=== HISTORY ===

Chapter Objectives :
> Accurately define the terms health, community health, population health, and public
health.
> Explain the difference between personal and community health activities
> List and discuss the factors that influence a community’s health

HEALTH
A state of complete of complete physical, mental, and social well being and not merely
the absence of disease and infirmity.” World Health Organization - 1947
A dynamic state or condition which is multidimensional in nature and results from the
adaptation to his/her environment.

COMMUNITY
Group of people who have common characteristics
--can be defined as location, race, ethnicity, age, occupation, interest in a particular
problems or outcomes or common bonds
--characterize by : membership, common symbol systems, shared values and norms,
mutual influence, shared needs and commitment to meeting them, shared
emotional connection

Community Health
--the health status of a defined group of people and the actions and conditions, both
private and public, to promote, protect, and preserve their health.

Population Health
--the health status of people who are not organized and have no identity as a group or
locality and the actions and conditions to promote, protect and preserve their health

Public Health
--health status of a defined group of people and governmental actions and conditions to
promote, protect, and preserve the people’s health

COMMUNITY HEALTH VS PERSONAL HEALTH :

PERSONAL
Individual actions and decision making that affect the health of an individual or their
immediate family

COMMUNITY
Activities aimed at protecting or improving the health of a population or community
Factors affecting the health of the community :

PHYSICAL FACTORS
Industrial development
Community size
Environment
Geography

SOCIAL/CULTURAL FACTORS
Beliefs, Traditions, and Prejudices
Economy, Politics, Religion
Socioeconomic Status
Social Norms

COMMUNITY ORGANIZATION
Ways in which communities organize their resources;
Tax vs Non-tax supported services

INDIVIDUAL BEHAVIORS
Takes the concerted effort of many - if not most - to make a community voluntary
program work
Brief History and Public Health

Brief History and Public Health :

EARLIEST CIVILIZATIONS
ANCIENT SOCIETIES - before 500 B.C.
 Northern India: evidence of bathrooms and sewers
 Sumarian clay tablet: evidence of prescription drugs
 Code of Hammurabi: laws pertaining to physicians and health practices

CLASSICAL CULTURES - 500 B.C. - 500 A.D.

 Greeks: Games of strength and skill for men
 Greeks: Active in community sanitation
 Romans: Built aqueducts and sewer systems
 Romans: Built hospitals and infirmaries for slaves

MIDDLE AGES - 500 to 1500 A.D.

 Spiritual era of public health
 Great epidemics of plague

RENAISSANCE AND EXPLORATION - 1500 to 1700 A.D.

 Rebirth of thinking about nature of the world and of humankind
 Belief that diseases were caused by environmental, not spiritual factors
 Brief History and Public Health
EIGHTEENTH CENTURY
- Characterize by Industrial Growth
 Cities overcrowded
 Water supplies inadequate
 Streets heaped with trash and garbage
 Occupational health
 Workplaces unsafe and unhealthy
 Workforce poor
 Children forced to work long hours
 Average death : 29 yrs old
 Dr. Jenner in 1796 demonstrated the process of vaccination against
smallpox

NINETEENTH CENTURY
 EARLY APPROACH
 Few advancements in public health
 Modern Era of public health begins 1850
 Better agriculture leads to improved nutrition
 Federal government approach “Laissez faire” (noninterference)
 Health quackery thrived
EPIDEMICS CONTINUED
 London cholera epidemic struck in 1849
 Epidemic problems in major cities
 Miasmas theory of contagious disease
 Dr. John Snow and the Broad Street pump

LEMUEL SHATTUCK’S HEALTH REPORT, 1850

This report is one of the fundamental documents in public health in the United
States. It is the first systematic use of birth and death records and other demographic
data to describe the health of a population. Its recommendations became foundation of
the sanitation movement in the United States, which saw the life expectancy increase
from 25 years in Boston in 1850 to more than 75 years by the year 2000. The proposed
law in part four of the report is the first attempt to write a comprehensive public health
code.

FIVE PERIODS OF ERA

 Miasma, 1850 to 1875
Miasmatic theory of disease states that diseases were caused by the
presence of miasma. Miasmas are poisonous emanations, from putrefying carcasses,
rotting vegetation or molds, and invisible dust particles inside dwellings. Miasmas could
be identified by its foul smell (Demaitre, 2004). From the time of ancient Greece till the
mid of 19th century, it was believed that the miasma would enter the body and cause
diseases like cholera and malaria. In the medical world the miasma theory was
advanced over the time to explain many important diseases. Even the disease called
malaria has got its name from miasma theory. In Italian mala means bad and aria
means air and it stands as the one of the proof of existence of miasma theory in the
ancients. In the mid of the 19th century the miasma theory was replaced by the Germ
theory of diseases (Maia 2013).

 Bacteriological, 1875 to 1900

 Health Resources Development, 1900 to 1960
 Social Engineering, 1960 to 1975
 Health Promotion, 1975 to present

BEGINNING OF TWENTIETH CENTURY

 Life expectancy less than 50 years
 Communicable diseases leading causes of death
 Children health concerns
 Vitamin deficiencies and poor dental health are common to slums

HEALTH RESOURCES (1900-1960)

 REFORM PHASE - 1900 to 1920
 Growth of health care facilities and providers
 GREAT DEPRESSION & WORLD WAR II 1929 – 1935
 Social Security Act of 1935
 National Institutes of Health established - 1930’s
 THE POSTWAR YEARS 1945 – 1960
 Communicable Disease Center established – 1946
 World Health Organization founded - 1948
 Period of SOCIAL ENGINEERING 1960 – 1973
 Congress passed Medicare and Medicaid bills – 1965
 OSHA Act Signed 1970
 Health Promotion Period (1975 - 1990)
 Lifestyle related diseases
 High medical care costs

PERIOD OF HEALTH PROMOTION 1974 – present

LIFESTYLE CHANGES
 World Health Organization’s “Health for All”, 1977
 Identification that premature death are traceable to lifestyle and health
behaviours
 Promoting Health/Preventing Disease: Objectives for the Nation, 1979
 226 Objectives based on preventive services, health protection,
and health promotion
 Healthy People 2000 (Over 300 objectives)
 Healthy People 2010
THE 21st CENTURY
Early 2000s
 World Planning
 reduce the burden of excess mortality and morbidity
 Environmental problems
 Lifestyle diseases
 Communicable diseases
 Alcohol and other drug abuse
 disasters
 developing effective health systems
 expanding the knowledge base
 Public health preparedness

World Community/Public Health in Early 2000s

 Communicable diseases
 Poor sanitation and unsafe drinking water
 Hunger

21st Century Global Health Achievements

 Reduction in child mortality
 Vaccine preventable diseases
 Access to safe water and sanitation
 Malaria prevention and control
 Prevention and control of HIV / AIDS
 Tuberculosis control of infectious diseases
 Control of neglected tropical diseases
 Tobacco control
 Global road safety
 Improved preparedness and response