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Health Impact Pyramid

The Health Impact Pyramid


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From CDC's Director Dr. Thomas Friedan's article, "A Framework for Public Health Action: The Health Impact Pyramid"

Levels of Intervention

Levels of Intervention

View "Levels of Intervention" in Part 1, Chapter 4 of link above

  • Primary - seeks to prevent disease or injury through reduction of risk factors.  This can be active (requiring individuals to act - ex. mandating vaccination before school entry) or passive (changing the default to a healthier option - ex. flouridation of water).   
  • Secondary - early detection of disease such as through screening of individuals (ex. mobile mammogram programs) or data collection and reporting (ex. reportable diseases sent from hospitals to local or state public health)  
  • Tertiary - once the disease or injury exists, reducing the impact (ex. isolating someone who is contagious to prevent spread to others) or improving the health outcomes (ex. maintenance of diabetes through healthy eating education programs)


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The 10 Essential Public Health Services


The 10 Essential Public Health Services (EPHS) describe the public health activities that all communities should undertake. For the past 25 years, the EPHS have served as a well-recognized framework for carrying out the mission of public health. The EPHS framework was originally released in 1994 and more recently updated in 2020. The revised version is intended to bring the framework in line with current and future public health practice.

The 10 Essential Public Health Services serves as a framework of the ideal strategies towards which all communities should strive to best address the public's health. The legal component of Public Health becomes increasingly important. Note that the 5th and 6th essential public health services are respectively "create, champion, and implement policies, plans, and laws that impact health," and "utilize legal and regulatory actions designed to improve and protect the public’s health."

Disclaimer: The views and opinions of the authors expressed herein do not necessarily state or reflect those of the State of Georgia, and shall not be used for advertising or product endorsement purposes. Georgia State University College of Law and the authors of the works contained on this website do not assume or accept any legal liability or responsibility for the accuracy, currentness, or comprehensiveness of the content on this website. The content on this website does not in any manner constitute the issuance of legal advice or counsel. The information on this website is intended to provide resources that may aid the research of the topics presented, and are in no way a comprehensive list of sources one should consult on the topics presented. Please note that case law, statutory law, and administrative law may be modified and/or overturned. Additionally, because the laws vary between jurisdictions, the laws referred to herein may or may not be applicable to the law within the reader’s jurisdiction.