INTRODUCTION TO PUBLIC HEALTH COURSE CODE PBH 101

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What is Public Health?

In the next 3 minutes:

Find a partner. Create a short definition. Share with class

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Introductions

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Pretest

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A BRIEF HISTORY OF PUBLIC HEALTH

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What is Public Health?

To promote health and quality of life by preventing and controlling disease, injury, and disability.
CDC Mission Statement

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Objectives
Define public health. Describe conditions that existed before the

advent of modern public health. Describe three public health interventions since 1900 that have increased life expectancy in the U.S and world itself.

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Requirements for Survival

Care

Shelter

Food

Water

Air
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History of public health

Around ten thousand years ago, when

people began to move from a nomadic to a more settled lifestyle, the risks to health changed too. Increased contact with people and animals and their waste products - generated new problems.
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Timeline
Ancient Greece
Roman Empire Middle Ages

Birth of Modern Medicine

Great Sanitary Awakening Modern Public Health

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Timeline
Ancient Greece
Roman Empire Middle Ages

Birth of Modern Medicine

Great Sanitary Awakening Modern Public Health

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Ancient Greeks
(500-323 BC)
Personal hygiene Physical fitness
Olympics

Naturalistic concept
Disease caused by imbalance

between man and his environment

Hippocrates

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Hippocrates (b. 460 BC)

Father of Western medicine Causal relationships
Disease and climate, water,

lifestyle, and nutrition

Coined the term epidemic

Epis (on or akin to)
Demos (people)

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Roman Empire
(23 BC 476 AD)
Adopted Greek health values Great engineers
Sewage systems Aqueducts

Administration
Public baths Water supply Markets

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Roman Aqueducts:
water

Southern France to carry fresh

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Le Pont du Gard

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Middle Ages
(476-1450 AD)
Shift away from Greek and Roman values
Physical body less important than

spiritual self Decline of hygiene and sanitation

Beginnings of PH tools
Quarantine of ships Isolation of diseased individuals

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The Plague (epidemic disease in western Eourpe

Death of 25% to 50% of population

Renaissance (1400-1600 AD) Global Exploration

Disease, spread by traders and explorers

Killed 90% of indigenous people in New World

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Age of Reason and Enlightenment (1650-1800 AD)

Birth of Modern Medicine
William Harvey
1628 theories of circulation

Edward Jenner
1796 cowpox experiment

Coined the term vaccine (vacca,

Latin for cow)

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Industrialization Urbanization (1800s)

Great Sanitary Awakening

(1800s-1900s)
Growth in scientific knowledge Humanitarian ideals

Connection between poverty and disease

Water supply and sewage

removal Monitor community health status

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Dr. John Snow

(1813-1858)

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Broad Street Pump:

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Father of modern epidemiology

for his work identifying the source of a cholera

outbreak in 1854. At the time, it was assumed that cholera was airborne. However, Snow did not accept this (bad air) theory In August 1854, a cholera outbreak occurred in Soho. After careful investigation, including plotting cases of cholera on a map of the area, Snow was able to identify a water pump in Broad (now Broadwick) Street as the source of the disease. He had the handle of the pump removed, and cases of cholera immediately began to diminish.
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Map of Diphtheria Deaths New York City

May 1, 1874 to December 31, 1875

Made under the direction of W. De F. Day, M.D., Sanitary Superintendent, NYC Health Dept. www.ihm.nlm.nih.gov
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Growth in Scientific Knowledge

Louis Pasteur
1862 germs caused many diseases 1888 first public health lab

Robert Koch
1883 identified the vibrio that causes

1822-1895

cholera, 20 years after Snows discovery Discovered the tuberculosis bacterium

1843-1910
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Sanitary Reform
England
1842 Edwin Chadwicks Survey

into the Sanitary Condition of the Labouring Classes in Great Britain

Landmark research Graphic descriptions of filth and

disease spread in urban areas

1848 General Board of Health

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1800-1890

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Redefining the Unacceptable

The landmarks of political, economic and social history are the moments when some condition passed from the category of the given into the category of the intolerableThe history of public health might well be written as a record of successive redefinings of the unacceptable.
- Geoffrey Vickers, Secretary, Medical Research Council, Great Britain, 1958

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Redefining the Unacceptable

In the next 5 minutes: Brainstorm and record a list of things affecting the publics health that have passed from tolerable (accepted) to intolerable (unaccepted). Include items that you wish would become unacceptable.

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Sanitation Revolution
Clean water; water treatment
Food inspection Soaps, disinfectants, and pharmaceuticals

Personal hygiene (bathing)

Public works departments; garbage

collection, landfills, and street cleaning Public health departments and regulation

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Twentieth Century
U.S. Mortality Rate: 1900-2001
Source: www.infoplease.com
18 17 16 15 14 13 12 11 10 9 8
19 00 19 25 19 34 19 39 19 44 19 49 19 54 19 59 19 65 19 70 19 75 19 80 19 85 19 90 19 95 20 00
Deaths per 1,000

Year

Ten Great Achievements in Public Health, 1900-1999

1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Vaccination. Motor-vehicle safety. Safer workplaces. Control of infectious diseases. Decline in deaths from coronary heart disease and stroke. Safer and healthier foods. CDC, Morbidity and Mortality Healthier mothers and babies. Weekly Report, December 24, 1999 / 48(50); 1141. Family planning. Available at: http://www.cdc.gov/mmwr/preview/ Fluoridation of drinking water. mmwrhtml/mm4850bx.htm Recognition of tobacco use as a health hazard.
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World Population Growth

2010

Population (in millions)

1850

Year
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Multiple Determinants of Health

Policies and Interventions Behavior
Physical Environment Individual Social Environment

Biology

Access to Quality Health Care

Source: U.S. Department of Health and Human Services, Health People 2010

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 Thank

you

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