UNIVERSITY OF SANTO TOMAS « ie Public Health Concepts Marilyn A. Ngo MS. PharmacyUNIVERSITY OF ako TOMAS : as j Prayer before (lass y Holy Sy Divine Creator, trve source of light and_ dense intellect. dissipate the darkness which covers that of sin and of ignorance. (jrant me a penetrating: mind to understand. a retentive memory. method ind ‘ease in learning. the lucidity to comprehend. and abundant grace in expressing myself. (vide the’ 7 beginning of my work, direct its progress. and bring’ to successi ‘ul completion. This | ask through JossUNIVERSITY F SANTO TOMAS Definition of Terms + Health - state of complete physical, mental and social well being and not merely the absence of disease or infirmity; successful defense of the host against forces tending to disturb body equilibrium + Public Health - concerned with threats to the overall health of a community based on population health analysis; science and art of preventing disease, prolonging life and promoting physical and mental health and efficiency through organized community efforts; science and art of promoting health, preventing disease and prolonging healthy life through organized efforts of society + Disease - Failure of the body defense mechanism to cope with forces tending to disturb body equilibriumUNIVERSITY OF SANTO TOMAS iy? ee Definition of Terms + Etiology - science of theory of the causes or origins of diseases + Epidemiology - study of the distribution of disease and the factors the influence the occurrence of disease in groups of peopleUNIVERSITY OF SANTO TOMAS Objectives of Public Health + Focus of a public health intervention is to prevent rather than treat a disease through surveillance of cases and the promotion of healthy behaviors fy’ t&eUNIVERSITY OF SANTO TOMAS History of Public Health * From the early beginnings of human civilization. it was recognized that polluted water and lack of proper waste disposal may spread disposal may spread vector-borne diseases * Early religions attempted to regulate behavior that specifically related to health, from types of food eaten, to the extent which certain behaviors could be indulged. such as drinking alcohol or sexual relations. + The establishment of governments placed responsibility on leaders to develop public health policies and programs to gain some understanding of the causes of disease to ensure stability, prosperity and maintain overall health. fy’ t&eUNIVERSITY OF SANTO TOMAS arly Public Health Interventions + By Roman times, it was well understood that proper diversion of human waste was a necessary tenet of public heaith in urban areas + Chinese developed the practice of variolation following a smallpox epidemic around 1000 BC + An individual without the disease could gain some measure of immunity against it by inhaling the dried crusts that formed around the lesions of infected individuals. Also, children were protected by inoculating a scratch on their forearms with the pus from a lesion. This practice was not documented in the West until the early 1700s, and was used on a very limited basis ‘The practice of vaccination did not become prevalent until the 1820s, following the work of Edward Jenner to treat smallpoxUNIVERSITY OF SANTO TOMAS arly Public Health Interventions fy’ t&e * During 14* century. Black Death in Europe, it was believed that removing bodies of the dead would further prevent the spread of the bacterial infection. This did little to stem the plague, however, which was most probably spread by rodent-borne fleas. Burning the areas of cities resulted in much greater benefit, since it removed the rodent infestations * The development of quarantine in the medieval period helped mitigate the effects of other infectious diseasesUNIVERSITY OF SANTO TOMAS arly Public Health Interventions fy’ t&e * Michel Foucault, the plague model of governmentality was to be opposed to the later cholera model + Cholera, which 2"4 pandemic devastated Europe between 1829 and 1851, was first fought by the use of what Foucault called “social medicine”. which focused on flux, circulation of air, location of cemeteries, etc. + All those concerns, born of the miasma theory of disease. were thus mixed with urbanistic concerns of the management of populations, which Foucault designed by the concepts of biopower‘arly Public Health Interventions + Science of epidemiology wes founded by John Snow's identification of a polluted public water as the cause of an 1854 cholera outbreak in Landon + Dr. Snow believed in the germ theory of disease as opposed to the prevailing miesma theory ‘+ Miasma theory taught correctly that disease is a result of poor sanitation, it was based only upon the prevailing theory of spontaneous generation. Microorganisms, which are now known to cause many of the most common infectious diseases, were first observed around 1680 by Anton van Leeuwenhoek + But the modem era of public health did not begin until the 1880s, when the culmination of Robert Kock’s germ theory and Lou's Pasteur’s production af artificial vaccines revolutionized the study of infectious diseaseModern Public Health + As the rate of infectious diseases in the developed world decreased through the 20" century, public health began to put more focus on chronic diseases such as cancer and heart disease + During the 20% century, the dramatic increase in average life span is widely credited to public health achievements, such as vaccination programs and control of infectious diseases, better safety policy such as motor-vehicle and worker safety, improved family planning, fluoridation of drinking water, and programs designed to decrease chronic disease such as heart disease and strokeModern Public Health + Developing world remained plagued by largely preventable infectious diseases, exacerbated by mainuttition and poverty + Front page headlines continue to present society with public health issues on daily basis: ‘emerging infectious diseases such as SARS, making its way from China to Canada and the US; prescription drug benefits under public programs such as Medicare: the increase of HIV-AIDS ‘among the young heterosexual women and its spread in South Africa ‘+ Increase of childhood obesity and the concomitant increase in type Il diabetes among children, impact of adolescent pregnancy. and the on-going social, economic and health disasters related to the 2005 tsunami and hurricane Katrina in 2006. These are all public health challengesModern Public Health + Since the 1980s. the growing of population health has broadened the focus of public health from individual behaviors and risk factors to population-level issues such as inequality, poverty and education + Concerned with addressing determinants of health across a population, rather than advocating for individual behavior change + There is a recognition that our health is affected by many factors including where we live, genetics, our income, our educational status and our social relationships - these are known as “social determinants of health”Modern Public Health + Most government recognize the importance of public health programs in reducing the incidence of disease, disability and the effects of aging, although public health generally receives significantly less government funding compared with medicine + Inrecent years, public health programs providing vaccinations have made incredible strides in promoting health, including the eradication of smallpox + Important public health issues: HIV-AIDS, diabetes, smoking, infectious disease. etc— . ‘vy ioe ore Principles of Public Health * Prevent epidemics and the spread of disease + Protect against environmental hazard + Prevent injuries + Promote and encourage healthy behaviors. + Respond to disaster and assist communities in recovery * Assure the quality and accessibility of health services‘ssential Services of Public Health ‘+ Monitor heatth status to identify community health problems + Diagnose, investigate heaith problems and health hazards in the community + Inform, evaluate and empower people about heatth issues + Mobilize the community partnership to identity and sove heatth problems + Develop policies and plans that support individual and community efforts + Enforce laws and regulations that protect heaitn and ensure safety + Link people to needed personal health services and assures the provision of health care when otherwise vunavatiapie ‘+ Assure a competent public health and personal health workforce + Evaluate effectiveness, accessibility and quality of personal and population ~based health services Research for new insights and innovate solutions to health prablemsComparison between Public Health & Medicine Publichealt Meacne Primary focus population Tndividoal Emphasis prevention Diagnosis ‘Health prorraton Treatment Whole community Whole patient arediom ~ intervention aimed at environment, human Medicale behavior & lifestyle, Medical care ‘Organizational ines | Analytical (epidemiology) ome ae | of specalization ‘Setting & populations (occupational health) Patient group ‘Substantive health program | Eboloay, pathophysioloay = ‘Sialic in aesesemant, poly, Gevelopment and | Tedhrical slsSpectrum of Health * Excellent + Fairly well + Those feeling under par * Those definitely ill‘actors that may affect health + Living or non-living disease agents + Inherent and acquired characteristics of man + Environmental factors in which man lives‘actors that may affect health + Living or non-living disease agents + Inherent and acquired characteristics of man + Environmental factors in which man lives