Empi Q8: Health Promotion in Physical Therapy truly quantitative & analytic in nature

● Epidemiologists collect, analyze & interpret data to form

OUTLINE solutions in public health
● Forefront of public health
I. Topic 1 ○ Constantly forming & informing health policies and
A. Subtopic A preventive strategies that will be used by medical
B. Subtopic B professionals
II. Topic 2

LECTURE | RECORDING | BOOK | IMPORTANT | MNEMONICS ENDEMIC ● Belongs to a particular people or country
○ E.g. Malaria in Africa

EPIDEMIC ● Disease that affects a large number of

PUBLIC HEALTH
people within a community, population or
region
● Science of protecting and improving the health of ○ E.g. HIV/measles in Ph
● Actively spreading new cases of the
families, communities, and entire populations throughout
disease, substantially exceeding what is
the world expected
● Involves not only the promotion of healthy lifestyle and
choices, but also great research surrounding disease and PANDEMIC ● An epidemic that belongs to a particular
injury prevention as well as the detection and control of people or country spread over multiple
infectious diseases (Center of Disease Control) countries or continents
○ E.g. COVID-19

Public Health vs. Epidemiology OUTBREAK ● Greater-than-anticipated increase in the

number of endemic cases
● Can also be a single case in a new area
● Public health considers the broader picture ○ Ex. COVID started as a number of
● Public health is a blend of the sciences cases in a specific area
○ Pulls together from biology, sociology,
environmental health,policies, ethics, epidemiology
to preserve & progress the health of people through Levels of Disease Prevention
evidence-based measures
● If you enjoy getting involved in the community, helping
others, etc., public health may be for you PRIMARY ● Improving overall health of the population
PREVENTION ● Focuses on prevention
● Vaccination & health promotion
EPIDEMIOLOGY
● A specific concentration within the public health field SECONDARY ● Improving testing
● While public health is an all-encompassing area of study, PREVENTION ● Early screening and detection of disease
this discipline focuses on uncovering the particular
patterns and causes of disruptions in public health TERTIARY ● Integrated patient-centered disease
● Investigate concerning health trends and diseases PREVENTION management
affecting specific populations, while public health workers ● Treatment and recovery focused
promote health and wellness within populations
● In layman’s terms, epidemiologists work to answer the
“who, what, where, when, and whys” of the field HEALTH PROMOTION
● Focuses on new outbreaks or diseases spreading in the
community ● Process of enabling people to increase control over, and
● Epidemiologists study the determinants & distirbution of to improve their health
health-related outbreaks ● Moves beyond a focus on individual behavior towards a
● On a daily basis, they use statistics, probability & wide range of social and environmental interventions
science-based research methods to determine specific
factors that trigger threatening events, diseases, &
5 Principles of Health Promotion
disorders in specific communities
● Epidemiologists use investigative measures to control &
mitigate the spread of related problems 1. A broad and positive health concept
● Because of all the research it requires, epidemiology is ○ Health should be considered broadly and not
 merely as the direct opposite of disease and death
○ It should also embrace dimensions of a good life
and the significance of social relations
○ Being healthy does not only mean lack of disease,
but also considers quality of life
2. Participation and Involvement
○ Involvement means ensuring the target group’s
influence on projects and interventions
○ Dapat di lang ma-deliver the materials, make sure
they participate also
3. Action and Action Competence
○ People are given the opportunity to build skills to
manage their own lives and change the conditions
and structures that influence their health
○ Action is when communities have the capacity to
act
■ When we go to communities, we capacitate the
people to have the capacity to act
○ Action competence means that they do not only act
for themselves but also for the community – for the
greater good
4. Health should viewed from a “settings” perspective
○ The structural and contextual settings in which
people live, work and reside influence their
opportunities for healthy living
○ Different settings/communities require different
focus
■ There is a different problem for each
community
5. Equity in health
○ Not everyone has the same opportunities for
leading healthy lives and changing practices
○ Health promotion interventions must take these
differences into account
Health System
● A system is an arrangement of parts and their
interconnections that come together for a purpose
● A health system consists of all organizations, people
and actions whose primary intent is to promote, restore
or maintain health
● Like any other system, it is a set of interconnected parts
that have to function together to be effective
● WHO recommends supporting and strengthening the
health system using 6 building blocks
SIX CORE COMPONENTS OR BUILDING BLOCKS
1. Service Delivery
○ A good service delivery comprises quality, access,
safety & coverage
2. Health Workforce
○ A well-performing workforce consists of human
resources management, skills & policies
○ Where manpower (HC workers) comes in
3. Health information systems
○ A well-performing system ensures the production,
analysis, assured quality, and cost-effective use
○ Dito papasok yung research field
■ They’re the ones responsible for collecting &
analyzing data and present possible solutions
to prevent certain diseases
4. Access to essential medicines
○ Procurement and supply programs need to ensure
equitable access, assured quality, and
cost-effective use
○ Medicine given to the public must be effective, of
quality, and affordable
5. Financing
○ A good health financing system raises adequate
funds for health, protects people from financial
catastrophes, allocates resources, and purchases
goods and services in ways that improve quality,
equity, and efficiency
6. Leadership / Governance
○ Effective leadership and governance ensures the
existence of strategic policy frameworks, effective
oversight, and coalition building, provision of
appropriate incentives, and attention to system
design, and accountability
○ Our health system is mostly based on the leader
since they are the ones making health policies
● When you strengthen a healthcare system, you improve
the building blocks
● You are able to manage the interactions between the
building blocks in ways to achieve more equitable &
sustainable improvement
● People are usually considered as the 7th building block
○ E.g. individuals, families, communities, consumers,
patients
● Overall goal of the 6 building blocks is to
○ Improve health
○ Responsiveness
■ When you have a disease, you are able to
address it immediately
○ Social & financial risk protection
■ Financial burden is not as heavy when you get
sick
○ Improved efficiency
WATCH!
https://m.youtube.com/watch?v=xuYj_87_z6I&feature=youtu
.be
EQUITY VS EQUALITY
● An effective response is acknowledging what
communities lack to allocate health resources equitably
 ● Equity means everyone gets what they need to achieve
the goal
● Equality means everyone gets the same
● Equity is often discussed as a concept grounded in
fairness
● Not just a concept but something we experience daily
● Backed by data that shows us where we are falling short
● Treating a pandemic means that we don’t blindly use a
one-size-fits-all approach
○ It means that we use the data to guide us on how
we best leverage our technological & financial
resources to address the barriers identified
EXAMPLE OF EQUITY
● During vaccination, we had priority groups
● There were a lot of issues regarding access
○ E.g. some senior citizens had difficulty filling up
forms because most is done digitally
● We prioritize other groups before the general public,
because they are more exposed
Imagine you are a team of 2 vaccination volunteers going up a
mountain. This vaccination drive only happens once a year.
Your goal is to vaccinate children who go up the mountain
(hassle to go all the way to you). Suddenly a car crashes next
to you and a women desperately needs help. If you decide to
bring the woman to a hospital, you will not make it to the
vaccination site and the children will die. What would you do?
● Our core humanity dictates us to treat the sick in front of
us and that is how we are wired
● That means we are not able to address the long term
needs of the prevention of people who may become sick
in the future
UTILITARIANISM
● Promotes the greatest amount of good for the greatest
number of people
● We must make prevention of disease and health
promotion priorities
● 90% of the budget on health is allocated in treatment &
care (way more than health prevention & promotion)
○ So it’s not surprising that there are outbreaks in
countries where failure for basic sanitation or
healthcare could have prevented them
○ Also not surprising people who take excess amount
of salt & unable to access tx for high BP are prone
to strokes
○ Also not surprising that people are unable to be
aware of the importance of stopping smoking or
govt inadequatelty raise the tax → people
eventually suffer from lung cancer and die
○ Also not surprising that the elderly with frailty go on
with earlier & accelerated death d/t failure of
nutrition system & basic dental hygiene
○ Overall impact is economic despair
In 1920s a famous professor at yale told his students “the goal
of every generation is to redefine the unacceptable and act
accordingly
● Was specifically talking about our appproach to health &
the prevention focus
● Our rationality tampers our progress
○ Ex. At a buffet, are you going to think what benefits
you long term & maximize your health?
○ Most of us would choose what tastes best, because
society is structured to make us think that way
● Barriers to this include the decisions we make
● We often see prevention and health promotion as
luxuries rather than essentials
● Public interest & media would focus more on an
individual with isolated cases (have weird s/sx) and
saving them from that case
○ Generates passion & enormous investment to save
that one life
● Although it is important to save lives of people with weird
cases, being able to stop an epidemic is even more
amazing
● Back to the sample scenario, we know that road traffic
injuries are preventable
○ VISION ZERO in Sweden which has the end goal
of reducing traffic deaths to 0
○ Nowadays, it has been unacceptable not to
vaccinate children
Let’s think further
● The future & current challenges of the world revolve
around a number of big killers
○ Heart & lung diseases, cancer are driven by 4
major risk factors
■ Smoking
■ Physical inactivity
■ Unhealthy & excess diet
■ Excess alcohol
● These risk factors & diseases constitute almost 60% of
 the burden of disease
HEALTH
● Most of us would think about pharmacies, hospitals,
medicine, medical devices
○ This focus is primarily on healthcare and not on
health itself
● We need to discern & choose which comapny is focusing
on health & put it in the center of business plans
○ These companies usually come from unlikely
places
○ Ex. Clothing industries promoting ana active
lifestyle, Softwares tracking exercise & diet, food
industry promoting healthy diets, fitness industry
○ These companies come together to redefine the
way we think of health and putting it at the center of
their business plan
● It should be unacceptable for food industries not to
reduce portion sizes, salt, sugar & fat that may be
harmful to our health
○ Be more aggressive in promoting healthy food
○ Can & more profitable
● We must always discern which companies promote
overall health of the community
● We must raise our ambition & voice
○ Prevent the preventable, promote health for all
WHAT DOES IT TAKE?
● Our government should be leading the way
○ More regulation, taxation, education
● But today we have more control over our lives
○ Younger generations choose to be healthier
○ Older generations do their best to assure that
younger generations would be healthier than they
were
○ Technology & behavioral economics are given new
opportunities to innovate
● Let’s place disease prevention and health promotion in
the center of health care
○ This is how we can promote healthy lifestyles
● Make the healthy choice, the easy choice
HOW CAN WE DO THAT?
● Physical therapy as an avenue for health promotion
○ One of the few HC workers who interact with
patients 1 on 1 multiple times
○ We interact with them from start to finish, until they
recover
○ We build connections, hence the importance of
building rapport
○ We teach them how they can continue doing their
treatments at home because that is the most
effective way on how we can contribute in health
promotion and disease prevention
● We play a key role in promoting fitness & wellness by
encouraging active living, early diagnosis of disease, and
prescribing targeted activity interventions to improve
fitness & participation
● We also help individuals overcome personal and
environmental barriers to an active lifestyle
● Hence why when we create a program for our patients,
we customize them according to their environment just to
be able to promote a better lifestyle for them
HOW DID MY PT EDUCATION CONTRIBUTE TO WHERE I AM
NOW?
● Tangina this is just him
● For the past 2 years I have been working with DOH
under the epidemiology bureau
○ Most undergrad fields for public health are
pharmacists, medtechs
● Mahirap yung mga naging coping strategies ng hospitals
after COVID so I asked my friends how can I help
● Eventually i saw an opening in DOH and applied
○ Was a bit tedious with exams n shit
○ There were 9 applicants at the start but after the
exams 6 were left for the panel interviews
○ Intimidating because you can hear other applicants
talking
○ After the hiring process, he got a call that he got in
● He is sharing how his UST PT education contributed to
where he is now (not being mayabang daw)
● All his competitors had bg on public health but despite
that he still got the job
○ Other applicants were medtechs who know alot
more about epidemiology, HIV, etc.
● As PTs we analyze things on a daily basis when we deal
with patients
○ Using clinical reasoning, we come up with a
treatment and plan of care
○ This is similar to what we do in epidemiology
WHAT WE DO?
● Epidemiologists work to answer the who, what, where,
when & whys of the field
● Collect Data → Sort → Arrange → Presented visually →
Explained with a story → Actionable (Useful for different
departments)
● A story without data is a myth and data without a story is
just a bunch of numbers
● We are in constant communication with different
hospitals, clinics and validate data
● Some days we have monitoring and evaluation sessions
where each of us present a new analysis or something
weird/notable on the surveillances
○ Whole team would provide insights based on the
presented material
● A lot of field works in different regions across the country
as speakers, presentors or even consultants
○ Lessened during the pandemic but slowly coming
back
● When you go to the regional offices, alagang alaga kayo
– they really cater to your needs and everything
● For long term activities we do researches that take 2-3
years
○ Usually surveys of multiple key populations across
the country
○ Gather both quantitative and qualitative data
focusing on the behavior & serologic data of
different populations concerning HIV
 13. HIV treatment is free
○ YES
HIV
○ In the Philippines, all HIV services are free (testing,
screening, counseling, treatment) & subsidized by
1. Can a healthy looking person have HIV? the government
○ YES ○ Even marginalized are catered to
2. Can mosquito bites transmit HIV?
○ NO
○ When mosquitoes bite, there are 2 tubes (to bite &
to suck) so the infected blood is not transmitted to
another person
3. Can condoms reduce the risk of HIV transmission?
○ YES
4. Can having sex with one faithful, uninfected partner
reduce risk of HIV transmission?
○ YES
5. Can a person get HIV from toilet bowls in public
restrooms?
○ NO
6. Can a person get HIV by sharing utensils with someone ● The Philippines leads the rise in HIV cases in the Asia &
who’s HIV positive? Pacific Region with 140% increase in annual new
○ NO infection between 2010 & 2016
○ Saliva is not a mode of transmission for HIV ● Philippines has become 1 out of the 8 countries that
○ There are 4 fluids that can transmit HIV: account for more than 85% of new infections in the whole
■ Blood region
■ Breastmilk ● In the Philippines, there are 96,266 cases reported to
■ Semen DOH currently since 1984 to Feb 2022
■ Vaginal fluids ○ Surveillance & reporting of HIV only started in 1984
7. Can a person get HIV by swimming in public ● With this rapid increase in cases, the latest estimate of
pools/beaches with someone who’s HIV positive? the DOH epidemiology bureau show that there will be
○ NO 22,100 new infections by the end of the year
8. Can sharing needles with an HIV infected person ● This epidemic is reflected with the increasing number of
increase risk of HIV transmission? people living with HIV (PLHIV)
○ YES ○ Foreseen to increase in the next 10 years
9. Does being an anal receiver (bottom) give you a higher ● In 2021, it is estimated to have 133,800 PLHIV
risk of getting HIV? ○ Given the current efforts in HIV response, the
○ YES estimated PLHIV is projected to triple to more than
○ HIV in the Philippines are mostly transmitted from 330K by 2030
males having sex with males ● By 2030, UN’s goal is to end AIDs globally
○ Seminal fluid goes into the anus that is usually torn ○ But with the current efforts, it is still not enough to
■ Virus from the seminal fluid goes into the torn halt transmission of HIV
anus
10. The chance of getting HIV from someone correctly taking
HIV treatment is lower
○ YES
○ When a person with HIV is correctly taking tx, it can
reach to a point that the virus is undetectable in the
body
○ If it is undetectable, it is untransmissible
○ Viral load is lower; hence, the risk of transmitting
HIV is also lower
11. There is a cure for HIV
○ NO
12. You only need to take HIV treatment for 10 years
○ NO ● Nearly half of new infections in 2021 are among the
○ You need to take treatment lifelong even if it is youth (15-24 y/o)
undetectable or non transmissible ● The rising HIV epidemic in the country can also be
○ You have to keep taking HIV meds or antiretroviral reflected with the increasing number of new infections
so that continued suppression of the virus per year
continues ● If we look at the age group aggregation of the new
infections, it is 47% of the youth in 2021
● On the right, we can see the distribution of age
● This is the data that is presented to stakeholders, partner
organizations for them to create policies or better
programs to stop the transmission of HIV
● During the game, it showed that basic knowledge on HIV
is not known yet
○ What more in low lying schools that is not given
much exposure regarding info dissemination
○ Baka less pa knowledge nila
● Nationally, only 50% got all the questions correct so there
is a big gap in info dissemination & knowledge
distribution regarding HIV, AIDs, STIs
PHILIPPINE NATIONAL AIDS COUNCIL: 6TH AIDS MEDIUM
TERM PLAN TARGETS
● To stop the increase of HIV in the country
● With the support of national, regional & local units, this
puts focus on different key populations
● Increase knowledge on HIV transmission, prevention &
services among 15-24 y/o to 90%
○ Currently, it’s just 50%
● Prevent new HIV infections (esp among 15-24 y/o)
○ Focused on populations who are at most risk (e.g.
male on male, female sex workers)
● Test and Treat 90% of people living with HIV
○ At the national level, we are only at 63-65%
● Eliminate mother-to-child transmission of HIV
○ Remember that breastmilk is one mode of
transmission
○ So, most pregnant women are required to do an
HIV test during check-ups so that it doesn’t pass to
the child
○ Children of HIV-positive women are bottle fed
ADDRESSING THE HIV EPIDEMIC AMONG THE YOUTH
1. Increasing general HIV knowledge among adolescents
by creating age-specific learning modules/materials and
maximizing online platforms
2. Integrating HIV-related and reproductive health
information in the curriculum and link adolescent and
youth friendly health services to school or wherever it is
within their reach
○ Much can be gained in implementing these
strategies
○ Since most of the youth receive info about HIV from
passive resources & schools, it is important to
equip youth with the proper knowledge of HIV
3. Increasing and normalizing access to prevention
programs and STI and HIV services
○ Highlight the importance of reducing stigma in
accessing services and making sure that these
services are linked
○ We know how condom acts have been a challenge
esp among minors
○ With early start of risky behaviors the youth engage
in, it is important that the use of condoms &
lubricants are available
○ HIV information & pre-exposure prophylaxis should
also be available
4. Improving access to and coverage of testing, treatment,
and care services, especially in the COVID-19 context
○ Ensure proper referral mechanism to various
community centers, community-based
organizations, clinics, testing & treatment facilities
■ Must also strengthen their collaboration
○ If we are not knowledgeable about a certain thing,
we tend to judge people about them
○ Stigma gets passed on from one generation to
another
○ Ex. a 15 y/o buys a condom
■ There is stigma; he/she is so young pa
■ We need to normalize this, because it is part of
prevention & sexual health
○ We have to increase knowledge & awareness of
people to reduce or eliminate stigma
● Now we have seen the HIV situation among the youth
and some of the strategies we implement as we move
forward towards ending HIV epidemic
● We are reminded that there are accessible HIV & STI
services esp in the metro
● We are encouraging everyone to increase awareness
about HIV and remove stigma & discrimination esp
among the youth
● We all have a voice
○ Let us all be the youth’s voice and become
instruments in ending the HIV epidemic
Q&A
● Bullet 1
○ Bullet 2
■ Bullet 3
Thing
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Don’t edit this docs please. Just
make a copy out of this