chapter one- public health: the population health approach

• Water chlorination, hand-washing, indoor plumbing: public health accomplishments that largely eliminated the transmission of common bacterial diseases.
• Prevention of heart disease is another recent win for public health
  • successes include: reduction of blood pressure/cholesterol, cigarette smoking prevention and cessation efforts, the use of low-dose aspirin, understanding role of exercise, and the widespread availability of defibrillators
• Refrigerator: another success of public health for food and product safety to improve health
• Previous definitions of public health include:
  • Public health is “the science and art of preventing disease, prolonging life and promoting health through organized community effort.”
  • The substance of public health is the “organized community efforts aimed at the prevention of disease and the promotion of health.”
• Newer definition of public health that is more relevant to 21st century:
  • The totality of all evidence-based public and private efforts throughout the life cycle that preserve and promote health and prevent disease, disability, and death.
  • This allows public health to be seen as a broader topic that examines the full aspects of everything in society that can cause a detriment to our health.
• %%“Health in all policies” approach:%% examination of the full range of interventions to address health issues, including the structure and function of healthcare delivery systems (plus the role of public policies that affect health when health was not the intended effect).
• %%Public health:%% protecting health in the face of disasters, preventing disease from addiction such as cigarettes and opioids, controlling infections such as HIV and Zika, and developing systems that ensure the safety of food and water that we consume.
• %%Population health approach:%% full range of factors that affect health and considers their interactions.

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^^Health Protection (Antiquity--1830s)^^

• Organized community efforts to promote health and prevent disease:

  • Integrated concepts of prevention into culture/religion/laws

  • Prohibitions against specific food (pork, beef, seafood). Including the specific preparations: officially designated methods of killing cattle and methods of cooking

  • Prohibitions against alcohol or limited use for religious ceremony (control behavior and prevent disease)

  • Prohibition of cannibalism (strong grounding in protection of health)

  • Sexual practices as having health consequences

  • Male circumcision

  • Pre-marital abstinence

  • Marital fidelity

  • Quarantine/isolation of individuals with disease or those who have been exposed to disease

  • At times, they were successful but without a solid scientific basis.

  • Didn’t work for the Black Plague where they walled the towns from outsider, but didn’t realize it was the rats and fleas spreading disease.

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• Individual Productions of Insights into Preventing Disease

  • 1740s: British naval commander, James Lind found that lemons/other citrus fruits prevents and treats scurvy which was a common disease among sailors at the time because their diet didn’t include citrus fruits.
  • End of 1700s: English physician, Edward Jenner recognized cowpox (common mild ailment amongst those who milked cows, protected those who developed it against life-threatening small pox.
  • He developed something that came to be a vaccine (vacca: cow in Latin):
    • Placed fluid from cowpox sores under the skin of recipients and then exposed them to small pox.
    • Despite this being a successful smallpox prevention effort, it took some time for vaccines to be widespread as there was no scientific basis to support this at the time.

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