Sociology Index

PUBLIC HEALTH MODEL

Unlike a ‘crime control model’ which focuses on punishment or moralizing with the offender, a public health model looks at particular kinds of crime (often drug abuse, prostitution, youth violence) as public health issues. A public health officer takes a very different view of crime than does a police constable.

The public health model encourages us to think of ways to stop the spread of drug abuse or violence, for example, or how to prevent drug abusers from harming themselves or spreading infection to the community, or on initiating education programs in schools to teach young people how to recognize the possible onset of violence, how to prevent it, who to call if violence is experienced, etc.

Implications of Public Health for Policy on Sexual Violence, KATHLEEN C. BASILE 
Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724, USA 
In the last ten years, researchers and practitioners have written about why sexual violence in particular should be viewed as a public health issue, and the importance of prevention of sexual violence.

However, little has been written about how to accomplish this. In this paper I describe steps that could be taken using the public health approach to better achieve prevention of sexual violence. Most research and prevention related to sexual violence have focused on the individual and relationship levels. The paper concludes with some examples of potential preventive measures and policies consistent with a public health model.

Youth gambling: A public health perspective
Carmen Messerlian & Jeffrey L. Derevensky, McGill
Abstract: Over the last decade research in the area of youth gambling has led to a better understanding of the risk factors, trajectories and problems associated with this behaviour. At the same time, governments have begun to recognize the importance of youth gambling and have offered to support research and treatment programs. Yet, public health and prevention in the realm of youth gambling has only recently drawn the attention of researchers and health professionals. Early work by Korn and Shaffer (1999) set the groundwork for a public health approach to gambling.

Evaluation of Error in Medicine - Application of a Public Health Model 
Karen J. Brasel, MD, MPH, Peter M. Layde, MD, MSc and Stephen Hargarten, MD, MPH 
From the Departments of Surgery (KJB), Family and Community Medicine (PML), and Emergency Medicine (SH), Wisconsin Injury Research Center, Medical College of Wisconsin, Milwaukee, WI. e-mail: kbrasel@mcw.edu
ABSTRACT: A case of a chest tube placed on the wrong side during a trauma resuscitation in the emergency department is presented as an example of medical injury. Two traditional models, the legal model and the managerial model, are described and their application to medical injury discussed. A new public health model is then applied to the case example as a more effective way to address medical injury. The public health model addresses the injury event rather than the error itself using Haddon's matrix as a framework. Pre-event, event, and post-event phases are examined to find the weakest link, where intervention has the highest likelihood of successfully preventing future injuries.

The EUHPID Health Development Model for the classification of public health indicators 
Georg Bauer, John Kenneth Davies, Juergen Pelikan
The European Community Health Promotion Indicator Development Model has been developed as the basis for establishing a European set of indicators for monitoring health promotion interventions. This paper offers the public health model more generally as a common frame of reference for broader public health practice and indicator development. The public health model builds around the physical, mental and social health of individuals and shows how health develops by interaction between individual and environmental health determinants. It demonstrates that health development can be analysed from a salutogenic and a pathogenic perspective and explains how the differing starting points of different intervention approaches such as health promotion and health care are related to these two perspectives. Finally, a classification system for pathogenic and salutogenic public health outcome indicators is derived from the model and has been applied to the current core list of the European Community Health Indicator system. The public health model and its application highlight the need for systematic salutogenic indicator development in the field of public health and for strengthening the health promotion perspective in the future.

‘Bullets as bacteria’ 
Television news magazines’ use of the public health model for reporting violence 

Renita Coleman, Louisiana State University, David D. Perlmutter, Louisiana State University
Surveys of mass media content related to social violence suggest that it generally focuses on the individual, atomistic ‘act’ (e.g. the bang-bang car chase) rather than issues of cause and prevention. Yet, increasingly - but with controversy - doctors, health officials and activists have pushed for a ‘public health’ model of reporting news about crime and violence that looks at interactions between the victim, the agent of injury or death, and the environment in which the injury or death took place rather than viewing it in strictly individual terms. The emphasis on entertainment seemed to negate any promised ‘public health’ angles. We conclude that the challenge for the public health model is to find ‘scripts’ that journalists deem to be publicly consumable and ratings friendly.

A public health model of the social determinants of health. Ansari Z, Carson NJ, Ackland MJ, Vaughan L, Serraglio A. 
Health Surveillance and Evaluation Section, Public Health Group (PHG), Department of Human Services (DHS), Melbourne.
As we move forward in the new century, epidemiologists and public health practitioners are faced with the challenge of reviewing the current direction of epidemiology and its links with public health. While the history of epidemiology has been a successful and productive one, there is a danger that modern epidemiology is becoming too narrow in its scope, concerned primarily with the analysis of risk factors in individuals, while ignoring sociological and ecological perspectives of health. We argue that a theoretical framework to guide the practice of epidemiology is needed which encompasses a role for social determinants of health while simultaneously also acknowledging the importance of behaviour and biology, and the inter-connectedness of all these factors. This paper presents a public health model of social determinants of health, which provides a framework for testing the causal pathways linking social determinant variables with health care system attributes, disease inducing behaviours and health outcomes. This approach provides an improved opportunity to identify and evaluate evidence-based public health interventions, and facilitates stronger links between modern epidemiology and public health practice.

Reconsidering the public health failings of the criminal justice system: a reflection on the case of Scott Ortiz
Thomas Kerr
Abstract: Throughout most of the world, the primary response to the health and social impacts of illicit drug use has been to intensify the enforcement of drug laws. The consequences of this policy approach include an unprecedented growth in prison populations and increasing concerns regarding drug-related harms within prisons and without, including increased risk of HIV and hepatitis C (HCV) infection. This has led to calls from public health and prisoner advocacy groups to prison authorities to improve health services available in the community and those available to prisoners. While considerable progress has been made with respect to the growing implementation of HIV and HCV prevention measures within some nations' prisons, the case of Scott Ortiz illuminates a new set of challenges for prisoners and their advocates as judges often have a faulty understanding of public health arguments and data. In this case we see one such instance where a judge acts in ways not rooted in sound public health evidence or practice to produce a perverse outcome that violates both sound medical and judicial objectives.