Transcript History of Public Health

The History of
Public Health
Kristine M. Gebbie, DrPH, RN
Columbia University School of Nursing
Center for Health Policy
630 West 168th Street, Mail Box 6
New York, NY 10032
(212) 305-1794
[email protected]
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CAROLINA
AHEC
Developed as part of an
Enhanced AHEC
Community Partnership for
Health Professions
Workforce and Educational
Reform project funded by
the Health Resource and
Service Administration
(HRSA)
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CAROLINA
AHEC
OBJECTIVES
Describe mission, responsibilities and
core functions of public health
systems
 Identify essential services
 Identify important historical figures

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CAROLINA
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Definition of Health

The state of complete physical,
mental and social well-being and not
merely the absence of disease or
infirmity WHO, 1947
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CAROLINA
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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.
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CAROLINA
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Public Health System Activities

Health promotion

Disease prevention
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CAROLINA
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Prevention Triangles
Tertiary
Prevention
Secondary
Prevention
Tertiary
Medical Care
Secondary
Medical Care
Primary Medical Care
Clinical Preventive Services
Primary
Prevention
Population Oriented Prevention
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CAROLINA
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Ethical Values
of Public Health

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Beneficence
Non-malfeasance
Autonomy
Social justice
Truth-telling
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Balancing Ethical Conflicts
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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.
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CAROLINA
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Key Events
in the
History of Public Health
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Key Events
Did you know that . . .
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South Carolina had the first
provincial health officer in America,
in 1712?
South Carolina had its first water
protection regulations in 1671?
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CAROLINA
AHEC
Key Events
Snow and Cholera
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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
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CAROLINA
AHEC
Death Rates From Cholera 1853-54
Water
Company
Southwark &
Vauxhall
Both
Companies
Lambeth
Water
Company
Southwark
& Vauxhall
Lambeth
Rest of
London
Population
(1851)
Cholera Deaths
(1853-4)
Deaths per
100,000 Living
167,654
192
114
301,149
182
60
14,632
Number of
Houses
0
Deaths From
Cholera
0
Deaths per
10,000 Houses
40,046
1263
315
26,107
98
37
256,423
1422
59
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CAROLINA
AHEC
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?
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CAROLINA
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Massachusetts and the
Shattuck Report

Massachusetts and the Shattuck
Report


1850 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 Health

Established in 1898.
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CAROLINA
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US Public Health Service

Marine Hospital Service

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Created from concern for protection
against imported infectious diseases
and need to care for sick seamen
US Public Health Service

Uniformed service on call for local,
national or international service in the
protection of the public’s health
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CAROLINA
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The Muckrakers
and New Agencies
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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
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CAROLINA
AHEC
Great Public Health
Achievements of This Century
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Vaccination
Motor vehicle safety
Safer workplaces
Control of infectious
diseases
Decline in deaths
from coronary heart
disease and stroke
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Safer, healthier food
Healthier mothers and
babies
Family planning
Flouridation of
drinking water
Recognition of tobacco
as a hazard
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Discussion Time

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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?
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Summary
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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.
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CAROLINA
AHEC