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Pharmacy in Public Health
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Defnition o Public Health1
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Defnition o Pubic Health2
3. Beaglehole R. Public Health at the Crossroads: Achievements and Prospects,2nded. West Nyack, NY:
Cambridge University ress! 2""#.
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Defnition o Public Health3
#. Yo$ng, %&. Population Health: Concepts and Methods. Ne' York, NY: ()*ord University ress! +-.
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The role o pharmacy
in public healthincludes: 1) Access to
medications 2) Assurin sae ! e"ecti#emedications
3) $aelyusin%discardin medications
&'A(P&
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*iure 1+2 Health and the natural history odisease
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Defnitions
Health promotion ,ccurs -hile indi#iduals are healthy to impro#e o#erallhealth. reduce ris/s. and increase resistance ie0posed+ These acti#ities oten taret entirepopulations
Exposure/risk factors *actors that increase the ris/ o a disease de#elopin
in a person or population
Disease prevention elated to e0posure and ris/ actors Acti#ities ocus
on pre#ention o a specifc disease and taretpopulations -ill consist o atris/ indi#iduals+
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*iure 1+3 Health $creenin at Health *air
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Population
(ay reer to the number o residentso a specifc eoraphic area orpolitical di#ision 4e++ state or city)
(ay reer to indi#iduals -ho sharecommon characteristics 4e++ o#erae 56)
(ay reer to residents in the ser#icearea o a clinic or hospital
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*iure 1+7 $in ad#ertisin -omen8s healthair
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Table 1+1 Public Health #ersus 9linicalPre#ention and Treatment
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&pidemioloy and $tatistics
&pidemioloy
/ Describes patterns o health and disease in apopulation
/ epresents the basic science o public health $tatistics
/ sed to summari;e data related to apopulation
/ sed to compare roups to identiy actorspromotin health or pre#entin disease
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&n#ironment and the&coloical Approach
9onsider the aspects o the en#ironmente0ternal to an indi#idual that a"ect health
/ &++ contaminated oods. accidents
&coloical approachthe relationship othe indi#idual -ith their en#ironment
/
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esponsibility or PublicHealth
=o#ernment has a critical role inassurin the health o populations
Health care proessionals ha#e aspecial responsibility or public healthbased on their e0pertise in health
9ommunity members ha#e a
responsibility to assure their li#inconditions are as healthy as possible
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&0panded oles orPharmacy in Public Health
Pharmacists ha#e responsibilities in publichealth related to:
/ (edications and their use
&'A(P&: access to medications -hen there is no 27hour pharmacy in the community
/ Abo#e a#erae /no-lede and trainin in health
&'A(P&: nderstandin o ho- >uoridation o -atersupplies can reduce ca#ities
/ esidents o the community
&'A(P&: because they li#e in the community they/no- that there are lots o stray dos around
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Pharmacist in Public Health
Disease and other public healthproblems oten cross borders
?eed to share inormation and coordinate
responses (ost inter#entions are local. but impact
can be lobal
The public health system has ro-n asits unctions ha#e e0panded Public and pri#ate orani;ations are in#ol#ed at
all le#els
9 $ d i
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9ase: $pread o
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=lobal Public Health $ystem
Figure 3.5, pg 56
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*unctions o H, rovide leadershi0 on im0ortant health matters
artner 'ith other 0$blic or 0rivate organi1ations as needed
ha0e the research agenda and ens$re ne' kno'ledge is disseminated
evelo0 standards and set norms and monitor im0lementation
romote 0olicy o0tions that are ethical and evidence4based.
rovide technical s$00ort and e)0ertise
5onitor and assess the trends in health
romote change and s$00ort the develo0ment o* its o'n s$stainable
instit$tional ca0acity
(Table 3.2, pg 53. Source WHO, International. The Role of WHO in ublic Health.!
Ph l i P bli
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Pharmacy oles in PublicHealthAt the local or state level
Be a'are o* health boards and task *orces
Become involved in ed$cation and a'areness 0rograms
Re0ort $n$s$al sales vol$mes *or medications or 0atient com0laints
Be an advocate *or local citi1ens and kee0 eyes o0en *or iss$es
At the federal level
artici0ate on task *orces 'ithin 0ro*essional organi1ations
erve on revie' 0anels or government committees
Use national vol$ntary re0orting systems
At the international level
artici0ate in vol$ntary medical and h$manitarian aid
Raise a'areness *or international travelers o* risks and 0revention
onate money or s$00lies
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a- in Public Health
Public health di"ers rom pharmacypractice in that it can enorce beha#iors#ia la-
Public health la-s address a #ariety oissues related to determinants o healthand health ris/s
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$ource o Authority
$tates ha#e Bpolice po-erC $tate o#ernment has po-er to act on behalo its citi;ens to protect or beneft them
nless that po-er is e0plicitly i#en to the ederalo#ernment
$tate authority reiterated in the 1thAmendment Police po-er may be deleated to local
o#ernments
Police po-er i#es states the ability to
create and enorce la-s that restrict ormandate beha#iors
This leads to a constant e"ort to ensurela-s are not unduly restricti#e o indi#idual
reedom
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Areas o Public Health a- 9hane beha#ior
(odiyin hihris/ beha#iors e@uirin beha#iors
Prohibitin beha#iors
eulate products or ser#ices icensure
(anuacturin
Distribution and ad#ertisin
Protect #ulnerable populations or places Access to ser#ices includin healthcare
9lean and sae en#ironment
Human rihts protection
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*aulty Products
There are many -ays a product cancause harm:
*ails to -or/ 4ine"ecti#e. subtherapeutic.
alse claims) 9auses harm 4unsae inredients. tampered)
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0amp e: nsa einredients
1E3F &li0ir $ulanilamide
traedy $ituation:
?o leal re@uirement to list inacti#einredients on label
?eeded a li@uid orm o ne- sulaantibiotic or children
Problem: D&= used as diluent G it is to0ic+
,#er 1 people. mostly childrendie
esolution: *ederal *ood. Dru !9osmetics Act
o 1E3
hoto so$rce U.. 67, Center *or r$g 8val$ation and Research
&0ample: ?o &Icacy
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&0ample: ?o &Icacy$tandards
1E6s &uropean Thalidomide Traedy
$ituation: Product appro#ed in &urope under re#ie- in +$+
/ Appro#al delayed because o neuroloical studiesresults
Joluntary standards or ne- products
Problem:Teratoenic e"ects appear in &urope
?eed more strinent re@uirements
or ne- product appro#al
esolution: 1E52 Keau#erHarris Dru Amendment
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Distribution eulations
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nsae se
nsuper#ised use o potentmedications
(edication errors
Abuse o clinically used medications
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$ummary Public health is ocused on the health o
populations Promotin better health and pre#entin a#oidable causes
o disease or early death
&pidemioloy and statistics are the tools o
public health The ecoloical approach is broad and considers
all actors associated -ith health
esponsibility or public health is sharedbet-een o#ernment. health proessionals.and community members
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$ummary
Lecause disease can cross borders. publichealth systems need to collaborate acrossborders
Public health systems e0ist at local. state.
tribal. national. and international le#els Loth pri#ate and public orani;ations included
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$ummary Police po-er allo-s state and local
o#ernments to pass la-s that supportpublic health e"orts
(ost pharmacy la-s ha#e their oriins
as a response to a public health issue ,ld problems are reemerin -ith the
ad#ent o technoloy. lobal trade. and
-ill re@uire ne- or amended la-s toaddress them
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