BASIC CONCEPT OF PUBLIC HEALTH

(3)

(History and Development of PH)

Oleh:
Prof. H. Didik Sarudji, M.Sc.
SEJARAH dan PERKEMBANGAN PH

A. RUMUSAN PH
RUMUSAN PH B. POKOK PERHATIAN
C. CENTRE FOR DISEASES CONTROL (10 Anjuran
POKOK PERH CDC)
D. SEJARAH PERKEMBANGAN DI INDONESIA
CD CONTROL
E. PENGARUH GLOBAL CLIMATE CHANGE THD PH
PH DIINDONESIA

GLO CL CHANGE
A. AWAL RUMUSAN PH (1920)

RUMUSAN PH

RUMUSAN PH
Charles-Edward A. Winslow,
A bacteriologist and professor of public health at the Yale
POKOK PERH School of Medicine from 1915 to 1945,
Proposed a definition of public health as :
CD CONTROL the science and art of preventing disease, prolonging life,
and promoting physical health and efficiency through
PH DIINDONESIA organized community efforts for the sanitation of the
environment, the control of community infections, the
GLO CL CHANGE education of the individual in principles of personal
hygiene, [and] the organization of medical and nursing
service for the early diagnosis and preventive treatment
of disease.
B. POKOK PERHATIAN

1. PENCEMARAN LINGKUNGAN
RUMUSAN PH
a. It has long been recognized that polluted water and air,
inadequate waste disposal, overcrowding and a
concomitant lack of hygiene, and lifestyle behavior
POKOK PERH contributed to the spread of disease.
b. Movingaway from the miasma theory of disease, which
CD CONTROL
argues that most diseases are caused by miasma
(Greek for ‘‘pollution,’’ that is, a noxious form of ‘‘bad
PH DIINDONESIA air’’),

GLO CL CHANGE
.

2. GERM THEORY OF DISEASE

a. to the germ theory of disease was an important step in
RUMUSAN PH disease prevention.
b. Hungarian physician Ignaz Semmelweis, for example,
POKOK PERH successfully reduced infant mortality at a Vienna
hospital by instituting a disinfection procedure.
CD CONTROL • His findings were published in 1850, but his work
was ill received by his colleagues, who unwisely
PH DIINDONESIA discontinued the procedure.
• Disinfection did not become widely practiced
GLO CL CHANGE c. until British surgeon Joseph Lister ‘‘discovered’’
antiseptics in 1865, helped significantly by the work of
the French chemist and microbiologist Louis Pasteur
and German physician and bacteriologist Robert Koch.
.

3. PERATURAN PENGAWASAN INDUSTRI MAKANAN

DAN OBAT dan KESEHATAN KERJA
RUMUSAN PH
a. The book dealt with conditions in the U.S. meat-packing
industry, causing a public uproar that partly
POKOK PERH contributed to the passage of the Pure Food and Drug
Act and the Meat Inspection Act in 1906.
CD CONTROL b. High rates of occupational injuries and occupational-
related diseases led to programs for industrial hygiene
and occupational health,
PH DIINDONESIA
c. U.S. Occupational Safety and Health Administration
(OSHA) created the Occupational Safety and Health
GLO CL CHANGE Act. Its mission is to prevent work-related injuries,
illnesses, and occupational fatality by issuing and
enforcing rules called standards for workplace safety
and health.
.

4. UKM YANG SECARA DRAMATIK MENURUNKAN

ANGKA KEMATIAN
RUMUSAN PH

POKOK PERH a. From 1900 to 1940, for example, mortality rates in the
U.S. fell by 40 percent, and life expectancy at birth
CD CONTROL increased from 47 years to 63 years.
b. Cataloged 10 of what it considered to be the most
PH DIINDONESIA notable public health achievements based on the
opportunity for prevention and the impact on death,
GLO CL CHANGE illness, and disability.
C. CENTRE FOR DISEASES CONTROL (10 Anjuran CDC)

5. SEPULUH (10) TINDAKAN YANG DIANJURKAN

RUMUSAN PH (The Centers for Disease Control and Prevention (CDC)
(1) Vaccination programs (as a result of widespread
POKOK PERH vaccine use, many of the infectiousdiseases that once
killed so many have been almost eliminated);
CD CONTROL (2) Occupational safety policies (since 1980, the rate of
fatal occupational injuries has decreased by 40
PH DIINDONESIA percent);
(3) Fluoridation of drinking water (fluoride was first added
GLO CL CHANGE to the public water system in 1945; tooth decay and
tooth loss has declined substantially as a result) ;
.

(4) Access to safe, improved family planning and

contraceptive services;
RUMUSAN PH
(5) Control of infectious diseases as a result of
antibiotics, clean water, and improvedsanitation ;
POKOK PERH
(6) Food safety (safer and more healthful foods can be
attributed to decreased microbial contamination and
CD CONTROL
increased nutritional;
PH DIINDONESIA (7) Recognition of tobacco use as a health hazard;
(8) Motor vehicle safety (safety belts, child safety seats,
GLO CL CHANGE motorcycle helmets, and engineering improvements in
both vehicles and highways have helped reduce fatal
motor vehicle accidents);
.

(9) Decline in deaths from coronary heart disease and

stroke (lifestyle modifications and pharmaceuticals
RUMUSAN PH have led to a decline in deaths for these diseases); and
(10)Healthier mothers and babies as a result of better
POKOK PERH hygiene, prenatal health care and nutrition.

CD CONTROL

PH DIINDONESIA

GLO CL CHANGE
.

6. TANTANGAN ABAD XXI

RUMUSAN PH The 21st century presents new challenges.
• Largely preventable infectious diseases, such as
POKOK PERH tuberculosis (TB), polio, measles, and cholera continue
to plague millions of people around the globe,
CD CONTROL
especially children.
• HIV/AIDS, which appeared on the scene in the mid-
PH DIINDONESIA 1980s, continues to be a major public health problem,
although antiretroviral medications have done wonders
in terms of extending life.
GLO CL CHANGE
7. SDGs
D. SEJARAH PERKEMBANGAN PH DI INDONESIA

Perintisan PH di Indonesia/ perkembangan dapat dikasimak

pada perkembangan Basic Health Services (Usaha-2
RUMUSAN PH
Kesehatan Pokok)
POKOK PERH
a. PERIODE 1917-1941 :
CD CONTROL PH diterapkan pada Propaganda pemberantasan peny.
Cacing Tambang dan pemakaian kelambu pada proyek
PH DIINDONESIA kesehatan di Banyumas.

GLO CL CHANGE b. PERIODE ZAMAN JEPANG S.D. PENYE-RAHAN KEDAULATAN

R.I. 1941-1950
Upaya Kesehatan R.I. tidak ada perkembangan berarti,
karena sibuk perang dan mempertahankan kemerdekaan.
.

c. PERIODE 1950-1960
RUMUSAN PH
Basic seven (WHO):
POKOK PERH 1. Mother and Child Health (MCH)
2. Medical Care (MC)
CD CONTROL
3. Environmental sanitation ES)
PH DIINDONESIA
4. Health education (HE)
GLO CL CHANGE 5. Public health nursing (PHN)
6. Communicable diseases control (CDC)
7. Statistics
.

c. PERIODE 1950-1960
RUMUSAN PH
Menerapkan Basic eight (Achmad):
POKOK PERH 1. KIA dan Keluarga Berencana;
2. Medical Care
CD CONTROL
3. Sanitasi Lingkungan
PH DIINDONESIA 4. Gizi *)
5. Pemeliharaan Kesehatan Masysrakat;
GLO CL CHANGE 6. Pengendalian Penyakit Manular;
7. Statistik;
8. Laboratorium*)
.

d. PERIODE 1960-1990:
RUMUSAN PH Menerapkan 12 Usaha Kesehatan Pokok`
Basic twelve (Sulianti)
POKOK PERH

CD CONTROL
1. KIA dan Keluarga Berencana;
2. Pengobatan dan Perawatan (MC);
PH DIINDONESIA 3. Sanitasi Lingkungan;
GLO CL CHANGE
4. Perawatan Kesehatan Masyarakat;
5. Penyuluhan Kesehatan;
6. Pemberantasan Penyakit Menular;
.

RUMUSAN PH 7. Gizi (Public Health Nutrition)

8. Usaha Kesehatan Sekolah;\
POKOK PERH
9. Laboratorium;
CD CONTROL 10.Statistik;
11.Pendidikan Tenaga Kesehatan;
PH DIINDONESIA
12.Kesehatan-2 khusus dgn ruang lingkup lebihh
GLO CL CHANGE
luas, disesuaikan dengan perkembangan dan
kondisi yad.
.

e. PERIODE 1990-SEKARANG
RUMUSAN PH Menerapkan 18 Usaha Kesehatan Pokok.
POKOK PERH yang dibagi dalam upaya kesehatan wajib,
pegembangan dan penunjang.
CD CONTROL
(lihat uraian sebelumnya)
PH DIINDONESIA

GLO CL CHANGE
E. PENGARUH GLOBAL CLIMATE CHANGE THD PH

DAMPAK PEMANASAN GLOBAL

THD KESEHATAN MASYARAKAT
RUMUSAN PH
❖ Pemanasan Global menyebabkan terjadinya perubahan
POKOK PERH iklim global (Global climate change).
❖ Perbahan iklim global berpengaruh pada prubahan
CD CONTROL cuaca regional;
❖ Perubahan cuaca regional menyangkut:
PH DIINDONESIA
▪ Gelombang panas
GLO CL CHANGE ▪ Suhu ekstrem berpengaruh thd
▪ Suhu, dan kesehatan
▪ Curah hujan masyarakat.
 Adaptive Modulating
capacity HEALTH EFFECTS
influences
Temperature-related
Mitigative illness and death
capacity
RUMUSAN PH Exteme weather-
related health
Microbial effects
Mitigation REGIONAL contamination
POKOK PERHDriving forces measures WEATHER pathways Water and food-
CHANGES borne desases
Transmission
Population • Heatwaves Vector-borne and
CD CONTROL dynamics dynamics rodent-borne
• Extreme diseases
weatrher Agro-
Unsustainable Green House ecosystems, Effects of food and
PH DIINDONESIA
Economic Gases
CLIMATE .temperature hydrology water shortages
Development (GHG) CHANGE
emission •precipitation Socioeconomics Mental, nutrion,
, demographics infectious, and other
GLO CL CHANGE health effects

Health-
Natural specific
causes adaptation Evaluation
Research measures of
needs
adaptation
.

1. PENGARUH PERUBAHAN IKLIM THD KES. MASY.

RUMUSAN PH
(1)ALUR KONTAMINASI DARI MIKROB
POKOK PERH • Krn sanitasi buruk akibat banjir
• Kekurangan air bersih
CD CONTROL • Penularan penyakit mudah terjadi
(2)DINAMIKA PENULARAN PENYAKIT
PH DIINDONESIA
• Vector borne diseases meningkat
GLO CL CHANGE
• Maturasi vektor (Nyamuk) lebih cepat.
• Perkembangbiakan vektor lebih cepat.
• Perkembangbiakan rodent (reservoir) lebih meluas.
.

(3) AGROEKOSISTEM DAN HIDROLOGI

RUMUSAN PH • Peningkatan jlmh sampah organik akibat perubahan
musim – memicu perkembangan vektor lalat.
POKOK PERH • Perubahan pola hidrologi menyebabkan banjir, tanah
longsor, badai, kekeringan, gelombang panas,
CD CONTROL kebakaran hutan dll.

PH DIINDONESIA (4)SOSIOEKONOMI DAN DEMOGRAFI

• Perubahan karakter masyarakat dalam menghadapi
GLO CL CHANGE
ketidak menentuan perubahan iklim/cuaca.
• Kemungkinan akan berpengaruh pada perubahan
demografis seperti migrasi dsb.
.
PENGARUH DARI 4 FAKTOR TSB:

RUMUSAN PH
(a) Suhu dan kematian
POKOK PERH Kenaikan angka kesakitan dan kematian mengubah pola
epidemiologis secara regional maupun global.
CD CONTROL
(b) Cuaca ekstrem dan kesehatan
PH DIINDONESIA • Kematian selama musim dingin 10-25%b lebih tinggi
dibanding musim panas.
GLO CL CHANGE
• Kematian akibat suhu sangat dingin meningkat.
.
(c) Pencemaran udara dan kesehatan
• Pencemaran udara meningkat seiring meningkatnya
RUMUSAN PH GRK. Lihat pencemaran udara.
(d) Penyakit yang ditularkan air dan makanan
POKOK PERH • Pengaruh perkembangan vektor
• Pengaruh sanitasi yang buru
CD CONTROL
(e) Penyakit yang ditularkan serangga dan tikus
PH DIINDONESIA • Peningkatan malaria diprediksi 5X lipat (five fold)
• Peningkatan penyakit DBD (DHF)
GLO CL CHANGE • Peningkatan penyakit Leptospirosis.
.
(f) Pengaruh kekurangan air dan makanan.
• Diare karena sanitasi buruk.
RUMUSAN PH • KKP karena kekurangan makanan
(g) Pengaruh thd mental psikologi
POKOK PERH
• Frustrasi akibat perubahan iklim yang tidka menentu –
depresi.
CD CONTROL
.
PH DIINDONESIA

GLO CL CHANGE
.

PENCEGAHAN/ELIMINASI TIMBULNYA DAMPAK

RUMUSAN PH
a. Mengurangi emisi CO2.
• Efisiensi penggunaan energi
POKOK PERH
• Penghijauan
• Pengembangan energi tanpaCO2
CD CONTROL
• Pengendalian pemanfaatan hutan
• Rehabilitasi hutan dan perhutanan rakyat
PH DIINDONESIA
b. Mengurangi emisi CFC
c. Mengurangi terproduksinya ozon
GLO CL CHANGE
d. Mengurangi emisi CH4
e. Mengurangi emisi N2O.
.