<!--Webmaster: D. Savage, Webmaster; Code: OD-->
	<!--Date of last revision: 18 December 1998-->
	<!--Approved by: John Fabre, CIO-->