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Division of Distance and Distributed Learning. RURAL PUBLIC HEALTH SYSTEMS PHPM 601 . INTRODUCTION AND THE HISTORY OF PUBLIC HEALTH MODULE 1. Introduction and History of Public Health OBJECTIVES.

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Division of

Distance and Distributed Learning

rural public health systems phpm 601





introduction and history of public health objectives
Introduction and History of Public HealthOBJECTIVES
  • Slides provide a brief exposure to the U.S. health system with a more detailed discussion/definition of public health.
  • Students gain first introduction to the population health perspective.
  • History of public health is described from its early roots in 19th century London.
rural public health systems
Rural Public Health Systems
  • Individual introductions
  • Course introduction
  • Group Assignments
  • General discussion of the history of public health
  • Video: James Burke — The Day the Universe Changed: Social Impacts of new Medical Knowledge
  • Brief intro to next session
brief introductions
Brief Introductions
  • Name
  • History
    • Job history or academic background
    • Experiences related to public health
  • Future
    • Why interested in PH, where going
    • Department affiliation
    • What you want to do when you grow up!
course information
  • Description
  • Objectives
  • Requirements
    • Exams, Presentations, Thought Papers, Rural Health Policy Analysis
  • Readings
  • Miscellaneous
  • Course Outline
public health
Public Health
  • What is public health?
  • Where did it come from?
  • What are some good examples of public health practices?
  • Who does these things?
  • Why is it important to us today?
definitions of health public health
  • “the science and art of preventing disease, prolonging life and promoting health and efficiency thru organized community effort” (Winslow, 1920)
  • “successive re-definings of the unacceptable” (Vickers, 1958)
  • “fulfilling society’s interest in assuring conditions in which people can be healthy” (IOM, 1988)
disease prevention s k ch 1
  • Primary prevention -- prevent the onset of disease
  • Secondary prevention – identify disease processes are early as possible and intervene to prevent progression beyond early stage
  • Tertiary prevention – rehabilitation or minimizing effect of disease
early models of disease
  • Disease as “magic”
  • Disease as “divine punishment”
  • Disease (individual and epidemic) as a function of environmental factors
history of public health
History of Public Health
  • Consider children’s health
  • Could trace to Middle Ages
    • children essentially enslaved
  • Early Colonial Life (1600’s)
    • kidnapped native children
    • imported Black slaves
    • “apprenticed” poor English white children
plight of infants
Plight of Infants
  • 1665-1714 Queen Anne (England) 18 births
    • 5 live born, 1 survived infancy
  • 1700s Infant Mortality Rates 400-600/1000
  • 1800s IMRs 200-600/1000
    • first studies of sanitary conditions
    • first evidence of schools and hospitals and workplace as sources of ill health
true rise of public health
True Rise of Public Health
  • Early view--plague phenomena that simply had to be accepted
  • Impact of industrialization
    • crowded conditions
    • poor working conditions
    • poverty
    • giant germ culture
1700 s
  • Waves of epidemics hit the urban areas
  • Particularly near ports
  • Disease isolation
    • fear, tradition, scientific speculation
1800 s
  • Battles over isolation vs environmental clean-up
  • Introduction of early registries and public health datasets
  • Impact of French & US civil wars on heath and medicine
1800 s epidemiology
1800’s epidemiology
  • 1837 Chadwick’s report on sanitary cond’s
  • 1848 & Snow’s Broad Street pump
  • 1855 Lambert Water Company
  • 1858 Thames river flowing lavatory
  • 1864 Lister’s antiseptic
  • Koch’s introduction of bacteriology
  • Far argued in favor of proximal variables
revisit what is public health
Revisit: What is Public Health
  • The System & Social Enterprise
  • The Profession
  • The Methods (knowledge and techniques)
  • Governmental Services
  • The Health of the Public
iom public health mission
IOM public health mission
  • Fulfilling society’s interest in assuring conditions in which people can be healthy.”
  • Core values:
    • improving health status of others provides benefits to all
    • assuring means vigilantly promoting and protecting everyone’s interests
three core functions or what public health does
Three core functions orWhat Public Health Does
  • Assessment
  • Policy development
  • Assurance
winslow s definition of public health
Winslow’s definition of Public Health
  • Science and art
  • organized community effort
  • birthright of health and longevity
as a system
As A System
  • Broad social enterprise
  • interdisciplinary approach
  • emphasis on prevention
  • linkage to government
  • components include:
    • inputs, processes, outputs and outcomes
unique features
Unique Features
  • Basis in social justice
  • Inherently political nature
  • Dynamic, ever-expanding agenda
  • Link with government
  • Grounding in science
  • Preventive focus
  • Uncommon culture and bond
vickers definition of public health
Vickers Definition of Public Health
  • “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 intolerable. I believe that the history of public health might well be written as a record of successive re-definings of the unacceptable.”
rose s paradox
Rose’s Paradox
  • What do we know about Down’s Syndrome?
  • What strategies would you use to impact the problem?
  • What subset of the population would you target?
what is public health1
What is Public Health ?
  • Tragedy of the Commons
  • Clean Water
  • 25% kids uninsured
  • Vast majority on death row African American males
  • Social Causation
module 2
Module 2
  • Determinants of Health and the Population Health Perspective
    • Readings:
      • IOM Ch. 2
      • Glass & McAtee
    • Optional Readings:
      • S&K Ch. 3
      • Lee & Estes Ch. 2
Division of

Distance and Distributed Learning