Public health intervention
A public health intervention is any effort or policy that attempts to improve mental and physical health on a population level. Public health interventions may be run by a variety of organizations, including governmental health departments and non-governmental organizations (NGOs). Common types of interventions include screening programs, vaccination, food and water supplementation, and health promotion. Common issues that are the subject of public health interventions include obesity, drug, tobacco, and alcohol use, and the spread of infectious disease, e.g. HIV.
Health interventions may be run by a variety of organizations, including health departments and private organizations. Such interventions can operate at various scales, such as on a global, country, or community level. The whole population can be reached via websites, audio/video messages and other mass media, or specific groups can be affected by administrative action, such as increasing the provision of healthy food at schools.
Screening refers to the practice of testing a set of individuals who meet a certain criteria (such as age, sex, or sexual activity) for a disease or disorder. Many forms of screening are public health interventions. For example, mothers are routinely screened for HIV and Hepatitis B during pregnancy. Detection during pregnancy can prevent maternal transmission of the disease during childbirth.
Vaccination programs are one of the most effective and common types of public health interventions. Typically programs may be in the form of recommendations or run by governmental health departments or nationalised health care systems. For instance, in the U.S., the Center for Disease Control decides on a vaccination schedule, and most private health insurers cover these vaccinations. In the UK, the NHS both decides and implements vaccination protocols. NGOs also may be involved in funding or implementing vaccination programs; for instance Bill and Melinda Gates Foundation assists governments in Pakistan, Nigeria and Afghanistan with the administration of polio vaccination.
- Iodised salt to prevent goitre.
- Folic acid in wheat flour to prevent spina bifida, a birth defect.
- Flouridated water to prevent tooth decay.
- Vitamin D milk to prevent rickets.
Interventions intended to change the behaviour of individuals can be especially challenging. One such form is health promotion, where education and media may be used to promote healthy behaviours, such as eating healthy foods (to prevent obesity), using condoms (to prevent the transmission of STDs), or stopping open defecation in developing countries (see for example in India the campaign Swachh Bharat Mission).
The use of laws to criminalise certain behaviours can also be considered a public health intervention, such as mandatory vaccination programs and criminalisation of HIV transmission. However, such measures are typically controversial, particularly in the case of HIV criminalisation where there is evidence it may be counter productive. Laws which tax certain unhealthy products may also be effective, although also not without controversy, and are sometimes called a "sin tax". Examples include the taxation of tobacco products in the U.S. and New Zealand, and sugared drinks in the UK.
Evaluating and predicting the efficacy of a public health intervention, as well as calculating cost effectiveness, is essential. An intervention should ideally lower morbidity and mortality. Several systematic protocols exist to assist developing such interventions, such as Intervention Mapping.
- Kim, Hyuncheol Bryant; Lee, Sun-Mi (2017-03-06). "When public health intervention is not successful: Cost sharing, crowd-out, and selection in Korea's National Cancer Screening Program". Journal of Health Economics. 53: 100–116. doi:10.1016/J.JHEALECO.2017.02.006. PMID 28340393.
- Kürüm, Esra; Warren, Joshua L.; Schuck-Paim, Cynthia; Lustig, Roger; Lewnard, Joseph A.; Fuentes, Rodrigo; Bruhn, Christian A. W.; Taylor, Robert J.; Simonsen, Lone (2017-07-31). "Bayesian model averaging with change points to assess the impact of vaccination and public health interventions". Epidemiology. 28 (6): 889–897. doi:10.1097/EDE.0000000000000719. PMC 5617796. PMID 28767518.
- Bhuyan, Soumitra S.; Chandak, Aastha; Smith, Patti; Carlton, Erik L.; Duncan, Kenric; Gentry, Daniel (2015-08-07). "Integration of public health and primary care: A systematic review of the current literature in primary care physician mediated childhood obesity interventions". Obesity Research and Clinical Practice. 9 (6): 539–552. doi:10.1016/J.ORCP.2015.07.005. PMID 26259684.
- Todd, Adam; Moore, Helen J.; Husband, Andrew K.; Bambra, Clare; Kasim, Adetayo; Sniehotta, Falko F.; Steed, Liz; Summerbell, Carolyn D. (2014-08-22). "Community pharmacy interventions for public health priorities: protocol for a systematic review of community pharmacy-delivered smoking, alcohol and weight management interventions". Systematic Reviews. 3: 93. doi:10.1186/2046-4053-3-93. PMC 4145162. PMID 25145710.
- M, Schrappe; K, Lauterbach (1998-01-01). "Systematic review on the cost-effectiveness of public health interventions for HIV prevention in industrialized countries". AIDS. 12 Suppl A: S231–8. PMID 9633007.
- Patil, Rajan R. (2013-11-01). "Application of PHEL - 'Public Health Epidemiological Logic' of Public Health Intervention and Public Health Impact". International Journal of Preventive Medicine. 4 (11): 1331–1336. PMC 3883261. PMID 24404371.
- "Screening for hepatitis B, HIV and syphilis". www.nhs.uk. 2018-01-10. Retrieved 2018-06-09.
- "Polio". Bill & Melinda Gates Foundation. Retrieved 2018-06-09.
- Hetzel, B. (1983-11-12). "Iodine Deficiency Disorders (Idd) and Their Eradication". The Lancet. 322 (8359): 1126–1129. doi:10.1016/S0140-6736(83)90636-0. ISSN 0140-6736. PMID 6138653.
- Honein, Margaret A. (2001-06-20). "Impact of Folic Acid Fortification of the US Food Supply on the Occurrence of Neural Tube Defects". JAMA. 285 (23): 2981–6. doi:10.1001/jama.285.23.2981. ISSN 0098-7484. PMID 11410096.
- Frieden, Thomas R. (April 2010). "A Framework for Public Health Action: The Health Impact Pyramid". American Journal of Public Health. 100 (4): 590–595. doi:10.2105/ajph.2009.185652. ISSN 0090-0036. PMC 2836340. PMID 20167880.
- Hiligsmann, Mickael; Neuprez, Audrey; Buckinx, Fanny; Locquet, Médéa; Reginster, Jean-Yves (December 2017). "A scoping review of the public health impact of vitamin D-fortified dairy products for fracture prevention". Archives of Osteoporosis. 12 (1): 57. doi:10.1007/s11657-017-0352-1. ISSN 1862-3514. PMC 5486688. PMID 28634891.
- Haverkate, M; D’Ancona, F; Giambi, C; Johansen, K; Lopalco, P L; Cozza, V; Appelgren, E; on behalf of the VENICE project gat, collective (2012-05-31). "Mandatory and recommended vaccination in the EU, Iceland and Norway: results of the VENICE 2010 survey on the ways of implementing national vaccination programmes" (PDF). Eurosurveillance. 17 (22). doi:10.2807/ese.17.22.20183-en. ISSN 1560-7917. PMID 22687916.
- Vamos, Cheryl A.; McDermott, Robert J.; Daley, Ellen M. (June 2008). "The HPV Vaccine: Framing the Arguments FOR and AGAINST Mandatory Vaccination of All Middle School Girls". Journal of School Health. 78 (6): 302–309. doi:10.1111/j.1746-1561.2008.00306.x. ISSN 0022-4391. PMID 18489462.
- Burris, Scott (2008-08-06). "The Case Against Criminalization of HIV Transmission". JAMA. 300 (5): 578–81. doi:10.1001/jama.300.5.578. ISSN 0098-7484. PMID 18677032.
- Cameron, E (December 2009). "Criminalization of HIV transmission: poor public health policy". HIV/AIDS Policy & Law Review. 14 (2): 1, 63–75. ISSN 1712-624X. PMID 20225503.
- Mykhalovskiy, Eric (2011-09-01). "The problem of "significant risk": Exploring the public health impact of criminalizing HIV non-disclosure". Social Science & Medicine. 73 (5): 668–675. doi:10.1016/j.socscimed.2011.06.051. ISSN 0277-9536. PMID 21835524.
- Wilson, Nick; Blakely, Tony; Tobias, Martin (2006-11-02). "What potential has tobacco control for reducing health inequalities? The New Zealand situation". International Journal for Equity in Health. 5 (1): 14. doi:10.1186/1475-9276-5-14. PMC 1654162. PMID 17081299.
- Briggs, Adam D. M.; Mytton, Oliver T.; Kehlbacher, Ariane; Tiffin, Richard; Rayner, Mike; Scarborough, Peter (2013-10-31). "Overall and income specific effect on prevalence of overweight and obesity of 20% sugar sweetened drink tax in UK: econometric and comparative risk assessment modelling study". BMJ. 347: f6189. doi:10.1136/bmj.f6189. ISSN 1756-1833. PMC 3814405. PMID 24179043.
- Bartholomew, L. K., Parcel, G. S., Kok, G., Gottlieb, N. H., & Fernández, M.E., 2011. Planning health promotion programs; an Intervention Mapping approach, 3rd Ed. San Francisco, CA: Jossey-Bass.