PHS 2101 - Chapter 1 Continued

• One major expectation of civilized society is that the living conditions will be basically healthy.
• People assume they are basically safe: water is safe to drink, food is safe to eat, the aspirin they take actually is an aspirin.
• In the mid-19th century, when record-keeping began in England and Wales, death rates were very high, especially among children.

  Of every 10 newborn infants: 2 or 3 died before their first birthday, 5 or 6 died before the age of six, only about 3 of 10 lived beyond age 25
• At that time, TUBERCULOSIS was the largest killer

  Epidemics of cholera, typhoid, and smallpox swept through communities, killing people of all ages and making them afraid to leave their homes
• Injuries to workers– often fatal– in mines and factories were common due to unsafe equipment, long working hours, poor ventilation and lighting, and child labor.
• There are a number of reasons why people’s lives in the U.S. are healthier today than a century ago:

  *clean water, air and food

  *safe disposal of sewage

  *better nutrition

  *education concerning healthy and unhealthy behaviors

  MOST OF THESE FACTORS FALL INTO THE DOMAIN OF PUBLIC HEALTH
• The term PUBLIC HEALTH refers to two different but related concepts.

  *One can say that the public health has improved since the last century– meaning that the general state of people’s health is now much better than it was.

  *the measures that people take as a society to bring about and maintain that improvement are also known as public health.
• people most often look to gov’t to take the primary responsibility (at the local, state and federal level)

  provide pure water and efficient sewage disposal

  governmental regulations ensure the safety of the food supply

  governments also ensure the quality of medical services provided through hospitals, nursing homes and other institutions
• Role of Gov’t in Public Health….

  governments also sponsor research and education programs on causes and prevention of disease

  Laws regulating people’s behavior prevent them from hurting each other.

  Laws requiring immunization of schoolchildren prevent the spread of infectious diseases.
• “the science and the art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community efforts for……………………….”

  *Preventive Cancer Screening

  *Drug Research and Development

  *Physical/Health Education
• “……..the sanitation of the environment…..”

  *Trash removal

  *Clean drinking water

  *Environmental Protection Agency
• “………..the control of community infections…………”

  *Hospitals

  *Centers for Disease Control and Prevention (CDC)
• “..........the education of the individual in principles of personal hygiene….”

  *School

  *Home
• “….......the organization of medical and nursing services for the early diagnosis and preventive treatment of disease….”

  *Children’s Health Initiatives

  *Cancer Screening Services (eg. skin, breast cancer)

  *Databases Containing Genetic Information Pertinent to Disease (eg. BIC)
• “………….and the development of the social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health.”

  *Social Outreach Programs That Provide Healthcare to the Impoverished

  *Employee Health Care Benefits

  *Medicare

  *Food and Drug Administration
• Public Health has had several key successes:

  *highly effective in reducing the threat of infectious diseases

  *average life span of Americans has been increasing
• Public Health has had many challenges:

  *most government spending is on medical care

  *concern about environmental pollution

  *aging population has introduced increased expenses into the system

  *social problems such as teenage pregnancy, violence and substance abuse are difficult to address; in part people do not thinking of them as public health issues.
• The irony here is that in addition to saving lives, public health programs clearly save money on medical costs.
• The majority of the gain has come from achievements in public health:

  *better nutrition

  *improvements in housing, sanitation and occupational safety
• What was the Public Health Response on Sept. 11th?

  *coordinated, rapid emergency medical care

  *ensuring the safety of clean-up workers and area residents

  *problems with polluted water, contaminated air
• How does that response compare to the Public Health Response to the anthrax scare of Fall 2001?

  *an outbreak of something abnormal that was reported to Public Health authorities; slower onset response?
• Public Health is a discipline which relies on several distinct areas of science and politics and which has as its major goal maximum health for all.
• Public Health prevention programs function through interventions designed to interrupt the Chain of Causation that leads to illness or injury

  *strengthening the resistance of the host to the agent

  *changing the environment in such a way that the host is less likely to encounter the agent