Introduction to Public Health and Infectious Diseases R. Erol Sezer

1. Introductionto PublicHealthandInfectiousDiseases R. Erol Sezer Yeditepe Üniversitesi Tıp Fakültesi Halk Sağlığı Anabilim Dalı

2. In 1920, Yale professor of public health and respected public health figure C.E.A. Winslow defined public health as “...the science and art of preventing disease, prolonging life and promoting health and efficiency through organized community effort for the sanitation of the environment, the control of communicable infections, the education of the individual in personal hygiene,

3. the organization of medical and nursing services for the early diagnosis and preventive treatment of disease, and for the development of the social machinery to insure everyone a standard of living adequate for the maintenance of health, so organizing these benefits as to enable every citizen to realize his birthright of health and longevity.”

5. Life expectancy at birth in Turkey malesfemales 1945-50 36.7 39.6 1955-60 46.5 49.7 1965-70 53.9 57.4 1975-80 60.3 64.0 Nusret Fişek. Nusret Fişek. Halk Sağlığına Giriş. Çağ Matbaası, Ankara 1983

6. Bebek Ölüm Hızının Uluslararası Karşılaştırması (1.000 Canlı Doğumda), 2012 Sağlık Bakanlığı İstatistik Yıllığı 2012

7. Infantmortality rate estimate in Turkey in 1963 % 190-270 perthousandlivebirths Gales KE. Thereport of an inquiryintobirthanddeathrates in Turkey. Hıfzıssıhha Okulu, 1964, Yayınlanmamış Rapor.

9. AccordingtotheInstitute of Medicine «Broad mission of public health is to fulfill society’s interest in assuring conditions in which people can be healthy.» Thisstatement’s main assumptions and implications:

10. «…First, the idea of assuring health for all people—the entire population— is embedded in the mission statement. We are obligated to ensure health-producing conditions for all people— not just the poor, not just the rich, but people of all incomes, but people of all races and ethnicities..»

11. «…Second, the work of public health is a societal effort with a societal benefit. Public health takes the view held by many professions and societies throughout human history that healthy people are more productive and creative, and these attributes create a strong society.» It is easierfortheindividualto be healthyandstayhealthy in healtypopulations.

12. ..Third, the public health mission acknowledges that health is not guaranteed. The mission states that “people can (not will) be healthy.” Health is a possibility, although we intend through our actions to make it highly probable. However, not everyone will be healthy even if each one exists in health-producing conditions. Public health efforts will not result in every person being healthy—although we certainly would not object to that kind of success…»

13. The fourth and fifth assumptions embedded in the publichealth mission are that prevention is the preferred strategy and to besuccessful, prevention must address the “conditions,” that is, physicalandsocialenvironment, in which people live.

14. …This choice of a prevention and environment-based strategy clearly distinguishes public health from the clinical professions, which focus on diagnosing individuals and treating them when they have health problems detectable by clinical methods—history, physical examinations, laboratory tests, imaging, and so forth.

15. There are three types of prevention: primary, secondary, and tertiary: • Primary prevention is concerned with eliminating risk factors for a disease.Intervening in an asymptomaticpersontopreventtheonset of thedisease. • Primordialprevention is defined as prevention of risk factorsthemselves.

16. Secondary prevention focuses on early detection and treatment of a disease byusingscreeningteststoidentifypre-clinicaldisease in an asymptomaticperson. • Tertiary prevention attempts to eliminate or moderate disability associated with advanced disease.»

17. In the Spring of 1994 a working group on the core functions of public health took on the task of developing a consensus list of “essential services of public health” that would provide one voice for public health professionals and simultaneously clearly articulate to the public and policy makers the important role of public health in health care. 

18. The 10 Essential Services of PublicHealthare: • Monitorhealthstatustoidentifyandsolvecommunityhealthproblems • Diagnoseandinvestigatehealthproblemsandhealthhazards in thecommunity • Inform, educate, andempowerpeopleabouthealthissues • Mobilize communitypartnershipsandactiontoidentifyandsolvehealthproblems • Developpoliciesandplansthatsupportindividualandcommunityhealthefforts

19. Enforcelawsandregulationsthatprotecthealthandensuresafety • Linkpeopletoneededpersonalhealthservicesandassuretheprovision of healthcarewhenotherwiseunavailable • Assure a competentpublicandpersonalhealthcareworkforce • Evaluateeffectiveness, accessibility, andquality of personalandpopulation-basedhealthservices • Researchfornewinsightsandinnovativesolutionstohealthproblems

20. Spirit of PublicHealth:A quatationfrom “Krieger, N., & Birn, A. E. (1998). A vision of socialjustice as thefoundationof publichealth: Commemorating 150 years of thespirit of 1848. AJPH, 88(11), 1603–1606.” “Todeclarethatsocialjustice is thefoundation of publichealth is tocalluponandnurturethatinvinciblehumanspiritthatledsomany of us toenterthefield of publichealth in thefirstplace: a spiritthat has a compellingdesiretomaketheworld a betterplace, free of misery, inequity, andpreventablesuffering, a world in whichweall can live, love, work, play, ailanddiewithourdignityintactandourhumanitycherished.”

24. Malaria in Turkey (1945-1970) Nusret Fişek. Halk Sağlığına Giriş. Çağ Matbaası, Ankara 1983