The History ofPublic Health : Dr. Deryck D. Pattron, Ph.D. The History ofPublic Health Definition of Health : The state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Definition of Health Definition of Public Health : Activities that society undertakes to assure the conditions in which people can be healthy, including organized community efforts to prevent, identify and counter threats to the health of the public. Definition of Public Health Public Health System Activities : Education.
Legislation. Public Health System Activities Levels of Prevention : Levels of Prevention Tertiary
Prevention Ethical Values of Public Health : Beneficence
Truth-telling Ethical Values of Public Health Balancing Ethical Conflicts : Public health practice is always struggling to find the correct balance between respect for individual autonomy and decision making and the need for limitations on individuals in order to achieve social justice and equity. Balancing Ethical Conflicts Key Eventsin theHistory of Public Health : Key Eventsin theHistory of Public Health Key EventsDid you know that . . . : From the beginnings of human civilization, it was recognized that polluted water and lack of proper waste disposal spread communicable diseases (theory of miasma). Key EventsDid you know that . . . Did you know that… : Early religions attempted to regulate behavior that specifically related to health, from types of food eaten, to regulating certain indulgent behaviors, such as drinking alcohol or sexual relations. Did you know that… Did you know that… : The establishment of governments placed responsibility on leaders to develop public health policies and programmes in order to gain some understanding of the causes of disease and thus ensure social stability prosperity, and maintain order. Did you know that… Early public health interventions : By Roman times, it was well understood that proper diversion of human waste was a necessary tenet of public health in urban areas.
The Chinese developed the practice of variolation following a smallpox epidemic around 1000 BC.
The practice of vaccination did not become prevalent until the 1820s, following the work of Edward Jenner to treat smallpox. Early public health interventions Early public health interventions : During the 14th century Black Death in Europe, it was believed that removing bodies of the dead would further prevent the spread of the bacterial infection.
The development of quarantine in the medieval period helped mitigate the effects of other infectious diseases.
A Cholera pandemic devastated Europe between 1829 and 1851. Early public health interventions Early Public Health Interventions : The science of epidemiology was founded by John Snow's identification of a polluted public water well as the source of an 1854 cholera outbreak in London.
Dr. Snow believed in the germ theory of disease as opposed to the prevailing miasma theory.
The modern era of public health did not begin until the 1880s, with Louis Pasteur's germ theory and production of artificial vaccines. Early Public Health Interventions Other Public Health Interventions : Latrinization, and the building of sewers.
the regular collection of garbage followed by incineration or disposal in a landfill.
Providing clean water and draining standing water to prevent the breeding of mosquitoes.
Edwin Chadwick in 1843 who published a report on the sanitation of the working class began the inception of the modern public health.
The industrial revolution had initially caused the spread of disease Other Public Health Interventions Modern Public Health : As the prevalence of infectious diseases in the developed world decreased through the 20th century, public health began to put more focus on chronic diseases such as cancer and heart disease. An emphasis on physical exercise was reintroduced. Modern Public Health Modern Public Health : During the 20th century, the dramatic increase in average life span:
Vaccination programmes and control of infectious diseases.
Effective safety policies such as motor vehicle and occupational safety.
Improved family planning.
Fluoridation of drinking water.
programmes designed to decrease chronic disease. Modern Public Health Challenges of Modern Public Health: Developed & Developing Countries : The developing world remained plagued by largely preventable infectious diseases, exacerbated by malnutrition and poverty.
Emerging infectious diseases such as HIN1, H5N1, SARS.
Increased incidence of HIV-AIDS among young heterosexual women and men.
Increase incidence of childhood obesity and the concomitant increase in type II diabetes among children.
The impact of adolescent pregnancy. Challenges of Modern Public Health: Developed & Developing Countries Changing Approaches of Public Health : The focus of public health from individual behaviors and risk factors to population level.
Addressing issues such as inequality, poverty, and education.
Recognition that health is affected where we live, genetics, our income, our educational status and our social relationships - these are known as "social determinants of health.
The new public health seeks to address health inequalities by advocating for population-based policies that improve health in an equitable manner. Changing Approaches of Public Health Some of the Great Public Health Achievements of This Century : Vaccination.
Improvement in primary health care and services.
Motor vehicle safety.
Control of communicable diseases.
Decline in deaths from coronary heart disease and stroke. Safer, healthier food or better means of informing the public about unhealthy foods.
Healthier mothers and babies.
Fluoridation of drinking water.
Recognition of tobacco as a hazard. Some of the Great Public Health Achievements of This Century Summary : Public Health:
Services were developed to address the health needs of communities.
Has developed a world view of health.
Focuses on populations rather than individuals. Summary Assessment 1 : Identify important historical figures and their contributions in the development of public health in Trinidad and Tobago.
What has been your personal awareness of public health?
What are current public health issues in your community?
Describe the mission, responsibilities and core functions of public health systems.
Identify essential public health services. Assessment 1 References : Brandt, A. M., and M. Gardner. 2000. Antagonism and Accommodation: Interpreting the Relationship Between Public Health and Medicine in the United States During the Twentieth Century. American Journal of Public Health 90:707 – 715.
Winslow, C.E.A. 1920. “The Untilled Fields of Public Health,” Science.
Willinson, R. and Marmot, M. ed. 2003. The Solid Facts: Social Determinants of Health. WHO.
White, K. L. 1991. Healing the schism: Epidemiology, medicine, and the public's health. New York: Springer-Verlag. References