LESSON 2: PUBLIC HEALTH

Health

* from the German word “hal” which means whole or sound
* dynamic state or condition of the human organism that is multidimensional
* determined by 5 factors

Determinants of Health

1. Gestational Endowments
2. Social Circumstances
3. Environmental Conditions
4. Behavioral Choices
5. Availability of Quality Medical Care

Gestational Endowments

genetic makeup, DNA

Social Circumstances

education, employment, income, poverty, housing, crime, social cohesion

Environmental Conditions

where people live and work, hazards, toxic or microbial agents

Behavioral Choices

diet, physical activity, substance use and abuse

Availability of Quality Medical Care

how medical care is available to people

Broader Determinants of Health

* culture and cultural continuity
* access to services and supports
* colonization
* globalization
* migration
* poverty
* self-determination
* territory

Public Health

* the science and art of preventing disease, prolonging life and promoting human health through organized efforts and informed choices of society, organizations, public and private, communities, and individuals
* includes activities that the society takes collectively to ensure the conditions in which people can be healthy

Public Health System

public health activities undertaken within the formal structure of government and the associated efforts of private and voluntary organizations and individuals

Global Health

* refers to health problems, issues, and concerns that transcend national boundaries
* may be influenced by circumstances in other countries
* best addressed by cooperative actions and solutions

Factors that Affect the Health of a Community

1. Physical Factors
2. Social and Cultural Factors
3. Community Organizing
4. Individual Behavior

Physical Factors

geography, environment, community size, industrial development

Social and Cultural Factors

beliefs, traditions and prejudices, economy, politics, religion, social norms, socioeconomic status

Community Organizing

process by which community groups are helped to identify common problems or change targets, mobilize resources, and develop and implement strategies for reaching their collective goals

Individual Behavior

the behavior of the individual community members contribute to the health of the entire community

History of Public Health

earliest community practices were unrecorded

1900 BC

Code of Hammurabi

Code of Hammurabi

* earliest written record of public health
* included laws for physicians and health practices

Book of Leviticus (Bible)

includes guidelines for personal cleanliness and sanitation

500 BCE to 500 CE

Greeks and Romans knew about water sanitation, aqueduct system, infirmary building, and charitable organizations

500 CE to 1000 CE

* AKA Dark Ages
* spiritual era of public health
* diseases were thought to have spiritual causes\\
* smallpox, influenza, measles, etc

Black Death

* killed 25 million in 4 years
* half of pop. of London lost and in some parts of France, only 1 in 10 survived

Yersinia pestis

cause of Black Death

1850 to present

modern era of public health

Lemuel Shattuck

outlined boards of health, collection of vital statistics, implementation of sanitary measures, and research as public health needs

Louis Pasteur

proposed the Germ Theory

Germ Theory

certain diseases are caused by the invasion of the body by microorganisms, organisms too small to be seen except through a microscope

1875 to 1900

bacteriological period of public health

Robert Koch

* established that specific bacteria or microbes can cause a particular disease (Koch 's postulates )
* causative agents for gonorrhea, typhoid fever, leprosy, tuberculosis, and more diseases were identified

Koch’s Postulates

1. the microorganism must be found in diseased but not healthy individuals
2. the microorganism must be cultured from the diseased individual
3. Inoculation of a healthy individual with the cultured microorganism must recapitulated the disease
4. The microorganism must be re-isolated from the inoculated, diseased individual and matched to the original microorganism

1900 to 1960

Health Resources Development Period

Health Resources Development Period

period of increased growth in health care facilities

1960 to 1973

Period of Social Engineering

Period of Social Engineering

establishment of Medicare / Medicaid which assists in payment of medical bills for older adults / PWD / and poor

1974 to present

Period of Health Promotion

Period of Health Promotion

passage of multiple healthcare laws and programs in the United States

1565 and earlier

Pre-Spanish Era

Pre-Spanish Era

* "health" was believed as a harmonious relationship with the environment
* diseases were believed to be caused by disharmony with the spiritual world
* wide use of medicinal herbs and rituals
* Babaylan - female healer / priestess

1565 to 1898

The Spanish Era

The Spanish Era

* replace of Babaylans by Spanish friars

Hospital Real

first hospital in the PH (Cebu)

Intramuros

center of health and medicine in the 90s

1574

smallpox epidemic - first recorded epidemic in PH history

1583

cholera epidemic

1898 to 1918

The American Era

1901

establishment of the Board of Health for the PH islands

1905

* creation of Culion Leper Colony in Palawan
* establishment of the Philippine Medical School under Commonwealth Act No. 1415

1907

opened and housed at School for Deaf and Blind located on Malecon Drive

1908

* University Charter Act (Act No 1870) was passed, forming UP
* renamed Philippine Medical School to University of the Philippines College of Medicine and Surgery

1910

opening of Philippine General Hospital

June 1927

* UP Institute of Hygiene was formed and offered Certificate of Public Health program for medical officers
* originally called School of Sanitation and Public Health
* mid 80s - renamed to UP College of Public Health

1918 to 1941

The Filipinization of Health Services and Mandate of Public Health

The Filipinization of Health Services and Mandate of Public Health

beginning of increased participation of Filipinos in governance

1919

Dr. Vicente de Jesus became the first Filipino director of Philippine General Hospital

Dr. Vicente de Jesus

first Filipino director of Philippine General Hospital

1942 to 1945

diseases such as TB, malaria, and severe malnutrition increased during the Japanese occupation; food and medicine were scarce

1947

birth of Department of Health

1952

introduction of Bacillus Calmette-Guerin (BCG) vaccine by UNICEF and DOH

1954

Rural Health Unit Act

Rural Health Unit Act

promoted establishments of clinics in every municipality

1963

institution of Food and Drug Administration

1975

Philippine Heart Center

1979

Philippine Children’s Medical Center

1981

Lung Center of the Philippines

1983

National Kidney Institute

1981 to 1985

implementation of Primary Health Care during the Alma Ata Declaration

1963

Launch of Project Maria

Project Maria

a government program which provided extended health services to rural areas

August 4, 1969

passage of RA 6111 or the Philippine Medical Care Act of 1969 or Medicare

RA 6111

Medicare was designed to extend healthcare to Filipinos within the nation 's economic means and capabilities, and to provide the people practical means to help themselves pay for sufficient medical care

1997

Government Service Insurance System (GSIS)

1998

Social Security System (SSS)

2005

Overseas Workers Welfare Administration (OWWA)

1995

institution of Philippine Health Insurance Corporation (PhilHealth)

February 14, 1995

National Health Insurance Act