This edition first published 2020
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Edition History: John Wiley & Sons, Inc. (1e, 2014)
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Library of Congress Cataloging‐in‐Publication Data
Names: Sharma, Manoj, author. | Branscum, Paul, author.
Title: Introduction to community and public health / Manoj Sharma and Paul Wesley Branscum.
Description: Second edition. | Hoboken, NJ : Wiley, [2020] | Revised edition of: Introduction to community and public health by Manoj Sharma, Paul Branscum, and Ashutosh Atri. [2014]. | Includes bibliographical references and index.
Identifiers: LCCN 2020012115 (print) | LCCN 2020012116 (ebook) | ISBN 9781119633747 (paperback) | ISBN 9781119633778 (adobe pdf) | ISBN 9781119633716 (epub)
Subjects: LCSH: Public health. | Community health services. | Health promotion. | Health planning.
Classification: LCC RA425 .S484 2020 (print) | LCC RA425 (ebook) | DDC 362.1–dc23
LC record available at https://lccn.loc.gov/2020012115
LC ebook record available at https://lccn.loc.gov/2020012116
Cover Design: Wiley
Cover Image: © Thomas Barwick /Getty Images
| 1.1 | One of the Many Dimensions of Health |
| 1.2 | Community Health Is about Promoting Health for Groups of Individuals |
| 1.3 | A Nigerian Boy Receiving a Smallpox Vaccination in 1967, an Example of an Organized Public Health Effort |
| 1.4 | Health Education Is about Facilitating Voluntary Health Behavior Change |
| 1.5 | Factors Affecting the Health of a Community |
| 1.6 | A Local Health Inspector Inspecting a Kitchen for Food Safety |
| 1.7 | Vaccination Was a Major Milestone in the History of Community and Public Health |
| 2.1 | Waterborne Transmission of Cholera Was First Recognized in Europe in the Mid‐1800s by John Snow |
| 2.2 | Bacteria: Examples of a Biological Agent |
| 2.3 | Page One of the US Death Certificate |
| 2.4 | Incidence Rates of Breast Cancer in Women by Race—United States, 1999–2007 |
| 2.5 | The Relationship between Flowing Water and Accumulated Water Is Analogous to the Relationship between Incidence (New Water Flowing) and Prevalence (Total Accumulated Water)54 |
| 2.6 | The Secular Trend in Tetanus Cases—United States, 1947–2009 |
| 3.1 | Schematic Diagram of the Case–Control Study |
| 3.2 | Confounding |
| 3.3 | Schematic Diagram of the Cohort Study |
| 3.4 | An Image from a 1950s Cohort Study Conducted with Miners Exposed to Airborne Particulates in Diatomaceous Earth Mining and Processing Plants |
| 3.5 | Schematic Diagram of a Randomized Clinical (or Controlled) Trial |
| 3.6 | Relationship of Infectious Diseases, Communicable Diseases, and Contagious Diseases |
| 3.7 | A Transmission Electron Micrograph of Measles Virus, a Paramyxovirus Transmitted by Direct Projection of Droplets |
| 4.1 | Graph of a Normal Distribution |
| 4.2 | Positively Skewed and Negatively Skewed Distributions |
| 4.3 | Bar Graph of a Hypothetical Distribution of Race in a Group (n = 20) |
| 4.4 | Pie Chart of a Hypothetical Distribution of Race in a Group (n = 20) |
| 4.5 | Histogram of a Hypothetical Age Distribution in a Group of College Students |
| 4.6 | Stem and Leaf Display of Hypothetical Data (n = 12) |
| 4.7 | Box and Whisker Plot for Hypothetical Data |
| 5.1 | Box and Whisker Plot of Hypothetical Posttest Knowledge Scores for Three Groups (n = 30) |
| 6.1 | The Ecological Model |
| 6.2 | Social Support Has Been Shown to Be a Major Determinant of Mental and Physical Health |
| 6.3 | The Whole School, Whole Community, Whole Child (WSCC) Model |
| 7.1 | Diagram for Prioritizing Epidemiological Factors |
| 7.2 | Program Planning Is about Involving Community Members as Important Stakeholders, and People Working Together as a Team |
| 7.3 | Program Planning Is about Diversity, and Involving Community Members of All Different Backgrounds |
| 7.4 | Diagram for Prioritizing Health Issues |
| 8.1 | According to the Health Belief Model, Teenagers Will Continue to Text While Driving If They Do Not Perceive Themselves to Be at Risk of Any Harm |
| 8.2 | According to Social Cognitive Theory, Children Who Observe Their Parents Obeying Traffic Laws, Such as Waiting for a Walk Light to Cross the Street, Will Likely Repeat This Behavior Later in Life |
| 8.3 | Adopter Categories on a Bell Curve |
| 8.4 | Rate of Adoption |
| 9.1 | Overview of the 4Mat Model of Learning |
| 9.2 | Lectures Can Be an Effective Way to Disseminate Large Amounts of Information to Large Groups |
| 9.3 | Diaphragmatic Breathing Can Be a Simple and Easy Way to Promote Stress Reduction |
| 9.4 | Using the Beach as a Peaceful Setting Is a Common Strategy in Guided Imagery |
| 10.1 | Demographic Transition |
| 10.2 | World Population: Past Estimates and Future Projections |
| 10.3 | Fertility Rates in the United States, 1917–1997 |
| 10.4 | A Combined Oral Contraceptive Pill |
| 10.5 | An Intrauterine Device (IUD) with Progestogen |
| 10.6 | An Opened Latex Condom and a Pregnancy Test (Showing the Sample Well): Items That May Be Used by the Sexually Active Individual |
| 11.1 | A Roadside Vendor Cooking Jalebi, a Popular Sweet Dish in South Asia |
| 11.2 | Mean Air Pollution (Particulate Matter of 10 μm or Less) in 13 Cities |
| 11.3 | Smog in Beijing: Air Pollution Remains a Major Issue for Many Nations |
| 11.4 | Components of Integrated Solid Waste Management |
| 11.5 | Workers Wearing Protective Clothing to Avoid Contamination from Hazardous Waste |
| 12.1 | Preventing Drinking and Driving Can Save Many Lives |
| 12.2 | The Four Components of Integrated Pest Management |
| 12.3 | Three Mile Island Nuclear Power Plant near Middletown, Pennsylvania: Site of a Partial Meltdown in 1979 |
| 12.4 | Homes North of Charleston, South Carolina, Damaged by Hurricane Hugo in 1989 |
| 12.5 | The Three Phases of Disaster Management |
| 13.1 | A Young Girl with Diabetes Performs Self‐Monitoring of Her Blood Glucose Level, an Important Aspect of Diabetic Preventive Care |
| 13.2 | Four Components of the US Health Care System |
| 13.3 | One of Insurers’ Many Cost Containment Strategies Is to Preferentially Cover Cheaper, Generic Versions of More Expensive, Brand Name Medications |
| 14.1 | Basic Schematic of a Logic Model |
| 14.2 | Sample Gantt Chart for a One‐Year Childhood Obesity Prevention Program |
| 14.3 | Example of a One‐Year Budget: Projected and Actual at Six Months |
| 14.4 | Essential Elements of a SWOT Analysis |
| 14.5 | Using a SWOT Analysis to Develop Organizational Strategies |
| 14.6 | Using a SWOT Analysis to Create Public Health Strategies |
| 14.7 | Outline for a Projected Sex Education Program Budget |
| 1.1 | Differences between Medicine and Community and Public Health |
| 1.2 | Factors Affecting Community Health |
| 1.3 | Foundational Principles, Overarching Goals, and Plan of Action in Healthy People 2030 |
| 1.4 | Ten Public Health Achievements between 1900 and 1999 in theUnited States |
| 1.5 | Summary of the Timeline of Community and Public Health |
| 1.6 | Current Challenges in Community and Public Health |
| 2.1 | Summary of the Uses of Epidemiology |
| 2.2 | Agent Factors in the Epidemiological Triad, with Examples |
| 2.3 | Host Factors in the Epidemiological Triad, with Examples |
| 2.4 | Environmental Factors in the Epidemiological Triad, with Examples |
| 2.5 | Age‐Adjusted (to 2000 US Standard Population) Prevalence of Coronary Heart Disease by Age and Sex—United States, 2006–2010 |
| 3.1 | Framework of a Case–Control Study |
| 3.2 | Advantages and Disadvantages of the Case–Control Study |
| 3.3 | Framework of a Cohort Study |
| 3.4 | Advantages and Disadvantages of the Cohort Study |
| 3.5 | Hypothetical Data for the Relationship between a Study Factor and a Health Outcome over One Year of a Cohort Study |
| 3.6 | Advantages and Disadvantages of the Randomized Clinical (or Controlled) Trial |
| 3.7 | Routes of Transmission for Infectious Diseases |
| 3.8 | Complete Immunization Schedule: United States |
| 3.9 | Differences between Infectious Diseases and Chronic Diseases |
| 3.10 | Common Chronic Diseases and Their Risk Factors |
| 4.1 | Four Scales of Measurement |
| 4.2 | Frequency Distribution Table of Age in a Sample of 100 Employees at a Worksite |
| 4.3 | Frequency Distribution of Age in a Sample of 100 Employees at a Worksite, with Cumulative Frequency, Relative Frequency, and Cumulative Relative Frequency |
| 4.4 | Hypothetical Distribution of Race in a Group (n = 20) |
| 4.5 | Hypothetical Age Distribution in a Group of College Students |
| 4.6 | Raw Data for Schoolchildren (n = 25) |
| 5.1 | Two Types of Error When Making a Statistical Decision |
| 5.2 | Hypothetical Knowledge Scores for a Theory‐Based Educational Program and a Knowledge‐Based Educational Program (n = 20) |
| 5.3 | Means and Standard Deviations (SDs) of Hypothetical Knowledge Scores for the Two Groups (n = 20) |
| 5.4 | Summary of t‐Test on Hypothetical Knowledge Scores for the Two Groups (n = 20) |
| 5.5 | Hypothetical Pretest and Posttest Knowledge Scores for a Theory‐Based Educational Program (n = 10) |
| 5.6 | Means and Standard Deviations of Hypothetical Pretest and Posttest Knowledge Scores for a Theory‐Based Educational Program (n = 10) |
| 5.7 | Summary of a Paired t‐Test on Hypothetical Pretest and Posttest Knowledge Scores (n = 10) |
| 5.8 | Hypothetical Posttest Knowledge Scores for Three Groups (n = 30) |
| 5.9 | Means and Standard Deviations on Hypothetical Posttest Knowledge Scores for Three Groups (n = 30) |
| 5.10 | ANOVA Summary Table for the Hypothetical Posttest Knowledge Scores for Three Groups (n = 30) |
| 5.11 | Results of Bonferroni Post Hoc Test on Hypothetical Posttest Knowledge Scores for Three Groups (n = 30) |
| 5.12 | Hypothetical Pretest, Posttest, and Follow‐up Knowledge Scores for a Theory‐Based Health Education Program (n = 10) |
| 5.13 | Means and Standard Deviations (SDs) of Hypothetical Pretest, Posttest, and Follow‐up Knowledge Scores for a Theory‐Based Health Education Program (n = 10) |
| 5.14 | Within‐Subject Effects Found by Repeated Measures ANOVA in Hypothetical Pretest, Posttest, and Follow‐up Knowledge Scores for a Theory‐Based Health Education Program (n = 10) |
| 5.15 | Distribution of Dental Caries in the Experimental and Control Groups of a Hypothetical Fluoridation Trial (n = 20) |
| 5.16 | Summary of Chi‐Square Test in a Hypothetical Fluoridation Trial (n = 20) |
| 5.17 | Summary of Common Inferential Tests Used in Biostatistics |
| 5.18 | Four Combinations of Statistical Significance and Practical Importance, and Their Implications |
| 6.1 | Academic Fields That Make Up the Behavioral and Social Sciences |
| 6.2 | Commonly Used Community Planning Models in Public Health |
| 6.3 | Commonly Used Theories in Public Health |
| 6.4 | Commonly Used Teaching Methods and Pedagogies in Public Health |
| 6.5 | Top 10 Causes of Death in the United States in 2017 and 1900 |
| 6.6 | The Nine Stages of the Community Readiness Model |
| 7.1 | Summary of Quantitative and Qualitative Methods for Evaluating Quality of Life |
| 7.2 | Essential Steps of the PATCH Model |
| 7.3 | Essential Steps and Substeps of the MATCH Model |
| 7.4 | Essential Steps of Intervention Mapping |
| 7.5 | Essential Steps of the APEXPH Model |
| 7.6 | Essential Dimensions of the PEN‐3 Model |
| 7.7 | Essential Steps of the Behavior Change Wheel |
| 7.8 | Essential Steps of the Generalized Model |
| 8.1 | Essential Building Blocks of the Health Belief Model |
| 8.2 | Essential Stages of Change, Processes of Change, and Levels of Change of the Transtheoretical Model |
| 8.3 | Top 10 Innovations of the Decade (2000–2010) |
| 9.1 | Cognitive Methods in Health Education |
| 9.2 | Affective Methods in Health Education |
| 9.3 | Examples of the 93 Behavior Change Techniques for Individual or Group Health Promotion |
| 9.4 | Environmental Methods in Health Promotion |
| 10.1 | Resident Population Projection by Race and Age, 2010 and 2015 |
| 10.2 | Urban and Rural Population by State, 2010 |
| 10.3 | Modern Methods of Contraception |
| 10.4 | Traditional Methods of Contraception |
| 11.1 | Air Pollution and Health |
| 11.2 | Health Effects of Major Air Pollutants |
| 11.3 | Water Treatment Interventions |
| 11.4 | Typical Noise Levels |
| 12.1 | Some Types of Unintentional Injuries |
| 12.2 | Preventive Strategies for Unintentional Injuries |
| 12.3 | Nonfatal Violence‐Related Injuries in the United States, 2017 |
| 12.4 | Preventive Strategies for Intentional Injuries |
| 13.1 | Health Profile of the United States in a Global Context |
| 13.2 | Health Profile of the United States in a Regional Context |
| 13.3 | Factors That Influence Health Care Utilization |
| 13.4 | Mechanisms Employed by HMOs to Limit Health Services |
| 13.5 | Cost Containment Policies for High Drug Costs |
| 13.6 | Shopping for a Health Insurance Plan |
| 13.7 | Operating Divisions of the US Department of Health and Human Services |
| 14.1 | Four Types of Resources (Inputs) for a Public Health Manager |
| 14.2 | Writing SMART Goals and Objectives |
| 14.3 | Types of Program Evaluation |
| 14.4 | Some Public Health Program Stakeholders and Their Interests |
| 15.1 | Systems Thinking Approaches versus Conventional Approaches with Respect to Health Systems |
| 15.2 | Transformational and Transactional Leadership |
| 15.3 | Competencies in the NCHL Model |
We have great pleasure in presenting the second edition of Introduction to Community and Public Health to you. We have been quite pleased with the appreciation and love that the first edition of this book has received from instructors, students, and practitioners. Dr. Ashutosh Atri, who was a co‐author in the first edition, is now a busy practicing psychiatrist and will no longer be with us, but his contributions to the first edition have been invaluable.
One of the needs of all students in public health, health education, and related disciplines is to understand the basics of community and public health. Currently, there are very few books on this topic, and none of the existing textbooks covers all the essential areas. This book is designed to primarily prepare students in public health and health education with the basics in all five of the core areas of community and public health identified by the Association of Schools of Public Health and Council on Education for Public Health (CEPH): biostatistics, environmental health sciences, epidemiology, health policy and management, and social and behavioral sciences. Our purpose has been to provide a text in the area of community and public health for undergraduate students (BS, BA), graduate students (MS, MA, MPH), and both entry‐level and advanced‐level practitioners in public health, health education, and health promotion. This book is also useful for medical students learning the basics of community medicine, allied health students, nursing students, counseling students, and students pursuing degree programs in communicative disorders. It is extremely helpful in preparing individuals for the certified in public health (CPH), certified health education specialist (CHES), and master certified health education specialist (MCHES) examinations. We have received excellent feedback on this book from students preparing for these exams and pursuing these degrees, as it provides an overview of all the necessary topics.
In this book, the essentials of community and public health have been emphasized. In the new edition, the chapters have been organized into six units to make it easier for readers to comprehend the encompassing nature of the book. The first unit is the introduction (Chapter 1); the second unit is about biostatistics in community and public health (Chapters 2 and 3); the third unit is about epidemiology in community and public health (Chapters 4 and 5); the fourth unit is about social and behavioral sciences in community and public health (Chapters 6–9); the fifth unit is about environmental issues in community and public health (Chapters 10–12); and the sixth unit is about health policy and management in community and public health (Chapters 13–15).
In the second edition, we have ensured that the introductory aspects of all foundational competencies for public health as identified by the Council on Education for Public Health (CEPH) are covered. Those competencies are mapped in Table P.1.
The second edition updates the text with the latest references and websites to explore. Some existing sections from the first edition have been expanded, such as those on infectious disease epidemiology (Chapter 3), chronic disease epidemiology (Chapter 3), and newer theories (Chapter 8). Some new sections have been added, including:
Table P.1 Mapping of Foundational Competencies in Public Health Education, as Identified by the Council on Education for Public Health (CEPH) and Addressed at an Introductory Level in This Book
| # | Foundational Competency | Addressed in Chapter(s) |
| Profession & Science of Public Health | ||
| 1. | Explain public health history, philosophy, and values | 1 |
| 2. | Identify the core functions of public health and the 10 essential services | 1, 13 |
| 3. | Explain the role of quantitative and qualitative methods and sciences in describing and assessing a population’s health | 2, 6 |
| 4. | List major causes and trends of morbidity and mortality in the United States or other community relevant to the school or program | 2, 3 |
| 5. | Discuss the science of primary, secondary, and tertiary prevention in population health, including health promotion, screening, etc. | 2, 6 |
| 6. | Explain the critical importance of evidence in advancing public health knowledge | 6, 8 |
| Factors Related to Human Health | ||
| 7. | Explain the effects of environmental factors on a population’s health | 1, 10–12 |
| 8. | Explain the biological and genetic factors that affect a population’s health | 1, 3 |
| 9. | Explain behavioral and psychological factors that affect a population’s health | 1, 6–8 |
| 10. | Explain the social, political, and economic determinants of health and how they contribute to population health and health inequities | 1 |
| 11. | Explain how globalization affects global burdens of disease | 1, 10 |
| 12. | Explain an ecological perspective on the connections among human health, animal health, and ecosystem health (e.g., One Health) | 1, 6, 10–12 |
| Evidence‐Based Approaches to Public Health | ||
| 13. | Apply epidemiological methods to the breadth of settings and situations in public health practice | 2, 3 |
| 14. | Select quantitative and qualitative data collection methods appropriate for a given public health context | 2–7 |
| 15. | Analyze quantitative and qualitative data using biostatistics, informatics, computer‐based programming, and software, as appropriate | 4–6 |
| 16. | Interpret results of data analysis for public health research, policy, or practice | 2–6 |
| Public Health and Health Care Systems | ||
| 17. | Discuss the organization, structure, and function of health care, public health, and regulatory systems across national and international settings | 13 |
| 18. | Discuss the means by which structural bias, social inequities, and racism undermine health and create challenges to achieving health equity at organizational, community, and societal levels | 13 |
| Planning & Management to Promote Health | ||
| 19. | Assess population needs, assets, and capacities that affect communities’ health | 6, 7 |
| 20. | Apply awareness of cultural values and practices to the design or implementation of public health policies or programs | 6, 8, 15 |
| 21. | Design a population‐based policy, program, project, or intervention | 7–10, 14 |
| 22. | Explain the basic principles and tools of budget and resource management | 14 |
| 23. | Select methods to evaluate public health programs | 8, 14 |
| Policy in Public Health | ||
| 24. | Discuss multiple dimensions of the policymaking process, including the roles of ethics and evidence | 9 |
| 25. | Propose strategies to identify stakeholders and build coalitions and partnerships for influencing public health outcomes | 9 |
| 26. | Advocate for political, social, or economic policies and programs that will improve health in diverse populations | 9 |
| 27. | Evaluate policies for their impact on public health and health equity | 14 |
| Leadership | ||
| 28. | Apply principles of leadership, governance, and management, which include creating a vision, empowering others, fostering collaboration, and guiding decision making | 15 |
| 29. | Apply negotiation and mediation skills to address organizational or community challenges | 15 |
| Communication | ||
| 30. | Select communication strategies for different audiences and sectors | 8 |
| 31. | Communicate audience‐appropriate public health content, both in writing and through oral presentation | 8 |
| 32. | Describe the importance of cultural competence in communicating public health content | 8, 15 |
| Interprofessional Practice | ||
| 33. | Perform effectively on interprofessional teams | 11–14 |
| Systems Thinking | ||
| 34. | Apply systems thinking tools to a public health issue | 15 |
In the second edition we have retained the practical features of the first edition which were appreciated and are as follows:
An instructor’s supplement is available at www.josseybass.com/go/sharma. Additional materials such as videos, podcasts, and readings can be found at www.josseybasspublichealth.com. Comments about this book are invited and can be sent to publichealth@wiley.com.
We hope you will like this comprehensive book and find it a useful resource in pursuing your community and public health goals. This is a book we hope you will keep as a reference throughout your career.
This book is accompanied by a companion website:
www.wiley.com/go/sharma/IntroductiontoCommunityPublicHealth2e
The website includes PowerPoint Slides and Test Banks.
Manoj Sharma, MBBS, Ph.D., MCHES® is a public health physician with a medical degree from the University of Delhi and a doctorate in Preventive Medicine (Public Health) from The Ohio State University. He is licensed to practice medicine and surgery anywhere in India by the Medical Council of India. He is also a master certified health education specialist certified from the National Commission on Health Education Credentialing. He has recently accepted a position as a tenured professor at the University of Nevada, Las Vegas in the School of Public Health. In his career, spanning over 30 years, he has trained/taught over 6,000 health professionals that include physicians, health education specialists, dietitians, community health nurses, health care administrators, epidemiologists, sanitarians, health and development workers, allied health professionals and others. He has designed and taught a variety of undergraduate and graduate courses in health behavior, health education, and health promotion at twelve national and international universities working full time or part-time (Jackson State University, University of Cincinnati, University of Nebraska at Omaha, University of Nebraska at Lincoln, University of Nebraska Medical Center, Southern Illinois University at Carbondale, Central Michigan University, Walden University, National University, The Ohio State University, Saint Mary's College of Minnesota and Minnesota State University, Mankato). He has worked for local health departments (City of Columbus, OH; Douglas County Health Department, NE; City of Cincinnati Health Department, OH, etc.); state health departments/agencies (OH, MS, NE, Ohio Commission on Minority Health, etc.); federal government agencies (Centers for Disease Control and Prevention – CDC, United States Environmental Protection Agency – USEPA, etc.); invited keynote presenter at universities (Chongqing Medical University, China; Lincoln Memorial University; University of Arkansas, University of Oklahoma); non-profit agencies (American Cancer Society, American Lung Association, Charles Drew Health Center, Indian Chicano Health Center, Voluntary Health Association of India, etc.); professional organizations (American Public Health Association, American School Health Association); and international agencies including governments of other nations (European Union, World Health Organization, Swiss Development Corporation, Government of Mongolia, Government of India, Associazione Italiana Amici di Raoul Follereau (Italy), etc.). He is a prolific researcher and as of January 2020 had published ten books, over 250 peer-reviewed research articles, and over 450 other publications and secured funding for over $4 million. He has been awarded several prestigious honors including the American Public Health Association's Mentoring Award, ICTHP Impact Award, William R. Gemma Distinguished Alumnus Award from College of Public Health Alumni Society at the Ohio State University and others. His research interests are in developing and evaluating theory-based health behavior change interventions, obesity prevention, stress-coping, community-based participatory research, and integrative mind-body-spirit interventions.
Paul Branscum, PhD, is an Associate Professor of Public Health in the Department of Kinesiology & Health at Miami University, in Oxford, OH. Dr. Branscum is a registered dietitian by initial training, earning his B.S. in Human Nutrition (2005) and M.S. in Nutrition Theories and Techniques of Behavior Change