7/30/2019 History of PH-2

1/22

Health (WHO)

as a state of complete physical, mentaland social well-being and not merely theabsence of disease or infirmity

http://en.wikipedia.org/wiki/World_Health_Organizationhttp://en.wikipedia.org/wiki/World_Health_Organization

7/30/2019 History of PH-2

2/22

Public Health (C.E.A. Winslow, 1920)

The science and art of preventingdisease, prolonging life and

promoting health through the

organized efforts and informedchoices of society, organizations,

public and private, communities

and individuals.

http://en.wikipedia.org/wiki/Charles-Edward_Amory_Winslowhttp://en.wikipedia.org/wiki/Healthhttp://en.wikipedia.org/wiki/Healthhttp://en.wikipedia.org/wiki/Charles-Edward_Amory_Winslow

7/30/2019 History of PH-2

3/22

Two characteristics of PH

1.Preventive > curative

2.Population-level > individual-level

7/30/2019 History of PH-2

4/22

Prevention

Surveillance of cases

Promotion of healthy behaviors

Treating a disease Vaccination programs

Distribution of condoms

http://en.wikipedia.org/wiki/Vaccinationhttp://en.wikipedia.org/wiki/Condomhttp://en.wikipedia.org/wiki/Condomhttp://en.wikipedia.org/wiki/Vaccination

7/30/2019 History of PH-2

5/22

PH modern concept

Theory of Miasmabeginnings of human civilization polluted water andlack of proper waste disposal spread communicablediseases

Regulate behavior that specifically related to health,from types of food eaten, to regulating certainindulgent behaviors, such as drinking alcohol orsexual relations

The establishment of governments placedresponsibility on leaders to develop public healthpolicies and programs in order to gain someunderstanding of the causes of disease and thusensure social stability prosperity, and maintain order

http://en.wikipedia.org/wiki/Governmenthttp://en.wikipedia.org/wiki/Leadershiphttp://en.wikipedia.org/wiki/Diseasehttp://en.wikipedia.org/wiki/Wealthhttp://en.wikipedia.org/wiki/Wealthhttp://en.wikipedia.org/wiki/Diseasehttp://en.wikipedia.org/wiki/Leadershiphttp://en.wikipedia.org/wiki/Government

7/30/2019 History of PH-2

6/22

By Roman times, proper diversion of human wastewas a necessary tenet of public health in urbanareas.

The Chinese developed the practice of variolation

following a smallpox epidemic around 1000 BC.immunity:

by inhaling the dried crusts that formed aroundlesions of infected individuals,by inoculating a scratch on their forearms with the

pus from a lesion (early-1700s not documented) Vaccination did not become prevalent until the

1820s, following the work of Edward Jenner to treatsmallpox

http://en.wikipedia.org/wiki/Ancient_Romehttp://en.wikipedia.org/wiki/Waste_managementhttp://en.wikipedia.org/wiki/History_of_Chinahttp://en.wikipedia.org/wiki/Variolationhttp://en.wikipedia.org/wiki/Smallpoxhttp://en.wikipedia.org/wiki/Inoculationhttp://en.wikipedia.org/wiki/Vaccinationhttp://en.wikipedia.org/wiki/Edward_Jennerhttp://en.wikipedia.org/wiki/Smallpoxhttp://en.wikipedia.org/wiki/Smallpoxhttp://en.wikipedia.org/wiki/Edward_Jennerhttp://en.wikipedia.org/wiki/Vaccinationhttp://en.wikipedia.org/wiki/Inoculationhttp://en.wikipedia.org/wiki/Smallpoxhttp://en.wikipedia.org/wiki/Variolationhttp://en.wikipedia.org/wiki/History_of_Chinahttp://en.wikipedia.org/wiki/Waste_managementhttp://en.wikipedia.org/wiki/Ancient_Rome

7/30/2019 History of PH-2

7/22

14th century Black Death in Europe, it was

believed that removing bodies of the dead

would further prevent the spread of the

bacterial infection. This did little to stem the

plague, however, which was most likely

spread by rodent-borne fleas.

burning

quarantine

http://en.wikipedia.org/wiki/Black_Deathhttp://en.wikipedia.org/wiki/Europehttp://en.wikipedia.org/wiki/Rodenthttp://en.wikipedia.org/wiki/Fleahttp://en.wikipedia.org/wiki/Fleahttp://en.wikipedia.org/wiki/Rodenthttp://en.wikipedia.org/wiki/Europehttp://en.wikipedia.org/wiki/Black_Death

7/30/2019 History of PH-2

8/22

A Cholera pandemic, Europe 1829 and 1851,

Foucault called "social medicine", which focused

on flux, circulation of air, location ofcemeteries,

etc. All those concerns, born of the miasmatheory of disease, were mixed with urbanistic

concerns for the management of populations,

which Foucault designated as the concept of

"biopower". The German conceptualized this inthe Polizeiwissenschaft("Science of police").

http://en.wikipedia.org/wiki/Cemeterieshttp://en.wikipedia.org/wiki/Miasma_theory_of_diseasehttp://en.wikipedia.org/wiki/Miasma_theory_of_diseasehttp://en.wikipedia.org/wiki/Urbanismhttp://en.wikipedia.org/wiki/Biopowerhttp://en.wikipedia.org/wiki/Polizeiwissenschafthttp://en.wikipedia.org/wiki/Polizeiwissenschafthttp://en.wikipedia.org/wiki/Biopowerhttp://en.wikipedia.org/wiki/Urbanismhttp://en.wikipedia.org/wiki/Miasma_theory_of_diseasehttp://en.wikipedia.org/wiki/Miasma_theory_of_diseasehttp://en.wikipedia.org/wiki/Cemeteries

7/30/2019 History of PH-2

9/22

The science ofepidemiology was founded by JohnSnow's identification of a polluted public water well asthe source of an 1854 cholera outbreak in London. Dr.Snow believed in the germ theory of disease as opposedto the prevailing miasma theory. Although miasma theory

correctly teaches that disease is a result of poorsanitation, it was based upon the prevailing theory ofspontaneous generation. Germ theory developed slowly:despiteAnton van Leeuwenhoek's observations ofMicroorganisms, (which are now known to cause many

of the most common infectious diseases) in the year1680, the modern era of public health did not begin untilthe 1880s, with Louis Pasteur's germ theory andproduction of artificial vaccines.

http://en.wikipedia.org/wiki/Epidemiologyhttp://en.wikipedia.org/wiki/John_Snow_(physician)http://en.wikipedia.org/wiki/John_Snow_(physician)http://en.wikipedia.org/wiki/Cholerahttp://en.wikipedia.org/wiki/Germ_theoryhttp://en.wikipedia.org/wiki/Miasma_theory_of_diseasehttp://en.wikipedia.org/wiki/Spontaneous_generationhttp://en.wikipedia.org/wiki/Anton_van_Leeuwenhoekhttp://en.wikipedia.org/wiki/Microorganismshttp://en.wikipedia.org/wiki/Louis_Pasteurhttp://en.wikipedia.org/wiki/Vaccinehttp://en.wikipedia.org/wiki/Vaccinehttp://en.wikipedia.org/wiki/Louis_Pasteurhttp://en.wikipedia.org/wiki/Microorganismshttp://en.wikipedia.org/wiki/Anton_van_Leeuwenhoekhttp://en.wikipedia.org/wiki/Spontaneous_generationhttp://en.wikipedia.org/wiki/Miasma_theory_of_diseasehttp://en.wikipedia.org/wiki/Germ_theoryhttp://en.wikipedia.org/wiki/Cholerahttp://en.wikipedia.org/wiki/John_Snow_(physician)http://en.wikipedia.org/wiki/John_Snow_(physician)http://en.wikipedia.org/wiki/Epidemiology

7/30/2019 History of PH-2

10/22

Other public health interventions include latrinization, thebuilding ofsewers, the regular collection of garbagefollowed by incineration or disposal in a landfill, providingclean water and draining standing water to prevent thebreeding of mosquitos. This contribution was made by

Edwin Chadwick in 1843 who published a report on thesanitation of the working class population in Great Britainat the time. So began the inception of the modern publichealth. The industrial revolution had initially caused thespread of disease through large conurbations around

workhouses and factories. These settlements werecramped and primitive and there was no organisedsanitation. Disease was innevitable and its incubation inthese areas was encouraged by the poor lifestyle of theinhabitants

http://en.wikipedia.org/wiki/Sanitary_sewerhttp://en.wikipedia.org/wiki/Landfillhttp://en.wikipedia.org/wiki/Landfillhttp://en.wikipedia.org/wiki/Sanitary_sewer

7/30/2019 History of PH-2

11/22

Modern PH

As the prevalence ofinfectious diseases in

the developed world decreased through

the 20th century, public health began to

put more focus on chronic diseases suchas cancer and heart disease. An emphasis

on physical exercise was reintroduced.[ ..

http://en.wikipedia.org/wiki/Infectious_disease_in_the_20th_centuryhttp://en.wikipedia.org/wiki/Infectious_disease_in_the_20th_centuryhttp://en.wikipedia.org/wiki/Infectious_disease_in_the_20th_centuryhttp://en.wikipedia.org/wiki/Infectious_disease_in_the_20th_centuryhttp://en.wikipedia.org/wiki/Infectious_disease_in_the_20th_centuryhttp://en.wikipedia.org/wiki/Infectious_disease_in_the_20th_century

7/30/2019 History of PH-2

12/22

In America, public health worker Dr. SaraJosephine Bakerlowered the infant mortalityrate using preventative methods. Sheestablished many programs to help the poor inNew York City keep their infants healthy. Dr.Baker led teams of nurses into the crowdedneighborhoods ofHell's Kitchen and taughtmothers how to dress, feed, and bathe their

babies. AfterWorld War I many states andcountries followed her example in order to lowerinfant mortality rates

http://en.wikipedia.org/wiki/Sara_Josephine_Bakerhttp://en.wikipedia.org/wiki/Sara_Josephine_Bakerhttp://en.wikipedia.org/wiki/Hell%27s_Kitchen,_Manhattanhttp://en.wikipedia.org/wiki/World_War_Ihttp://en.wikipedia.org/wiki/World_War_Ihttp://en.wikipedia.org/wiki/Hell%27s_Kitchen,_Manhattanhttp://en.wikipedia.org/wiki/Sara_Josephine_Bakerhttp://en.wikipedia.org/wiki/Sara_Josephine_Baker

7/30/2019 History of PH-2

13/22

During the 20th century, the dramaticincrease in average life span is widelycredited to public health achievements,

such as vaccination programs and controlof infectious diseases, effective safetypolicies such as motor-vehicle andoccupational safety, improved family

planning, fluoridation of drinking water,anti-smoking measures, and programsdesigned to decrease chronic disease.

http://en.wikipedia.org/wiki/Family_planninghttp://en.wikipedia.org/wiki/Family_planninghttp://en.wikipedia.org/wiki/Fluoridationhttp://en.wikipedia.org/wiki/Fluoridationhttp://en.wikipedia.org/wiki/Family_planninghttp://en.wikipedia.org/wiki/Family_planning

7/30/2019 History of PH-2

14/22

Meanwhile, the developing world remained plagued bylargely preventable infectious diseases, exacerbated bymalnutrition and poverty. Front-page headlines continueto present society with public health issues on a dailybasis: emerging infectious diseases such as SARS,

making its way from China (see Public health in China)to Canada and the United States; prescription drugbenefits under public programs such as Medicare; theincrease of HIV-AIDS among young heterosexualwomen and its spread in South Africa; the increase of

childhood obesity and the concomitant increase in type IIdiabetes among children; the impact of adolescentpregnancy; and the ongoing social, economic and healthdisasters related to the 2004 Tsunami and HurricaneKatrina in 2005.

http://en.wikipedia.org/wiki/Malnutritionhttp://en.wikipedia.org/wiki/Public_health_in_Chinahttp://en.wikipedia.org/wiki/Childhood_obesityhttp://en.wikipedia.org/wiki/Childhood_obesityhttp://en.wikipedia.org/wiki/Public_health_in_Chinahttp://en.wikipedia.org/wiki/Malnutrition

7/30/2019 History of PH-2

15/22

Since the 1980s, the growing field ofpopulation health hasbroadened the focus of public health from individual behaviors andrisk factors to population-level issues such as inequality, poverty,and education. Modern public health is often concerned withaddressing determinants of health across a population, rather thanadvocating for individual behaviour change. There is a recognition

that our health is affected by many factors including where we live,genetics, our income, our educational status and our socialrelationships - these are known as "social determinants of health." Asocial gradient in health runs through society, with those that arepoorest generally suffering the worst health. However even those inthe middle classeswill generally have worse health outcomes thanthose of a higher social stratum.[4] The newpublic health seeks toaddress these health inequalities by advocating for population-based policies that improve health in an equitable manner

http://en.wikipedia.org/wiki/Population_healthhttp://en.wikipedia.org/wiki/Risk_factorhttp://en.wikipedia.org/wiki/Public_healthhttp://en.wikipedia.org/wiki/Public_healthhttp://en.wikipedia.org/wiki/Risk_factorhttp://en.wikipedia.org/wiki/Population_health

7/30/2019 History of PH-2

16/22

six core disciplines ofbiostatistics,

epidemiology, health services

administration, health education,

behavioral science and environmentalscience.[5][9]

http://en.wikipedia.org/wiki/Biostatisticshttp://en.wikipedia.org/wiki/Epidemiologyhttp://en.wikipedia.org/wiki/Health_administrationhttp://en.wikipedia.org/wiki/Health_administrationhttp://en.wikipedia.org/wiki/Health_educationhttp://en.wikipedia.org/wiki/Behavioral_sciencehttp://en.wikipedia.org/wiki/Environmental_sciencehttp://en.wikipedia.org/wiki/Environmental_sciencehttp://en.wikipedia.org/wiki/Public_healthhttp://en.wikipedia.org/wiki/Public_healthhttp://en.wikipedia.org/wiki/Public_healthhttp://en.wikipedia.org/wiki/Environmental_sciencehttp://en.wikipedia.org/wiki/Environmental_sciencehttp://en.wikipedia.org/wiki/Behavioral_sciencehttp://en.wikipedia.org/wiki/Health_educationhttp://en.wikipedia.org/wiki/Health_administrationhttp://en.wikipedia.org/wiki/Health_administrationhttp://en.wikipedia.org/wiki/Epidemiologyhttp://en.wikipedia.org/wiki/Biostatistics

7/30/2019 History of PH-2

17/22

History of PH

Health & illness from pop perspective

how the organization of societies facilitates

or mitigates the production and

transmission of disease

how do populations and groups of

individuals go about securing their health

Working inward from the environment

individual

7/30/2019 History of PH-2

18/22

We will concentrate primarily on the

modern world (i.e., 1750 onwards) and

omit detailed examination of public health

in antiquity and the middle ages, althoughthese time periods will be alluded to

frequently.

7/30/2019 History of PH-2

19/22

Recurrent themes in the history of publichealth will be highlighted, such as therelationship between humans and the

environment, the role of urbanization, theshifting interpretation of disease causation,the significance of bacteriology, thechanging epidemiological panorama, and

the problems of measuring the impact ofpublic health on the health status of thepopulation.

7/30/2019 History of PH-2

20/22

Quarantine is a public health policy that

can be traced to the Black Death of the

14th century. Towns and cities developed

systems of quarantine to isolated travelersand merchandise that came from places

known to be infected.

7/30/2019 History of PH-2

21/22

The second quarter of the nineteenth century is

widely regarded as the period in which state

medicine came of age. Originating in western

Europe and inextricably linked with the name ofthe British lawyer Edwin Chadwick, the basis of

the sanitary idea was the creation of a central

public health administration which directed local

authorities in the provision of drains, sewers,street cleaning and the environmental regulation

of housing, nuisances and offensive trades.

7/30/2019 History of PH-2

22/22

since 1977, smallpox has been globally

eradicated. It is one ofthemost tangible

successes for public health.