EPH -1022 Communicable & Non-communicable diseases Case summary
Summary Case 1: From Hygiene to New Public Health – Communicable Diseases & NCDs
Learning goals:
1) What are communicable diseases? Which diseases are infectious, which also communicable?
2) What are non-communicable diseases, what are chronic diseases?
3) What is “New Public Health”?
a. How did the increase in knowledge lead to concepts like “New Public Health”?
b. What has changed in “Public health” over the last 150 – 200 years?
Communicable diseases Non-communicable diseases
Definition Diseases that are caused by infectious agents Diseases that are not transferred
and can be transmitted from an infected person from a person to another
to other people, animals or other sources in the
environment
Similarities Infectious: Chronic
&
Differences All communicable diseases are infectious A disease that is persistent or
long-lasting; more than at least a
Not all infections are communicable (e.g. year (CDC)
Tetanus)
Cause/ Pathogenic microorganisms (viruses, fungi, Lifestyle choices:
Agents bacteria) - Diet
- Physical activity
Spreading - Allergy
- Direct: infectious agent is transferred - Unhealthy behaviour
through close physical contact (smoking, alcohol …)
- Indirect: agent is transferred through
air, water or other vectors
Influenced by:
- Socioeconomic,
- Environmental,
- Behavioural factors
- International travel & migration
Inherited Cannot be inherited from one generation to Might be inherited from one
another generation to another
In horizontal transmission, pathogens (mainly
viruses) are transmitted among individuals of
the same generation, while vertical transmission
1
,EPH -1022 Communicable & Non-communicable diseases Case summary
occurs from mothers to their offspring.
neglected diseases: neglected (tropical) diseases
(NTDs), such as dengue, lymphatic filariasis,
trachoma, and leishmaniasis, are called
"neglected," because they generally afflict the
world's poor and historically have not received
as much attention as other diseases.
Impact Rise of NCDs
Worldwide: responsible for 70%
deaths
Europe: responsible for 86% of
deaths and 77% of disease
burden
Diabetes, Cardiovascular
disease, Cancer, Chronic
Respiratory Disease and
Mental health
Examples - HIV/AIDS - Cancer
- Hepatitis - Cardiovascular diseases
- Influenza - Chronic respiratory
- Measles diseases
- Poliomyelities - Diabetes
- Rotavirus - Mental health
- Typhoid - Alzheimer
- Sexually transmitted infections - Obesity
- Cholera
- Malaria
- Tuberculosis
- Leprosy
2
,EPH -1022 Communicable & Non-communicable diseases Case summary
Awofeso N. What’s new about the "new public health"?.Am J Public Health. 2004;94(5):705-709.
doi:10.2105/ajph.94.5.705
- 6 major approaches to public health practice
1) Public health as health protection,
mediated through societies social
structures (antiquity – 1830s)
2) The shaping of a distinct public health
discipline by the sanitary movement
(miasma control) (1840s – 1870s)
3) Public health as a contagion control
(1880s-1930s)
4) Public health as preventive medicine
(1940s-1960s)
5) Public health as primary health care
(1970s – 1980s)
6) The new public health – health promotion
(1990s – present)
Tulchinsky, T.H., Varavikova, E.A. What is the “New
Public Health”?Public Health Rev32,25–53 (2010). https://doi.org/10.1007/BF03391592
The new public health:
- An extension of the traditional public health
- To improve the health of individuals and populations
- Organized efforts of society: prevention, protection, promotion
- Addresses health inequalities
- Transdisciplinary and multi-organizational: evolves with new science, technology and
knowledge of human and system behaviour
- Political and practical application public policy
- Addresses contemporary health issues: climate change, rapid transmission of disease,
chronic diseases, antibiotic resistance, aging population
- Prevention > treatment
- Cross-disciplinary trainings of professionals
- Monitoring
3
, EPH -1022 Communicable & Non-communicable diseases Case summary
Summary Case 2: Epidemiological changes in Europe
1. What is the health status across Europe and how has it changed in the last decades?
a. Further discuss and compare Western and Eastern Europe.
2. How can different factors explain those changes?
3. What is the epidemiological transition theory?
4. Why has the original theory been criticized?
a. How has it been revised?
5. Why is use of a framework like the epidemiological transition useful?
What is the health status across Europe and how has it changed in the last decades?
a) Further discuss and compare Western and Eastern Europe.
Regions
- Western and Southern Europe (15 countries which were members of the EU before 2004)
- Central Europe (plus Malta and Cyprus – 13 countries which joined the EU after 2004)
- Eastern Europe and Central Asia (12 countries which formed the Commonwealth of
Independent States (CIS) after the fall of the Soviet Union)
- Health of EU population continues to increase
- Life expectancy has increased all over Europe - not steady
- Decrease in communicable diseases
- Advances in medicine (e.g. vacines)
- Women live on average longer than men
- Increase levels of obesity
- Increase in STDs (sexually transmitted diseases)
East-West Health Gap
- countries in the West: longest life expectancy; steady increase (6.3 years for males and 4.6
years for females)
o examples: 83,4 in Spain – 80,4 Denmark (2015)
o explanations: reduction in mortality in older ages; reduction of cardio-vascular
mortality
- countries in central Europe: medium life expectancy, high increase (6.4 years for males and
5.6 years for females)
o examples: 80 in Slovenia – 74,8 in Latvia and Lithuania
- countries in the East: lowest life expectancy; slowly increase (1.3 years for males and 2.1
years for females - over 25 years)
o 75,2 in Armenia to 70 in Russian Federation (2015)
o explanations: modest improvements by reductions in infant and premature
mortality; deterioration of socio-economic conditions, under financing and under-
development of health systems; deregulation and poor control of health hazards
(tobacco, alcohol, illicit drugs)
4
Summary Case 1: From Hygiene to New Public Health – Communicable Diseases & NCDs
Learning goals:
1) What are communicable diseases? Which diseases are infectious, which also communicable?
2) What are non-communicable diseases, what are chronic diseases?
3) What is “New Public Health”?
a. How did the increase in knowledge lead to concepts like “New Public Health”?
b. What has changed in “Public health” over the last 150 – 200 years?
Communicable diseases Non-communicable diseases
Definition Diseases that are caused by infectious agents Diseases that are not transferred
and can be transmitted from an infected person from a person to another
to other people, animals or other sources in the
environment
Similarities Infectious: Chronic
&
Differences All communicable diseases are infectious A disease that is persistent or
long-lasting; more than at least a
Not all infections are communicable (e.g. year (CDC)
Tetanus)
Cause/ Pathogenic microorganisms (viruses, fungi, Lifestyle choices:
Agents bacteria) - Diet
- Physical activity
Spreading - Allergy
- Direct: infectious agent is transferred - Unhealthy behaviour
through close physical contact (smoking, alcohol …)
- Indirect: agent is transferred through
air, water or other vectors
Influenced by:
- Socioeconomic,
- Environmental,
- Behavioural factors
- International travel & migration
Inherited Cannot be inherited from one generation to Might be inherited from one
another generation to another
In horizontal transmission, pathogens (mainly
viruses) are transmitted among individuals of
the same generation, while vertical transmission
1
,EPH -1022 Communicable & Non-communicable diseases Case summary
occurs from mothers to their offspring.
neglected diseases: neglected (tropical) diseases
(NTDs), such as dengue, lymphatic filariasis,
trachoma, and leishmaniasis, are called
"neglected," because they generally afflict the
world's poor and historically have not received
as much attention as other diseases.
Impact Rise of NCDs
Worldwide: responsible for 70%
deaths
Europe: responsible for 86% of
deaths and 77% of disease
burden
Diabetes, Cardiovascular
disease, Cancer, Chronic
Respiratory Disease and
Mental health
Examples - HIV/AIDS - Cancer
- Hepatitis - Cardiovascular diseases
- Influenza - Chronic respiratory
- Measles diseases
- Poliomyelities - Diabetes
- Rotavirus - Mental health
- Typhoid - Alzheimer
- Sexually transmitted infections - Obesity
- Cholera
- Malaria
- Tuberculosis
- Leprosy
2
,EPH -1022 Communicable & Non-communicable diseases Case summary
Awofeso N. What’s new about the "new public health"?.Am J Public Health. 2004;94(5):705-709.
doi:10.2105/ajph.94.5.705
- 6 major approaches to public health practice
1) Public health as health protection,
mediated through societies social
structures (antiquity – 1830s)
2) The shaping of a distinct public health
discipline by the sanitary movement
(miasma control) (1840s – 1870s)
3) Public health as a contagion control
(1880s-1930s)
4) Public health as preventive medicine
(1940s-1960s)
5) Public health as primary health care
(1970s – 1980s)
6) The new public health – health promotion
(1990s – present)
Tulchinsky, T.H., Varavikova, E.A. What is the “New
Public Health”?Public Health Rev32,25–53 (2010). https://doi.org/10.1007/BF03391592
The new public health:
- An extension of the traditional public health
- To improve the health of individuals and populations
- Organized efforts of society: prevention, protection, promotion
- Addresses health inequalities
- Transdisciplinary and multi-organizational: evolves with new science, technology and
knowledge of human and system behaviour
- Political and practical application public policy
- Addresses contemporary health issues: climate change, rapid transmission of disease,
chronic diseases, antibiotic resistance, aging population
- Prevention > treatment
- Cross-disciplinary trainings of professionals
- Monitoring
3
, EPH -1022 Communicable & Non-communicable diseases Case summary
Summary Case 2: Epidemiological changes in Europe
1. What is the health status across Europe and how has it changed in the last decades?
a. Further discuss and compare Western and Eastern Europe.
2. How can different factors explain those changes?
3. What is the epidemiological transition theory?
4. Why has the original theory been criticized?
a. How has it been revised?
5. Why is use of a framework like the epidemiological transition useful?
What is the health status across Europe and how has it changed in the last decades?
a) Further discuss and compare Western and Eastern Europe.
Regions
- Western and Southern Europe (15 countries which were members of the EU before 2004)
- Central Europe (plus Malta and Cyprus – 13 countries which joined the EU after 2004)
- Eastern Europe and Central Asia (12 countries which formed the Commonwealth of
Independent States (CIS) after the fall of the Soviet Union)
- Health of EU population continues to increase
- Life expectancy has increased all over Europe - not steady
- Decrease in communicable diseases
- Advances in medicine (e.g. vacines)
- Women live on average longer than men
- Increase levels of obesity
- Increase in STDs (sexually transmitted diseases)
East-West Health Gap
- countries in the West: longest life expectancy; steady increase (6.3 years for males and 4.6
years for females)
o examples: 83,4 in Spain – 80,4 Denmark (2015)
o explanations: reduction in mortality in older ages; reduction of cardio-vascular
mortality
- countries in central Europe: medium life expectancy, high increase (6.4 years for males and
5.6 years for females)
o examples: 80 in Slovenia – 74,8 in Latvia and Lithuania
- countries in the East: lowest life expectancy; slowly increase (1.3 years for males and 2.1
years for females - over 25 years)
o 75,2 in Armenia to 70 in Russian Federation (2015)
o explanations: modest improvements by reductions in infant and premature
mortality; deterioration of socio-economic conditions, under financing and under-
development of health systems; deregulation and poor control of health hazards
(tobacco, alcohol, illicit drugs)
4
