BIPN 100 Study Guide - Final Guide: Health Equity, Health Care, Public Health
13 Jun 2018
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Session objectives for Primary Care and Public Health (FPM 50)
Winter 2018
Revised 3.12.2018
Objectives for the COURSE:
On completion of this course, students will be able to:
1. Define primary care, its role in healthcare systems and the need for integration of
primary care and public health
a. Primary care is the provision of integrated, accessible health care services by
clinicians who are accountable for addressing a large majority of personal health
care needs, developing a sustained partnership with patients, and practicing in
the context of family and community.
2. Compare and contrast the disciplines and priorities of primary care and public health and
identify shared priorities such as improving population health, disease prevention,
screening, and health promotion
a. Both have the common goals of preventing disease and injury, the promotion of
health and well-being, to reduce health care costs, improve population health,
address social and environmental determinants of health, utilize health data, and
advocate for health and policy change.
b. PC targets the patient, PH, the population. PC’s focus is on healing illness and
prevention; PH’s is preventing injury and illness. PC assesses via diagnostic
exams, PH assess population health through data collected and analyzing that
(epidemiology). PC intervenes by treatments in behavioral changes, medication
etc., while PH intervenes through programs and health policies. Follow-up in PC
is continuous, comprehensive, patient-centered, and has coordinated care. PH
follow-up is done by monitoring the effectiveness of its interventions.
3. Define key concepts such as health disparities, social determinants of health, health risk
factors, burden of disease, prevention and screening and apply these terms to relevant
health issues
a. Health disparities is a higher burden of illness, injury, disability, or mortality
experienced by one population relative to another population.
b. Social determinants of health are the conditions in the environments in which
people are born, live, learn, work, play, worship and age in that affect a wide
range of health, functioning, and quality of life outcomes and risks.
c. Risk factors are any attribute, characteristic, or exposure of an individual that
increases the likelihood of developing a disease or injury.
d. Burden of disease is the cost and impact of a disease on a person’s or
population’s health. Can be calculated using the DALY or QALY.
e. Prevention is preventing the disease from happening in the first place, and has
three levels: primary is before the disease occurs, secondary is once the patient
is diagnosed but isn’t symptomatic, and tertiary is preventing as many M&M’s
from happening as possible after dx.
f. Screening is testing patients before they are symptomatic.
4. Describe the role of primary care, including advocacy and policy change, in addressing
pressing public health issues such as medical errors, mental health, family planning and
pregnancy, addiction and preventive screening/immunizations.
a. Primary care can be involved in all of these levels by having patients visit their
PCP regularly and having one-on-one conversations with their PCP. Medical
errors like physician bias can be brought up personally, mental health can be
screened for in an informal or formal matter, and the PCP can be the patient’s
center of care to coordinate among their various providers as needed, family
planning by administering pregnancy tests and consulting the patient on their
options for contraception and the relative risks associated.
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Session objectives for Primary Care and Public Health (FPM 50)
Winter 2018
Revised 3.12.2018
5. Describe the major causes of morbidity and mortality in the United States such as
diabetes, coronary artery disease and cancer and explain how the interactions between
primary care and public health affect the health outcomes of persons, families, and the
population as a whole
a. The major causes of M&M in the US are seen in the impact of diabetes, CAD,
and cancer in the cost that the treatments for the disease or the disease itself
costs, due to indirect and direct medical costs.
6. Describe the importance of the patient’s perspective of living with a medical illness and
how the patient’s experience with and access to community/societal resources may
affect health behaviors and/or outcomes
a. The patient’s view on their illness can have an impact on their mental health as
well as their physical health. Studies have shown that those with a chronic
disease are more likely than those who do not to develop a mental illness, that
can be attributed at least in part due to the stress of managing a chronic illness.
Increased support from their support networks, like family, friends, physicians, or
other patients with similar circumstances, can equip the patient to deal better with
their prognosis.
7. Describe career options that combine training and experience in primary care and public
health
a. There are programs that take medical students abroad to see the impact different
diseases have world-wide that are relevant for some populations, but not all.
There are combined MPH and MD programs.
Objectives for individual SESSIONS:
Objectives: At the end of this session, students will be able to:
Introduction to Primary Care and public health (D.Reddy)
• List the course requirements and student expectations
• Define primary care and public health
• Compare and contrast the key priorities of primary care and public health and recognize
the need for integration of primary care and public health
• Define key concepts such as prevalence, risk factors, morbidity and mortality. social
determinants of health, health disparities, burden of disease, prevention and screening
• Describe the purpose of the Healthy People 2020 objectives and the relevance to
primary care and public health
o Mission:
▪ Strives to identify nationwide health improvement priorities
▪ Increase public awareness and understanding of the determinants of health,
disease, and disability and the opportunities for progress
▪ Provide measurable objectives and goals that are applicable at the national,
state, and local levels
▪ Engage multiple sectors to take actions to strengthen policies and improve
practices that are driven by the best available evidence and knowledge
o Identify critical research, evaluation, and data collection needs
find more resources at oneclass.com
find more resources at oneclass.com
Session objectives for Primary Care and Public Health (FPM 50)
Winter 2018
Revised 3.12.2018
• Describe the purpose of the United States Preventive Services Task Force as it relates
to screening and prevention
o The USPSTF sets standards for physicians to refer to when screening patients to
make sure that everyone is held to the same standard, and that patients are not
unnecessarily being screened for something that they don’t need to be for. It sets
what’s the most cost-effective way to screen for illnesses, and strives to make
accurate, up-to-date, and relevant recommendations about preventative services
in primary care.
Understanding Health Determinants and Disparities (M. Johnson)
• Define “health disparity” and “health care disparity”
o Health disparity is a higher burden of illness, injury, disability, or mortality
experienced by one population group relative to another. Can come from biologic
or genetic backgrounds.
o Health care disparity is the systematic differences between groups in health
insurance coverage, access to, and use of care, and quality care.
• Give examples of populations commonly affected by disparities
o Old age has more health disparities than young to middle age.
• Describe examples of disparities in the US
o African Americans who have a heart attack are less likely to receive evidence-
based treatments than whites
• Discuss the determinants of health and how they relate to disparities
o SDH is a person’s biology and genetics, individual behaviors, social environment,
physical environment, and health services they have. The biology and genetics
are mainly what would contribute to health disparities, and the others would
largely impact health care disparities.
• Discuss possible mechanisms of addressing disparities on the individual provider and
systems levels
o Provider level issues can be dealt with by tracking a doctor’s outcomes on their
patients, keeping demographics in mind, and educating providers on physician
bias. Overall, public health campaigns can be done to increase awareness of
disparities, encouraging the promotion of providers in underserved areas,
encouraging diversity, providing culturally sensitive training.
• Participate in a discussion about health and health care disparities in breast cancer
o Women who are minorities who get screened in mammograms are less likely
than whites to be treated as needed, there was the example of the African
American woman who only got insurance once she was diagnosed with cancer,
and there is overall seen a longer time to get treatment after diagnosis of cancer
in African American women.
Primary Care in the US Healthcare System and its Role in Improving the Health of the
Public (D. Reddy)
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find more resources at oneclass.com
Document Summary
Pc"s focus is on healing illness and prevention; ph"s is preventing injury and illness. Pc assesses via diagnostic exams, ph assess population health through data collected and analyzing that (epidemiology). Pc intervenes by treatments in behavioral changes, medication etc. , while ph intervenes through programs and health policies. Follow-up in pc is continuous, comprehensive, patient-centered, and has coordinated care. Pcp regularly and having one-on-one conversations with their pcp. Studies have shown that those with a chronic disease are more likely than those who do not to develop a mental illness, that can be attributed at least in part due to the stress of managing a chronic illness. Objectives: at the end of this session, students will be able to: Identify critical research, evaluation, and data collection needs. It sets what"s the most cost-effective way to screen for illnesses, and strives to make accurate, up-to-date, and relevant recommendations about preventative services in primary care.
