Public Health

Wikipedia Definition

Public health is “the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals” (1920, C.E.A. Winslow).[1]

It is concerned with threats to health based on population health analysis. The population in question can be as small as a handful of people or as large as all the inhabitants of several continents (for instance, in the case of a pandemic). The dimensions of health can encompass “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”, as defined by the United Nations’ World Health Organization.[2] Public health incorporates the interdisciplinaryapproaches of epidemiologybiostatistics and health servicesEnvironmental healthcommunity healthbehavioral health, andoccupational health are other important subfields.

The focus of public health intervention is to improve health and quality of life through the prevention and treatment of disease and other physical and mental health conditions, through surveillance of cases and the promotion of healthy behaviors. Promotion of hand washing and breastfeeding, delivery of vaccinations, and distribution of condoms to control the spread ofsexually transmitted diseases are examples of common public health measures.

NHS Challenges

The needs to save up to £20bn over the next few years to meet the ever-rising demand for quality health care and improved patient outcomes, and has created a number of  NHS Innovation Challenges Prizes  to recognise and reward ideas which tackle some of the biggest health and social care challenges that exist in England today – they make an interesting overview of where some of the opportunities for improvement lay, and are also a potential source of funding!

Public Health & Mobile Technology Resources

In his excellent mPublic Health blog, Dr Tom Porter of the Public Health Commissioning Network has listed a number of excellent resources, which I am sharing again with you here:

mHealth (WHO) – includes public health aspects of mHealth in its definition
mHealth for Development (UN/Vodafone)
mHealth (Wikipedia)
mHealth Alliance – founded by the UN Foundation, Rockefeller Foundation, and the Vodafone Foundation in 2009
Presentation on public health aspects of mHealth (Andre Blackman) and Andre’s blog Pulseandsignal.com
Use and extent of mobile technologies
Africa lags smartphone market (Biztech Africa) Summary of late 2010 market analysis suggesting only 5% current penetration of smartphones in Africa and India rising to 15% by 2015, in contrast to the 70% predicted in many developed countries, partly due to mobile data costs and patchy coverage

Should we be building SMS or internet services for Africa? (White African)  Interesting discussion around whether it is better to capitalise on readily available technologies such as SMS or drive development of the market by increasing content reliant on data services.

Evidence & research
Towards the development of an mHealth strategy (pdf, WHO, 2008)
Manchester mHealth Innovation Centre (University of Manchester, UK)
Journal of Telemedicine and Telecare (RSM press)

Relevant Cochrane reviews (only 1 currently!)
Whittaker R, Borland R, Bullen C, Lin RB, McRobbie H, Rodgers A. Mobile phone-based interventions for smoking cessation. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD006611. DOI: 10.1002/14651858.CD006611.pub2

(note a number of groups have proposed relevant review protocols but the reviews themselves have not yet seen the light of day)

Other studies
Juzang, I et al. A pilot programme using mobile phones for HIV prevention. doi:10.1258/jtt.2010.091107
US feasibility study looking at texting for HIV prevention messages – encouraging if small.

FrontlineSMS | Medic Mobile (FrontlineSMS offshoot for mHealth)
HopePhones.org – if you’re in the US you can donate your old mobile/cellphone for recycling, with the proceeds going to buy appropriate ones for developing country healthcare use (anyone know of a UK equivalent?)
Google Breadcrumb  Labs product for easily creating simple text-based tutorials, ideal for mobile phones.  Requires no programming/web knowledge, although to view the resulting pages does require an internet-connected phone.
Google SMS tips for health  Tool for use in Uganda, allows people to text to find out more info on health issues such as malaria, HIV etc.and find local clinics
HealthMap Clever visualisation of reported disease outbreaks, including free iOS and Android mobile versions (Outbreaks near me) – but a bit buggy in my experience, both on a laptop and phone.  Still, lots of potential
airTEXT  Simple but clever application of texting for public health benefit – subscribers get a text when air pollution levels rise including advice on how to minimise exposure
iTriage  iOS and Android app with symptom checker and listing of nearest appropriate care provider.  The sort of thing which, if it relied less on a data connection (e.g. by using voice or SMS instead), could benefit governments, health insurers and providers in many developing countries



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