introduction to community medicine

Previous names for Community Medicine

Public Health, Preventive Medicine, Social Medicine, and Community Health.

Year of the UK recommendation for Community Medicine departments

1968 (recommended for every medical school in England).

Primary goal of Community Medicine beyond treatment

To ask why illness happens, how it spreads, and what can be done at scale.

Four things Community Medicine equips future doctors to do

Think beyond the hospital, address root causes, build leadership/research skills, and serve populations ethically.

Etymology of "Hygiene"

Derived from Hygeia, the goddess of health in Greek mythology.

Definition of Hygiene

The science of health including all factors contributing to healthful living.

Birthplace and time of Public Health

England, around 1840.

Pioneer of sanitary reforms in England (1800-1890)

Edwin Chadwick.

The "Great Sanitary Awakening"

A movement started in England focused on sanitary reforms to improve public health.

Winslow’s 1920 definition of Public Health

The Science and Art of (1) preventing disease, (2) prolonging life, and (3) promoting health/efficiency through organized community effort.

James Lind’s 1753 discovery

Use of fresh fruit and vegetables for the prevention of scurvy.

Edward Jenner’s 1796 contribution

The first vaccination against smallpox.

Scientific fields that enriched preventive medicine

Nutrition, chemotherapy, antibiotics, insecticides, and hormones.

Definition of Preventive Medicine

The science and art of preventing disease, prolonging life, and promoting physical and mental health and efficiency.

Preventive Medicine vs. Public Health focus

Preventive Medicine focuses on the healthy individual

Modern scope of Preventive Medicine

Concerned with both acute communicable diseases and chronic non-communicable diseases (CVD, cancer, accidents).

Definition of Social Medicine

The study of man as a social being in his total environment.

The two pillars of Social Medicine

Medicine and Sociology.

Social Etiology concept

The fact that the suffering of man can be partly due to social causes, not just pathogens.

Social Pathology concept

The fact that consequences of disease are not only physical but also social.

Social Therapy/Remedies

Comprehensive therapeutics must include social remedies in addition to medical care.

Public Health Phase 1: Disease Control (1880-1920)

Focused on sanitary legislation and physical environment (water/sewage) to improve general health.

Public Health Phase 2: Health Promotion (1920-1960)

Initiated personal health services like maternal-child health, school health, and industrial health.

Public Health Phase 3: Social Engineering (1960-1980)

Addressed chronic diseases (cancer, CVD, addiction) and prioritized social/behavioral aspects.

Public Health Phase 4: Health for All (1980-2000s)

Focused on narrowing the health gap between rich and poor through Primary Health Care (PHC).

Core principle of "Health for All" (HFA)

Equity in health (all people should have the opportunity to enjoy good health).

Primary goal of HFA in the 21st Century

Elimination/eradication of diseases and Universal Health Coverage (UHC).

Definition of Universal Health Coverage (UHC)

Everyone, everywhere, has access to quality care they need without financial hardship.

The "Universal" in UHC

All people regardless of race, gender, age, and social status.

The 5 pillars of health services in UHC

Promotive, preventive, curative, rehabilitative, and palliative care.

The 6 characteristics of "Quality" in UHC

Safe, effective, patient-centered, timely, efficient, and equitable.

Definition of "Financial Catastrophe" in health

Out-of-pocket expenditure exceeding 40% of household income net of subsistence needs.

Definition of Community Medicine (Modern)

Science and art of promoting health through comprehensive interventions implemented via health systems and community engagement.

Objective: Community Diagnosis

To identify health needs, risks, and resources of a population.

Objective: Disease Prevention

Implementing primary, secondary, tertiary, and quaternary prevention strategies.

Objective: Equity and Social Justice

Reducing health disparities and ensuring fair access.

Importance of Evidence-Based Planning

Uses epidemiological data and biostatistics to guide policies and allocate resources.

Role in Outbreak Response

Supports early detection, rapid response, and long-term system strengthening during emergencies.

Integration with Health Systems

Enhances efficiency by linking clinical services with public health infrastructure.