Transcript The History and Mission of Public Health

What is Public Health?
Public Health is
Healthy People in
Healthy Communities
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Definition of Public Health
• Public health is the science and art of
• Preventing disease.
• Prolonging life.
• Organizing community efforts for the:
• Sanitation of the environment.
• Control of communicable diseases.
• Education of the individual in personal hygiene.
• Organization of medical and nursing services for the early diagnosis
and preventive treatment of disease.
• Development of the social machinery to ensure everyone a
standard of living adequate for the maintenance of health.
(Winslow, 1923)
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“On Airs, Waters, and Places”
“ These things one ought to consider most attentively, and
concerning the waters which the inhabitants use, whether
they be marshy and soft, or hard, and running from
elevated and rocky situations, and then if saltish and unfit
for cooking; and the ground, whether it be naked and
deficient in water, or wooded and well watered, and
whether it lies in a hollow, confined situation, or is
elevated and cold; and the mode in which the inhabitants
live, and what are their pursuits, whether they are fond of
drinking and eating to excess, and given to indolence, or
are fond of exercise and labor, and not given to excess in
eating and drinking.”
Hippocrates, 400 BC, translated by Francis Adam
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Plague in Marseilles, 1720
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Death Rates 1860 – 1970
3500
Deaths per 100,000
Tuberculosis
3000
Whooping Cough
2500
Measles
2000
1500
1000
500
0
1860 1870 1880 1890 1900 1910 1920 1930 1940 1950 1960 1970
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Leading Causes of Death, 1990
Developed Nations
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Heart disease
Cerebrovascular disease
Cancer – lung, trachea
Lower respiratory infections
Chronic Obstructive
Pulmonary Disease
Cancer – colon, rectum
Cancer – stomach
Traffic accidents
Self-inflicted injuries
Diabetes
Developing Nations
1.
2.
3.
4.
5.
6.
7.
Lower respiratory infections
Heart disease
Cerebrovascular disease
Diarrhoeal diseases
Perinatal conditions
Tuberculosis
Chronic Obstructive Pulmonary
Disease
8. Measles
9. Malaria
10. Traffic accidents
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Twentieth Century
• Governmental Reform
• 1908 First Bureau of
Child Hygiene, New
York City Health Dept.
• Dr. Josephine Baker
• Appointed Bureau chief.
• Established school
nurse program.
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Representations (1800s)
Dickens
Daumier
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What are the Requirements
for Survival?
• Write down a list of critical things that
humans need.
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Mortality Rates U.S. vs % GNP
Spent on Medical Care, 1900-1970
8.5%
Total Mortality
Percent GNP on
Medical Care
15
7.5%
12.5
6.5%
10
5.5%
7.5
Mortality Minus
11 Infectious Diseases
3.5%
5
% GNP on Medical Care
Mortality rates per 1,000
17.5
4.5%
1900
1910
1920
1930
1940
1950
1960
1970
J. McKinley and S. McKinley, “The Questionable Contribution of Medical Measures to the Decline of Mortality
in the Twentieth Century.” Millbank Memorial Fund Quarterly 55 (1977): 413 Millbank Memorial
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New York State Courts
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Legal
Hierarchy
U.S. Constitution
U.S. Congress
Federal Agencies
State Constitution
State Legislatures
Local Health Dept.
Municipal Home Rule
State Agencies
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Legal Functions
Legislative Branch
Laws, Statutes,
Ordinances
Executive Branch
Rules, Regulations
Judicial Branch
Interpretations
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Examples
Host
Agent
Environment
Human
Human
Bacteria, Virus
Energy
Water, Food, Air
Automobile
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