Public Health and Epidemiology

Most accounts of health and healthcare in Africa are written by foreigners. African Health Leaders: Making Change and Claiming the Future redresses the balance. Written by Africans, who have themselves led improvements in their own countries, this online resource discusses the creativity, innovation and leadership that has been involved tackling everything from HIV/AIDs, to maternal, and child mortality and neglected tropical diseases. It celebrates their achievements and shows how, over three generations, African health leaders are creating a distinctively African vision of health and health systems. It covers how African Health Leaders are claiming the future - in Africa, but also by sharing their insights and knowledge globally and contributing fully to improving health throughout the world, and illustrates how African leadership can enable foreign agencies and individuals working in Africa to avoid all those misunderstandings and misinterpretations of culture and context which lead to wasted efforts and frustrated hopes. It also addresses the need to tackle weak governance, corrupt systems and low expectations and sets out what Africa needs from the rest of the world in the spirit of global solidarity - not primarily in aid, but through investment, collaboration, partnership and co-development.Less

Behavioral Economics and Public Health is the first title to apply the groundbreaking insights of behavioral economics to the persisting problems of health behaviors and behavior change. In addition to providing a primer on the behavioral economics principles that are most relevant to public health, this title offers details on how these principles can be employed to mitigating the world's greatest health threats, including obesity, smoking, risky sexual behavior, and excessive drinking. With contributions from an international team of scholars from psychology, economics, marketing, public health, and medicine, this title is a trailblazing new approach to the most difficult and important problems of our time. Less

In recent years, there has been an explosion of research focused on using technology in healthcare, including Web and mobile health assessment and intervention tools, as well as smartphone sensors and smart environments for monitoring and promoting health behavior. This work has shown that technology-based therapeutic tools offer considerable promise for monitoring and responding to individuals’ health behavior in real time. They may extend the reach of clinicians or serve as stand-alone tools, may be cost-effective and offer countless opportunities for tailoring behavioral interventions that are optimally responsive to individuals’ needs and preferences. Technology may enable entirely new models of healthcare both within and outside of formal systems of care. This book defines the state of scientific research related to the development, experimental evaluation, and effective dissemination of technology-based therapeutic tools targeting behavioral health. It provides an overview of evidence-based approaches to harnessing technology in areas of substance use, mental health, diet and exercise, medication adherence, and chronic disease management. The book also defines the state of implementation research examining models for integrating technology-based behavioral healthcare systems to increase the quality and reach of evidence-based and cost-effective behavioral healthcare, and discusses public health and policy implications of this work. This book consists of contributions from an interdisciplinary group of authors who are leaders in fields of paramount importance to the arena of technology and behavioral health, including the science of behavior change, emerging technologies, health economics, novel methodologies and analytics, implementation science, regulation, privacy and security, and public policy.Less

Medical innovation as it stands today is fundamentally unsustainable. There is a widening gap between what biomedical research promises and its current impact in terms of patient benefit and health system improvement. This book highlights the global problem, analyses underlying causes, and provides powerful prescriptions for change to close the gap.It contrasts progress in biomedicine with other areas of science and technology, such as information technology, in which there are faster, more reliable returns for society from scientific advance. It questions whether society is right to expect so much from biomedicine and why we have become accustomed to such poor returns.It focuses on four specific ‘gaps in translation’ between bioscience breakthroughs and ultimate patient benefit, and explains how unhelpful mental models and differing perceptions of value, risk, and uncertainty contribute to stifling progress.Specific examples are examined, in which these bottlenecks have prevented promised progress (e.g. antibiotic-resistant infections), and others in which these barriers have been overcome, as a result of patient pressure (e.g. HIV treatment) or a sense of impending crisis (e.g. pandemic influenza).Less

Bridging the Gap details the role, lessons, and effectiveness of community health workers (CHWs) in bringing health care to underserved immigrant communities. Combining education, advocacy, and local cultural acumen, CHWs have proven successful in the United States and abroad, improving community health and establishing an evidence base for how CHW programs can work for immigrants. Based on a decade of in-depth evaluations from several immigrant health programs in New York City with complementary interviews with dozens of immigrants and CHWs, Bridging the Gap offers insights into how CHWs help immigrants overcome the obstacles to health care. The authors carefully distil first-hand lessons into recommendations for best practices in developing and utilizing effective CHW programs—insights that will be immediately useful to any community group, municipal agency, or health care organization.Less

Although urban living has accounted for being the lifestyle for more than half of the global population since 2010, nearly half are still living in a rural context. As pointed out by the United Nations as a backdrop of the Sustainable Development Goals (SDGs) (2016–2030), at least 1.8 billion people across the world still consumed faecally contaminated drinking water by 2015, 2.4 million lacked access to basic sanitation services such as toilets or latrines, and nearly 1,000 children died every day of preventable water and sanitation-related diarrhoeal diseases. Rural areas fare far worse: children are about 1.7 times more likely to die before their fifth birthday as those in urban areas. About 16% of the rural population do not use improved drinking water sources, compared to 4% of the urban population. About 50% of people living in rural areas lack improved sanitation facilities, compared to only 18% of people in urban regions. Far too many one-off rural on-site public health knowledge transfer projects fail to deliver long-term results. Theoretical understanding may be strengthened among non-governmental organization (NGO) practitioners and volunteers to support project planning, monitoring, and evaluation. Based on public health theories and illustrated by relevant examples, as well as the insights gained from the long-established CCOUC Ethnic Minority Health Project in China, this book introduces how health, emergency, and disaster preparedness education programmes could be organized in remote rural Asia, which could become a useful reference for organizers and volunteers of rural development projects.Less

This resource reviews the current status of cancer epidemiologic research and training — rationale, requisite infrastructure, methodologic principles, and illustrative examples in low- and middle-income countries — in order to facilitate future advances by trained health professionals. It summarizes and reviews research studies that are in progress concerning major prevalent cancers of the breast, uterine cervix, lung and bronchus, upper aerodigestive tract, stomach, liver, colon, and HIV-associated cancers. It also covers specific studies conducted in Africa, Asia, Central and South America, and the Middle East, as well as studies in Australia, Europe, North America, and in populations that migrate from LMICs to developed countries. The result is a valuable resource for both program leaders as well as graduate and post-graduate students pursuing careers in international cancer epidemiologic research.Less

Expert public psychiatrists use case studies to share best practice strategies in this clinically oriented introduction to community mental health. Today, the majority of psychiatrists work with people who suffer not only from mental illness but also from poverty, trauma, social isolation, and discrimination. Psychiatrists cannot do this work alone but, instead, are part of teams of behavioral health workers navigating larger health care and social service systems. In an increasingly complex health care environment, mental health clinicians need to master systems-based practice in order to provide optimal care to their patients. The rapid development of public psychiatry training programs is a response to the learning needs of psychiatrists in an evolving system. This book begins with seven foundational principles of public psychiatry—recovery, trauma-informed care, integrated care, cultural humility, harm reduction, systems of care, and financing care—using cases to bring these concepts to life. Then, using a population health framework, cases are used to explore the typical needs of different age groups or vulnerable populations and to illustrate evidence-based/best practices that have been employed to meet these needs. Common to all of the chapters is a focus on the potential of each person, regardless of illness, to achieve personal goals, supported by a clinician who is also an advocate, activist, and leader.Less

Child Health: a Population Perspective provides students with a multifaceted overview of the importance of child health as a population health strategy. Child health considers the determinants, interventions, and policies that affect health outcomes for the youngest segment of our population. Child health also recognizes that investments in our nation’s young have implications for the future workforce as well as adult health outcomes. Child Health: a Population Perspective is a foundational text for training future leaders in maternal and child health. The book provides perspectives in three key areas: current issues facing children in the United States, theoretical concepts behind understanding child health, and practical approaches to address child health in practice, including case studies. The authors also provide a historical perspective of how child health has developed in this country, as well as the impact of immigration and a global view of child health internationally. The authors have created a core text for maternal and child health or pediatrics courses in schools of public health, medicine, and nursing. Undergraduate students, pediatric residents, maternal and child health fellows, and practitioners in the field can benefit from this comprehensive yet concise book.Less

It is every health professional’s responsibility to be able to identify and respond to child abuse. This book equips health professionals working with children with the knowledge to recognize at-risk children or those already suffering abuse. Child protection work is challenging both emotionally and strategically, and so practical advice on how to navigate the multidisciplinary processes involved is provided using many challenging cases and exercises. The realistic fictional cases aim to immerse readers in the scenario and challenge them on how to take action to safeguard the children involved. Real cases in which children suffered actual harm are also presented, and readers are taken through the learning points, recommendations, and subsequent changes in legislation. New challenges in child protection from trafficking, child sexual exploitation, gang violence, radicalization, and internet bullying and abuse are defined, and abuse resulting from cultural practices such as female genital mutilation, witchcraft and spirit possession, honour-based violence, and forced marriage is also covered. Advice is provided for those undertaking work in low-resource settings with non-government organizations and charities. Practical advice is offered on accurate documentation, writing police and court reports, talking to parents, and answering frequently asked questions. New gender-specific anatomically positioned body maps of infants, toddlers, young children, and teenagers are included to help improve medical record-keeping. The complicated safeguarding process is broken down into palatable and stimulating chunks that can be read in a few sittings or just dipped into for advice.Less

Orchestrating and coordinating contributions from more than 75 selected public health specialists and environmental scientists, the editors have developed a concise and comprehensive resource that represents a core curriculum on climate change and public health, including key strategies for adaptation and mitigation. Written primarily for students and mid-career professionals in public health and environmental sciences, the book clearly describes concepts and their application to the health impacts of climate change. Chapters are supplemented with case studies, graphs, tables and photographs. Less

Epidemiology is a population science that underpins health improvement and health care, and is concerned with the pattern, frequency, trends, and causes of disease. This book teaches its applications to population health research, policy-making, health service planning, health promotion, and clinical care. The book emphasizes concepts and principles. In 10 chapters, the book explains what epidemiology is; illustrates the basis of epidemiology in populations; provides a framework for analysing diseases by time, place, and person; introduces error, bias, and confounding; explains how we move from association to causation; considers the natural history, spectrum, and iceberg of disease in relation to medical screening; discusses the acquisition and analysis of data on incidence and prevalence of risk factors and diseases; shows the ways in which epidemiological data are presented, including relative and absolute risks; provides an integrated overview of study designs and the principles of data analysis; and considers the theoretical and ethical basis of epidemiology both in the past and the future. The emphasis is on interactive learning, with each chapter including learning objectives, theoretical and numerical exercises, questions and answers, and a summary. The text is illustrated, with detailed material in tables. The book is written in plain English, and the necessary technical and specialized terminology is explained and defined in a glossary. The book is for postgraduate courses in epidemiology, public health, and health policy. It is also suitable for clinicians, undergraduate students in medicine, nursing and other health disciplines, and researchers.Less

This unique collection of interactive case studies covers diverse topics at the intersection of public health and business, including direct-to-consumer genetic testing, programs to impact prescription adherence, the marketing of e-cigarettes and marijuana, workplace safety in Bangladesh, and cancer screening in Japan. Teaching notes for all cases are available to instructors adopting the text.Less

This book presents a system of critical appraisal applicable to clinical, epidemiological and public health studies and to many other fields. It assumes no prior knowledge. The methods are relevant to students, practitioners and policymakers. The book shows how to assess if the results of one study or of many studies show a causal effect. The book discusses study designs: randomised and non-randomised trials, cohort studies, case-control studies, and surveys, showing the presentation of results including person-time and survival analysis, and issues in the selection of subjects. The system shows how to describe a study, how to detect and assess selection biases, observation bias, confounding, and chance variation, and how to assess internal validity and external validity (generalisability). Statistical methods are presented assuming no previous knowledge, and showing applications to each study design. Positive features of causation including strength, dose-response, and consistency are discussed. The book shows how to do systematic reviews and meta-analyses, and discusses publication bias. Systems of assessing all evidence are shown, leading to a general method of critical appraisal based on 20 key questions in five groups, which can be applied to any type of study or any topic. Six chapters show the application of this method to randomised trials, prospective and retrospective cohort studies, and case-control studies. An appendix summarises key statistical methods, each with a worked example. Each main chapter has self-test questions, with answers provided.Less

Current Topics in Occupational Epidemiology is an in-depth study of contemporary issues and emerging themes in the field. Divided into seven parts it discusses 'new' occupational diseases such as pneumonia in welders, as well as 'older' diseases including morbidity and mortality among miners. Societal trends have encouraged the application of occupational epidemiological methods to new issues such as the ageing workforce, return to work after illness, and the migration of workers. This resource tackles these issues, as well the extension of epidemiology to surveillance systems, systematic reviews, and economic analyses.Less

Preventive medical interventions—and even non-medicalized public health programmes that implicitly promise health benefits in the future, from actions taken now—all carry a strong ethical requirement: primum non nocere (‘first, do no harm.’) This is especially true nowadays, when new preventive advice and interventions are being promoted on a daily basis, sometimes by scientifically ill-informed special interest groups. This slim volume provides a set of ‘critical appraisal’ tools to help those considering a preventive action to be sure that it is effective (does more good than harm), efficient (is a competitive use of scarce resources), and equitable in its impact across society. Throughout the book worked examples are provided and ‘case-studies’, illustrating the risks and benefits (and in some cases the costs per unit of health benefit) of specific preventive interventions, both laudable, and not so laudable. The nine chapters focus on the following aspects of prevention: the hierarchy of preventive options; the assessment of causation; finding and appraising scientific evidence; prevention directed at entire populations (as opposed to individuals); the scientific perils underlying ‘healthy nutrition’ advice; measuring chronic disease risk factors and medically managing them, e.g. statin treatment of high cholesterol; PSA screening for prostate cancer: more harm than good?; genetic screening for future disease risk; and assessing the health equity implications of prevention. This book is aimed at front-line primary care and public health professionals, to help them better inform, and serve, their patients and communities.Less

It is becoming increasingly important to examine the relationship between the outcomes of a clinical trial and the costs of the medical therapy under study. The results of such analysis can affect reimbursement decisions for new medical technologies, drugs, devices or diagnostics. It can aid companies seeking to make claims about the cost-effectiveness of their product, as well as allowing early consideration of the economic value of therapies which may be important to improving initial adoption decisions. It is also vital for addressing the requirements of regulatory bodies. Economic Evaluation in Clinical Trials provides practical advice on how to conduct cost-effectiveness analyses in controlled trials of medical therapies. This new edition has been extensively rewritten and revised; topics discussed range from design issues such as the types of services that should be measured and price weights, to assessment of quality-adjusted life years. Illustrative materials, case histories and worked examples are included to encourage the reader to apply the methods discussed. Less

This resource examines the current trends in increased air/water pollution and energy consumption, and the depletion of natural resources, and the disproportionate impact on the poor and the economically viable solutions that can serve to remedy them — solutions that simultaneously address environmental and economic problems. This gap in previous research, evidence, and writing has left low-income countries often unwilling to take on major environmental problems and many poor communities believing they faced impossible choices between improving the environment in which they live and increasing the jobs and income available. Bringing together evidence-based recommendations and in-depth case studies of successful policies and programs around the world, this resource examines innovative solutions to this crucial challenge. In doing so, it addresses a comprehensive range of environmental sustainability challenges affecting low-, middle-, and high-income countries.Less

This book provides a broad, in-depth primer on chemicals in the total environment, covering the atmosphere, hydrosphere, lithosphere and biosphere. It defines the terminology used in environmental health science related to chemicals, describes the sources of chemical agents in the environment, how they disperse and transform as they travel throughout the environment, their effects on environmental quality and human health, how levels and exposures are monitored and quantified, the technology for control of chemical pollutants, how environmental standards and guidelines are developed, and procedures for human health risk assessment and risk management. It can serve as a textbook for courses taken by advanced undergraduate or graduate university students and may also be a useful reference for practitioners working in environmental and public health areas.Less

This second edition of Epidemiologic Methods offers a rigorous introduction to the concepts and tools of epidemiologic research. Aimed chiefly at future epidemiologists, it offers clear descriptions, practical examples, and question/answer sections for each of the science's key concepts. Authored by two award-winning epidemiology instructors, this online resource is organized around three main themes: general concepts and tools of epidemiology; major study designs; and special topics, including screening, outbreak investigations, and use of epidemiology to evaluate policies and programs. Less