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Public Health

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Delivery of malaria treatment by community health worker in Djénébougou, Mali. October 2013.
COVID-19 vaccination center, fair grounds Cologne, 1st vaccination
Installing E. 80th Street pipeline, Seattle, Washington, USA, 1931
The Addl. Secretary, Ministry of Health and Family Welfare, Shri Keshav Desiraju addressing at the launch of the media campaign of National Tobacco Control Programme, in New Delhi on February 02, 2012. The WHO Representative, Dr. Nata Menabde and other dignitaries are also seen.
Various aspects of public health: Clockwise from top left: Community health worker in Mali, vaccination example (COVID-19 vaccination in Germany), anti-smoking campaign in India, historical sewer installation photo from the United States.

Introduction

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This page about Public Health can be displayed as Wiki2Reveal slides. Single sections are regarded as slides and modifications on the slides will immediately affect the content of the slides. The content addresses the following topics:

  • (1) Origin of Public Health
  • (2) Interdisciplinary Scope
  • (3) Challenges, Requirements and Constraints

Learning Tasks

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  • Describe the link between Public Health and One Health.
  • What are historical drivers for the establishment of Public Health initiatives?
  • Explain the requirements and constraints of international collaboration to fight pandemics and epidemiological risks?
  • How does public health "literacy" or awareness of public health risk mitigation strategies contribution the health of society? Identify examples and explain how they work?

Wiki2Reveal Presentations

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Wiki2Reveal presentations can be used as a collaborative maintained Open Educational Resources

Objective

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This learning resource about Public Health has the objective to be introduced into the origin and current initiatives and concepts in the public health domain and related approaches in the health care system and governmental agencies.

Learning Moduls

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Overview

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Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals".[1][2]

Determinants of Health

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Analyzing the determinants of health of a population and the threats it faces is the basis for public health.[3] The public can be as small as a handful of people or as large as a village or an entire city; in the case of a pandemic it may encompass several continents.

Concept of Health

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The concept of health takes into account physical, psychological, and social well-being.[1][4]

Interdisciplinary Science

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Public health is an interdisciplinary field. For example, epidemiology, biostatistics, social sciences and management of health services are all relevant.

Important Sub-fields

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Other important sub-fields include environmental health, community health, behavioral health, health economics, public policy, mental health, health education, health politics, occupational safety, disability, oral health, gender issues in health, and sexual and reproductive health.[5]

Public Health as part of overall Health Care System

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Public health, together with primary care, secondary care, and tertiary care, is part of a country's overall healthcare system.

Public Health Implementation

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Public health is implemented through the surveillance of cases and health indicators, and through the promotion of healthy behaviors.

Common Public Health Initiatives

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Common public health initiatives include promotion of hand-washing and breastfeeding, delivery of vaccinations, promoting ventilation and improved air quality both indoors and outdoors, suicide prevention, smoking cessation, obesity education, increasing healthcare accessibility and distribution of condoms to control the spread of sexually transmitted diseases.

Access to Health Care Services and Disease Prevention

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There is a significant disparity in access to health care and public health initiatives between developed countries and developing countries, as well as within developing countries. In developing countries, public health infrastructures are still forming. There may not be enough trained healthcare workers, monetary resources, or, in some cases, sufficient knowledge to provide even a basic level of medical care and disease prevention.[6][7]. A major public health concern in developing countries is poor maternal and child health, exacerbated by malnutrition and poverty coupled with governments' reluctance in implementing public health policies.

History of Public Health

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From the beginnings of human civilization, communities promoted health and fought disease at the population level.[8][9] In complex, pre-industrialized societies, interventions designed to reduce health risks could be the initiative of different stakeholders, such as army generals, the clergy or rulers. Great Britain became a leader in the development of public health initiatives, beginning in the 19th century, due to the fact that it was the first modern urban nation worldwide.[10]

Sanitation and Disease Prevention

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The public health initiatives that began to emerge initially focused on sanitation (for example, the Liverpool and London sewerage systems), control of infectious diseases (including vaccination and quarantine) and an evolving infrastructure of various sciences, e.g. statistics, microbiology, epidemiology, sciences of engineering.[10]

Definitions and purposes

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A community health worker in Korail Basti, a slum in Dhaka, Bangladesh

Definition

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Public health has been defined as "the science and art of preventing disease", prolonging life and improving quality of life through organized efforts and informed choices of society, organizations (public and private), communities and individuals.[2] The public can be as small as a handful of people or as large as a village or an entire city. The concept of health takes into account physical, psychological, and social well-being. As such, according to the World Health Organization, "health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".[4]

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The WHO is the predominant agency associated with global health.

Public health is related to global health which is the health of populations in the worldwide context.[11] It has been defined as "the area of study, research and practice that places a priority on improving health and achieving equity in "Health for all" people worldwide".[12] International health is a field of health care, usually with a public health emphasis, dealing with health across regional or national boundaries.[citation needed] Public health is not the same as public healthcare (publicly funded health care).

Preventive Medicine

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The term preventive medicine is related to public health. The American Board of Preventive Medicine separates three categories of preventive medicine: aerospace health, occupational health, and public health and general preventative medicine. Jung, Boris and Lushniak argue that preventive medicine should be considered the medical specialty for public health but note that the American College of Preventive Medicine and American Board of Preventive Medicine do not prominently use the term "public health".[13](p1) Preventive medicine specialists are trained as clinicians and address complex health needs of a population such as by assessing the need for disease prevention programs, using the best methods to implement them, and assessing their effectiveness.[13](pp1,3)

Population Health

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Since the 1990s many scholars in public health have been using the term population health.[14](p3) There are no medical specialties directly related to population health.[13](p4) Valles argues that consideration of health equity is a fundamental part of population health. Scholars such as Coggon and Pielke express concerns about bringing general issues of wealth distribution into population health. Pielke worries about "stealth issue advocacy" in population health.[14](p163) Jung, Boris and Lushniak consider population health to be a concept that is the goal of an activity called public health practiced through the specialty preventive medicine.[13](p4)

Lifestyle Medicine

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Lifestyle medicine uses individual lifestyle modification to prevent or revert disease and can be considered a component of preventive medicine and public health. It is implemented as part of primary care rather than a specialty in its own right.[13](p3) Valles argues that the term social medicine has a narrower and more biomedical focus than the term population health.[14](p7)

Purposes

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The purpose of a public health intervention is to prevent and mitigate diseases, injuries and other health conditions. The overall goal is to improve the health of populations and increase life expectancy.[citation needed]

Characteristics and components

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Public health is a complex term, composed of many elements and different practices. It is a multi-faceted, interdisciplinary field.[10] For example, epidemiology, biostatistics, social sciences and management of health services are all relevant.

Public Health Sub-Fields

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Other important sub-fields include environmental health, community health, behavioral health, health economics, public policy, mental health, health education, health politics, occupational safety, disability, gender issues in health, and sexual and reproductive health.[5]

Multidisciplinary Public Health Practice

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Modern public health practice requires multidisciplinary teams of public health workers and professionals. Teams might include epidemiologists, biostatisticians, physician assistants, public health nurses, midwives, medical microbiologists, pharmacists, economists, sociologists, geneticists, data managers, environmental health officers (public health inspectors), bioethicists, gender experts, sexual and reproductive health specialists, physicians, and veterinarians.[15]

Temporal and spatial Requirements and Constraints

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The elements and priorities of public health have evolved over time, and are continuing to evolve.[10] Different regions in the world can have different public health concerns at a given time[citation needed] and public health risks may have temporal and spatial patterns (e.g. communicable diseases and dependencies of mosquito abundance on environmental conditions.

Preventive Initiatives

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Common public health initiatives include promotion of hand-washing and breastfeeding, delivery of vaccinations, suicide prevention, smoking cessation, obesity education, increasing healthcare accessibility and distribution of condoms to control the spread of sexually transmitted diseases.[citation needed]

Country examples

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Canada

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In Canada, the Public Health Agency of Canada is the national agency responsible for public health, emergency preparedness and response, and infectious and chronic disease control and prevention.[16]

Cuba

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Since the 1959 Cuban Revolution the Cuban government has devoted extensive resources to the improvement of health conditions for its entire population via universal access to health care. Infant mortality has plummeted.[17] Cuban medical internationalism as a policy has seen the Cuban government sent doctors as a form of aid and export to countries in need in Latin America, especially Venezuela, as well as Oceania and Africa countries.

Colombia and Bolivia

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Public health was important elsewhere in Latin America in consolidating state power and integrating marginalized populations into the nation-state. In Colombia, public health was a means for creating and implementing ideas of citizenship.[18] In Bolivia, a similar push came after their 1952 revolution.[19]

Ghana

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Ghanaian children receive insecticide-treated bed nets to prevent exposure to malaria transmitting mosquitos.

Though curable and preventive, malaria remains a major public health issue and is the third leading cause of death in Ghana.[20] In the absence of a vaccine, mosquito control, or access to anti-malaria medication, public health methods become the main strategy for reducing the prevalence and severity of malaria.[21] These methods include reducing breeding sites, screening doors and windows, insecticide sprays, prompt treatment following infection, and usage of insecticide treated mosquito nets.[21] Distribution and sale of insecticide-treated mosquito nets is a common, cost-effective anti-malaria public health intervention; however, barriers to use exist including cost, household and family organization, access to resources, and social and behavioral determinants which have not only been shown to affect malaria prevalence rates but also mosquito net use.[22][21]

United States

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The United States lacks a coherent system for the governmental funding of public health, relying on a variety of agencies and programs at the federal, state and local levels.[23] Between 1960 and 2001, public health spending in the United States tended to grow, based on increasing expenditures by state and local government, which made up 80–90% of total public health spending. Spending in support of public health in the United States peaked in 2002 and declined in the following decade.[24] State cuts to public health funding during the Great Recession of 2007–2008 were not restored in subsequent years.[25] As of 2012, a panel for the U.S. Institute of Medicine panel warned that the United States spends disproportionately far more on clinical care than it does on public health, neglecting "population-based activities that offer efficient and effective approaches to improving the nation's health."[26][24] As of 2018 , about 3% of government health spending was directed to public health and prevention.[27][28][29] This situation has been described as an "uneven patchwork"[30] and "chronic underfunding".[31][32][33][34] The COVID-19 pandemic has been seen as drawing attention to problems in the public health system in the United States and to a lack of understanding of public health and its important role as a common good.[27]

See also

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References

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  1. ↑ 1.0 1.1 Gatseva, Penka D.; Argirova, Mariana (1 June 2011). "Public health: the science of promoting health". Journal of Public Health 19 (3): 205–206. doi:10.1007/s10389-011-0412-8. ISSN 1613-2238. 
  2. ↑ 2.0 2.1 Winslow, Charles-Edward Amory (1920). "The Untilled Field of Public Health". Modern Medicine 2 (1306): 183–191. doi:10.1126/science.51.1306.23. PMID 17838891. https://zenodo.org/record/1448241. 
  3. ↑ "What is Public Health". Centers for Disease Control Foundation. Atlanta, GA: Centers for Disease Control. Retrieved 27 January 2017.
  4. ↑ 4.0 4.1 What is the WHO definition of health? from the Preamble to the Constitution of WHO as adopted by the International Health Conference, New York, 19 June – 22 July 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of WHO, no. 2, p. 100) and entered into force on 7 April 1948. The definition has not been amended since 1948.
  5. ↑ 5.0 5.1 PERDIGUERO, E. (2001-07-01). "Anthropology in public health. Bridging differences in culture and society.". Journal of Epidemiology & Community Health 55 (7): 528b–528. doi:10.1136/jech.55.7.528b. ISSN 0143-005X. PMC 1731924. //www.ncbi.nlm.nih.gov/pmc/articles/PMC1731924/. 
  6. ↑ Lincoln C Chen; David Evans; Tim Evans; Ritu Sadana; Barbara Stilwell; Phylida Travis; Wim Van Lerberghe; Pascal Zurn (2006). World Health Report 2006: working together for health. Geneva: WHO. OCLC 71199185. 
  7. ↑ Jamison, D T; Mosley, W H (January 1991). "Disease control priorities in developing countries: health policy responses to epidemiological change.". American Journal of Public Health 81 (1): 15–22. doi:10.2105/ajph.81.1.15. ISSN 0090-0036. PMID 1983911. PMC 1404931. //www.ncbi.nlm.nih.gov/pmc/articles/PMC1404931/. 
  8. ↑ Rosen, George (2015). A history of public health (Revised expanded). Baltimore. ISBN 978-1-4214-1601-4. OCLC 878915301. 
  9. ↑ Porter, Dorothy (1999). Health, Civilization and the State: A History of Public Health from Ancient to Modern Times. London and New York: Routledge. ISBN 978-0415200363. 
  10. ↑ 10.0 10.1 10.2 10.3 Crook, Tom (2016). Governing systems: modernity and the making of public health in England, 1830–1910. Oakland, California. ISBN 978-0-520-96454-9. OCLC 930786561. 
  11. ↑ "The World Health Organization and the transition from "international" to "global" public health". Am J Public Health 96 (1): 62–72. January 2006. doi:10.2105/AJPH.2004.050831. PMID 16322464. PMC 1470434. //www.ncbi.nlm.nih.gov/pmc/articles/PMC1470434/. 
  12. ↑ "Towards a common definition of global health". Lancet 373 (9679): 1993–5. June 2009. doi:10.1016/S0140-6736(09)60332-9. PMID 19493564. PMC 9905260. //www.ncbi.nlm.nih.gov/pmc/articles/PMC9905260/. 
  13. ↑ 13.0 13.1 13.2 13.3 13.4 Jung, Paul; Lushniak, Boris D. (March 2017). "Preventive Medicine's Identity Crisis". American Journal of Preventive Medicine 52 (3): e85–e89. doi:10.1016/j.amepre.2016.10.037. PMID 28012813. 
  14. ↑ 14.0 14.1 14.2 Valles, Sean A. (2018). Philosophy of population health : philosophy for a new public health era. London. ISBN 978-1-351-67078-4. OCLC 1035763221. https://www.worldcat.org/oclc/1035763221. 
  15. ↑ Joint Task Group on Public Health Human Resources; Advisory Committee on Health Delivery & Human Resources; Advisory Committee on Population Health & Health Security (2005). Building the public health workforce for the 21st century. Ottawa: Public Health Agency of Canada. OCLC 144167975. 
  16. ↑ "Canada: International Health Care System Profiles". international.commonwealthfund.org. Retrieved 2020-05-25.
  17. ↑ Pineo, "Public Health", p. 483.
  18. ↑ Hanni Jalil, "Curing a Sick Nation: Public Health and Citizenship in Colombia, 1930–1940." PhD dissertation, University of California, Santa Barbara 2015.
  19. ↑ Nicole Pacino, "Prescription for a Nation: Public Health in Post-Revolutionary Bolivia, 1952–1964." PhD dissertation, University of California, Santa Barbara 2013.
  20. ↑ "CDC Global Health – Ghana". www.cdc.gov. Retrieved 9 April 2018.
  21. ↑ 21.0 21.1 21.2 Agyepong, Irene Akua; Manderson, Lenore (January 1999). "Mosquito Avoidance and Bed Net Use in the Greater Accra Region, Ghana". Journal of Biosocial Science 31 (1): 79–92. doi:10.1017/S0021932099000796. ISSN 1469-7599. PMID 10081239. 
  22. ↑ "Ghana Demographic and Health Survey 2014" (PDF). Retrieved 18 May 2020.
  23. ↑ Leider, Jonathon P.; Resnick, Beth; Bishai, David; Scutchfield, F. Douglas (1 April 2018). "How Much Do We Spend? Creating Historical Estimates of Public Health Expenditures in the United States at the Federal, State, and Local Levels". Annual Review of Public Health 39 (1): 471–487. doi:10.1146/annurev-publhealth-040617-013455. ISSN 0163-7525. PMID 29346058. 
  24. ↑ 24.0 24.1 Himmelstein, David U.; Woolhandler, Steffie (January 2016). "Public Health's Falling Share of US Health Spending". American Journal of Public Health 106 (1): 56–57. doi:10.2105/AJPH.2015.302908. PMID 26562115. PMC 4695931. //www.ncbi.nlm.nih.gov/pmc/articles/PMC4695931/. 
  25. ↑ Alfonso, Y. Natalia; Leider, Jonathon P.; Resnick, Beth; McCullough, J. Mac; Bishai, David (1 April 2021). "US Public Health Neglected: Flat Or Declining Spending Left States Ill Equipped To Respond To COVID-19". Health Affairs 40 (4): 664–671. doi:10.1377/hlthaff.2020.01084. ISSN 0278-2715. PMID 33764801. PMC 9890672. //www.ncbi.nlm.nih.gov/pmc/articles/PMC9890672/. 
  26. ↑ Institute of Medicine (2012). For the Public's Health: Investing in a Healthier Future (in en). Washington, DC: The National Academies Press. p. 2. doi:10.17226/13268. ISBN 978-0-309-22107-8. 
  27. ↑ 27.0 27.1 Butcher, Lola (17 November 2020). "Pandemic puts all eyes on public health". Knowable Magazine. doi:10.1146/knowable-111720-1. https://knowablemagazine.org/article/health-disease/2020/pandemic-puts-all-eyes-public-health. Retrieved 2 March 2022. 
  28. ↑ "Health Care Costs Accounted for 17.7 Percent of GDP in 2018". California Health Care Foundation. 2 June 2020. Retrieved 2 March 2022.
  29. ↑ Nunn, Ryan; Parsons, Jana; Shambaugh, Jay (10 March 2020). "A dozen facts about the economics of the US health-care system". Brookings Institution. Retrieved 2 March 2022.
  30. ↑ Wallace, Megan; Sharfstein, Joshua M. (6 January 2022). "The Patchwork U.S. Public Health System". New England Journal of Medicine 386 (1): 1–4. doi:10.1056/NEJMp2104881. PMID 34979071. 
  31. ↑ "Explore Public Health Funding in the United States | 2021 Annual Report". America's Health Rankings. Retrieved 2 March 2022.
  32. ↑ "GHJP Report Calls for Reinvestment to Revive Public Health in the U.S." Yale Law School. June 7, 2021. Retrieved 2 March 2022.
  33. ↑ Eager, William; Herman, David; House, Margaret; Robinson, Leah; Williams, Christopher (2021). Confronting a legacy of scarcity: a plan for America's reinvestment in U.S. public health. Yale School of Public Health. https://law.yale.edu/sites/default/files/area/center/ghjp/documents/publichealthfunding_final_6.7.21.pdf. 
  34. ↑ "The Impact of Chronic Underfunding on America's Public Health System: Trends, Risks, and Recommendations, 2021". Trust for America's Health. May 7, 2021. Retrieved 2 March 2022.

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