Population HealthPopulation Healthforfor

Health ProfessionalsHealth Professionals

Module 1Module 1

The Perspective

of Public Health

Module I PurposeModule I Purpose

Present the public health perspective on health and illness at community level

Introduce basic vocabulary of public health

Establish framework for understanding specific skills and practices of public health in later modules

OBJECTIVESOBJECTIVES

Describe mission, responsibilities and core functions of public health systems

Identify essential servicesList key infrastructure componentsIdentify important historical figuresDescribe future trends

Part 1Part 1

The History

Of

Public Health

Definition of HealthDefinition of Health

The state of complete physical, mental and social well-being and not merely the absence of disease or infirmity WHO, 1947

Definition of Public 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.

Public Health System ActivitiesPublic Health System Activities

Health promotion

Disease prevention

Prevention TrianglesPrevention Triangles

Population Oriented Prevention

Clinical Preventive Services

Primary Medical Care

SecondaryMedical Care

TertiaryMedical CareTertiary

Prevention

SecondaryPrevention

PrimaryPrevention

Ethical ValuesEthical Valuesof Public Healthof Public Health

Beneficence Non-malfeasance Autonomy Social justice Truth-telling

Balancing Ethical ConflictsBalancing 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.

Key EventsKey Eventsin thein the

History of Public Health History of Public Health

Key EventsKey EventsDid you know that . . .Did you know that . . .

South Carolina had the first provincial health officer in America, in 1712?

South Carolina had its first water protection regulations in 1671?

Key EventsKey EventsSnow and CholeraSnow and Cholera

Epidemiology: mapping cases of cholera and household use of water sources revealed pattern involving a single water pump

Removing the handle from the Broad Street pump ended the epidemic

Death Rates From Cholera Death Rates From Cholera 1853-54 1853-54

WaterCompany

Population(1851)

Cholera Deaths(1853-4)

Deaths per100,000 Living

Southwark &Vauxhall

167,654 192 114

BothCompanies

301,149 182 60

Lambeth 14,632 0 0

WaterCompany

Number ofHouses

Deaths FromCholera

Deaths per10,000 Houses

Southwark& Vauxhall

40,046 1263 315

Lambeth 26,107 98 37Rest ofLondon

256,423 1422 59

Did you know that . . .Did you know that . . .

In an 1881 report the SC Board of Health identified swamp drainage as an important tool in stopping malaria, 10 years before the mosquito was identified as the specific vector of the disease?

Massachusetts and the Massachusetts and the Shattuck ReportShattuck Report

Massachusetts and the Shattuck Report1850 review of sanitation practices and the

potential for improving health status by enforcement of a sanitary code led to creation of local board of health in Massachusetts. This movement spread to other localities.

SC State Board of HealthEstablished in 1898.

US Public Health ServiceUS Public Health Service

Marine Hospital ServiceCreated from concern for protection

against imported infectious diseases and need to care for sick seamen

US Public Health ServiceUniformed service on call for local, national

or international service in the protection of the public’s health

The MuckrakersThe Muckrakersand New Agencies and New Agencies

Food and Drug Administration created to administer Pure Food, Drug and Cosmetic Act

Superfund administered by the Environmental Protection Agency

U.S. Department of Agriculture Occupational Safety & Health Act

Great Public Health Great Public Health Achievements of This CenturyAchievements of This Century

Vaccination Motor vehicle safety Safer workplaces Control of infectious

diseases Decline in deaths

from coronary heart disease and stroke

Safer, healthier food Healthier mothers

and babies Family planning Flouridation of

drinking water Recognition of

tobacco as a hazard

Discussion TimeDiscussion Time

What has been your personal awareness of public health?

Have you ever visited a public health program? Used a public health service?

What are current public health issues in your community?

Summary of Module 1, Part 1Summary of Module 1, Part 1

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.

Module AuthorModule Author

Kristine M. Gebbie, DrPH, RN

Columbia University School of Nursing

Center for Health Policy