Transcript comp1_unit7a_lecture_slides

Component 1: Introduction to Health
Care and Public Health in the U.S.
1.7: Public Health Part I
1.7a: History of Public Health in
the US
What is public health?
• Private Health
• Public Health
– Clinicians, Health
Practitioners
– Treat Individual Health
Problems
– Action usually taken
after illness/injury
occurs
Component 1/Unit 7a
– Agencies
– Treat/Maintain Health
of Populations
– Actions include
Education, Policy,
Research, Monitoring
Health IT Workforce Curriculum
Version1.0/Fall 2010
2
Determination of Public Health
Interest
In order for a condition to realistically be of interest to public health, it usually
needs to match some degree of each of the following criteria:
The condition/disease must be a) severe enough in its effects to warrant some
type of intervention/monitoring, b) preventable or at least able to be mitigated
by health interventions, behavioral modifications, etc., and c) prevalent
enough in the population to warrant some type of intervention/monitoring.
Severity
Preventability
Component 1/Unit 7a
Prevalence
Health IT Workforce Curriculum
Version1.0/Fall 2010
3
History of Public Heath in the US
The Official Beginning
1798: An act passed that established a federal network of hospitals
for ill/disabled merchant seamen. The Federal government deducted
monthly sums from seamen’s wages. This act was widely
considered to have laid the foundation for the national public health
service.
(Note: Public Health had earlier beginnings in other parts of the world,
which are not addressed here)
Component 1/Unit 7a
Health IT Workforce Curriculum
Version1.0/Fall 2010
4
History of Public Heath in the US
1800’s
• 1800: Technique of smallpox vaccination introduced into the US
• 1878: National Quarantine Act passed, starting transfer of
quarantine functions from state to federal level (at that time, the
Marine Hospital Service).
• 1891: Immigration legislation passed, assigning medical
examination of immigrants to the Marine Hospital Service. Wording
of the law directed the exclusion of “all idiots, insane persons,
paupers or persons likely to become public charges, persons
suffering from a loathsome or dangerous contagious disease“ (and
also criminals).
• 1893: First US school of public health and preventive medicine
established, the Army Medical School (renamed Walter Reed Army
Institute of Research in 1953).
Component 1/Unit 7a
Health IT Workforce Curriculum
Version1.0/Fall 2010
5
History of Public Heath in the US
1900 - 1944
• 1900: Pneumonia and influenza are leading causes of death in the
US.
• 1902: The Marine Hospital Service changed to the Public Health
and Marine Hospital Service. In 1912, renamed the Public Health
Service.
• 1910: The high rate of tuberculosis in the garment industry was one
of the triggers leading to the entry of the Public Health Service into
the arena of workplace health and safety.
• 1916: First non-military school of public health in the US established
at Johns Hopkins University (enabled by Rockefeller Foundation
grant).
• 1921: Bureau of Indian Affairs Health Division created (Predecessor
of the Indian Health Service).
• 1935-40: Passage of the Social Security Act and the Federal Food,
Drug and Cosmetic Act.
• 1944: Massive use of penicillin drastically changes treatment of
infections and STDs.
Component 1/Unit 7a
Health IT Workforce Curriculum
Version1.0/Fall 2010
6
History of Public Heath in the US
1946:
• Establishment of the Communicable Disease Center,
predecessor of the Centers for Disease Control and Prevention
(CDC)
– The CDC’s overwhelming first focus was mosquito control to fight
malaria, primarily through application of the pesticide DDT
– The new center was actually an outgrowth of the wartime agency
MAWA - Malaria Control in War Areas
• From that beginning, CDC grew into its current emphases of working
with states and other partners to monitor and prevent outbreaks,
maintain national health statistics, and to prevent and control
infectious and chronic diseases, injuries, and environmental health
hazards.
Component 1/Unit 7a
Health IT Workforce Curriculum
Version1.0/Fall 2010
7
History of Public Heath in the US
1950’s
• 1953: Creation of the Department of Health, Education and Welfare.
In 1979, the Department of Education was split off, leaving the
separate Department of Health and Human Services (HHS).
• 1955: Salk polio vaccine licensed. Indian Health Service moved to
HHS.
Component 1/Unit 7a
Health IT Workforce Curriculum
Version1.0/Fall 2010
8
History of Public Heath in the US
1960’s
• 1961-69: Migrant Health Act passed, providing clinics for agricultural
workers. The first Surgeon General’s Report on Smoking released.
Medicare and Medicaid programs were created. Older Americans
Act created social and nutritional programs. Head Start program
created. International Smallpox Eradication program established.
• 1967: CDC assumes foreign quarantine functions.
• 1969: CDC provided quarantine procedures, equipment, for the
Apollo moon landings and other US space travels.
Component 1/Unit 7a
Health IT Workforce Curriculum
Version1.0/Fall 2010
9
History of Public Heath in the US
1970’s
• 1970-1979: National Health Service Corps created. National Cancer
Act passed.
• Worldwide eradication of smallpox in 1977.
• Health Care Financing Administration created to manage Medicare
and Medicaid.
Component 1/Unit 7a
Health IT Workforce Curriculum
Version1.0/Fall 2010
10
History of Public Heath in the US
1980’s
• AIDS-HIV
– 1981 – AIDS identified
– 1984 – HIV virus identified by PHS and French scientists
– 1985 – HIV detection blood test licensed
• Also, passage of National Organ Transplantation Act and McKinney
Act (health care for homeless). Agency for Health Care Policy and
Research created.
Component 1/Unit 7a
Health IT Workforce Curriculum
Version1.0/Fall 2010
11
History of Public Heath in the US
1990’s
• Human Genome Project established; Nutrition Labeling and
Education Act passed; Ryan White Comprehensive AIDS Resource
Emergency (CARE) Act began providing support for people with
AIDS; establishment of Vaccines for Children Program (free
immunizations to children in low-income families); Enactment of the
Health Insurance Portability and Accountability Act (HIPAA); State
Children's Health Insurance Program (SCHIP) created (enabling
states to extend health coverage to more uninsured children).
Component 1/Unit 7a
Health IT Workforce Curriculum
Version1.0/Fall 2010
12
History of Public Heath in the US
2000-2009
• Human genome sequencing published; HHS responds to anthrax
bioterrorism attack; creation of Office of Public Health Emergency
Preparedness; Medicare Prescription Drug Improvement and
Modernization Act of 2003 expands Medicare
• American Recovery and Reinvestment Act (ARRA) of 2009 includes
the HITECH stimulus opportunity.
Component 1/Unit 7a
Health IT Workforce Curriculum
Version1.0/Fall 2010
13