The History of Health and Health Education Chapter 2

Why study history? Can’t fully appreciate the profession without knowing about the origin Allows you to see progress made & observe trends over time Provides an appreciation of the struggles & obstacles faced by pioneers of the profession Learn from the past

Approximate Timeline by Era Early Humans Conjecture Observation, trial, & error Puzzled by disease and death Early efforts at community health India: 4,000 years ago, signs of sanitation Oldest health-related documents Smith Papyri – surgical techniques Code of Hammurabi – laws pertaining to health practices (physician fees)

Approximate Timeline by Era (con’t.) Egyptians (3000-1500 B.C.) Primitive medicine due in part to conservatism of priest-physicians Known for cleanliness Hebrews – (1500 B.C.) Extended Egyptian hygienic thought First written hygienic code: book of Leviticus

Approximate Timeline by Era (con’t.) Greeks (1000-400 B.C.) 1st to put emphasis on disease prevention Balance among physical (athletics), mental (philosophy), and spiritual (theology) Asclepius – god of medicine Hygeia – power to prevent disease Panacea – ability to treat disease Hippocrates (460-377 B.C.) – the first epidemiologist and father of medicine

Approximate Timeline by Era (con’t.) Romans (500 B.C.- A.D. 500) Accepted ideas of Greeks Emphasis on community health (e.g., sewer & aqueduct systems) Appreciation for hygiene Developed first hospital Public medical service & private medical practice Study of anatomy & practice of surgery

Approximate Timeline by Era (con’t.) Middle Dark Ages (500 B.C.- A.D. 1500) Political and social unrest; many health advances lost Overcrowding, sewage removal, lack of fresh water problems Christianity was born; had importance of body Many epidemics, i.e., leprosy & bubonic (black) plague Many theories for disease; many superstitions Education about health continued

Approximate Timeline by Era (con’t.) Renaissance (rebirth) (A.D. 1500 - 1700) Science re-emerged as legitimate field Still much disease & plague; medical care rudimentary Barber-surgeons English royalty lived better; hygiene problems 16th century in Italy; public health boards instituted Microscope discovered; epidemiology studied

Approximate Timeline by Era (con’t.) Age of Enlightenment (1700s) Period of revolution, industrialization, & growth in cities Disease & epidemics still problems Miasmas theory – from vapors Edward Jenner discovered vaccine for smallpox Health education still not a profession

Approximate Timeline by Era (con’t.) The 1800s First 50 years, much disease, little progress 1842, Chadwick’s Report on an Inquiry into the Sanitary Conditions of the Laboring Populations of Great Britain 1849, Snow removes pump handle in London 1862, Pasteur proposes germ theory 1876, Koch aligns specific microbes with specific diseases 1875-1900, bacteriological period of public health

Public Heath in the United States Health conditions similar to Europe: deplorable; sanitation poor; much disease Many immigrants, cities growing, overcrowding Quarantine & environmental regulations used 1789, first life expectancy tables created 1790s, some cities formed local health boards 1798, Marine Hospital Service Act

Public Heath in the U.S. (con’t.) 1800-1850 Little progress, still much disease Industrial Revolution brought more people to cities 1850-1900 Public health reform slow to get started 1850, Shattuck’s Report of Sanitary Commission of Massachusetts 1872, APHA founded State boards of health formed 1879, National Board of Health created

Public Heath in the U.S. (con’t.) 1900-1920 Reform phase of public health Many social problems First voluntary health agencies formed 1902, National Assoc. for Study & Prevention of TB 1913, American Cancer Society 1912, Marine Hospital Service becomes U.S. Public Health Service 1920s Relatively quiet period in public health Need for health education existed

Rules of Good Health – 1922 (Means, 1975) Full bath more than once a week Brush teeth at least once a day Sleep long hours with windows open Drink as much milk as possible, but no coffee or tea Eat some vegetables or fruit everyday Drink at least 4 glasses of water a day Play part of every day outdoors A bowel movement every morning

Public Heath in the U.S. (con’t.) 1930s & 1940s Emphasis on treatment over prevention 1930, Hygienic Laboratory converted to the National Institute of Health (now called National Institutes of Health (NIH)) Social Security Act of 1935, beginning of federal government’s involvement in social issues 1946, Communicable Disease Center was established (now called Centers for Disease Control & Prevention (CDC)) 1946, National Hospital Survey & Construction Act, also known as Hill-Burton Act: distribution & quality of hospitals

Public Heath in the U.S. (con’t.) 1950s & 1960s Switch of emphasis from communicable to noncommunicable diseases Seed planted for health educators to play a greater role in prevention 1965, amendments to Social Security Act of 1935 Medicare: health insurance for the elderly Medicaid: health insurance for the poor

Public Heath in the U.S. (con’t.) 1970s, 1980s, & 1990s 1974, Canadian report A New Perspective on the Health of Canadians: importance of lifestyle & environmental factors to health 1974 to present, Health Promotion Era of Public Health 1979, Healthy People published: importance of lifestyle 1980, Promoting Health/ Preventing Disease: Objectives of the Nation: 1st set of objectives 1990, Healthy People 2000, National Health Promotion & Disease Prevention Objectives 1997, health educator, new occupation classification

Is the nation’s health promotion and disease prevention agenda A roadmap to improve health using a 10-year plan Composed of three parts

Part I Healthy People 2010: Understanding & Improving Health History Determinants of health model How to use a systematic approach Leading Health Indicators (LHI)

LEADING HEALTH INDICATORS Physical activity Overweight & obesity Tobacco use Substance abuse Responsible sexual behavior Mental health Injury & violence Environmental quality Immunization Access to health care

Part II Healthy People 2010: Objectives for Improving Health Overarching goals Increase quality and years of healthy life Eliminate health disparities 467 objectives distributed over 28 focus areas 1) Access to Quality Health Services, 2) Arthritis, Osteoporosis, & Chronic Back Conditions, 3) Cancer, 4) Chronic Kidney Disease, 5) Diabetes, 6) Disability & Secondary Conditions, 7) Education & Community-Based Programs, 8) Environmental Health, 9) Family Planning, 10) Food Safety, 11) Health Communication, 12) Heart Disease & Stroke, 13) HIV, 14) Immunizations & Infectious Diseases, 15) Injury & Violence Prevention, 16) MIC Health, 17) Medical Product Safety, 18) Mental Health & Mental Disorders, 19) Nutrition & Overweight, 20) Occupational Safety & Health, 21) Oral Health, 22) Physical Activity & Fitness, 23) Public Health Infrastructure, 24) Respiratory Diseases, 25) STDs, 26) Substance Abuse, 27) Tobacco Use, 28) Vision & Hearing

Part III Tracking Healthy People 2010 – provides a comprehensive review of the statistical measures that will be used to evaluate progress

School Heath in the United States 1647, “Old Deluder” law passed in MA 1837, Mann, Secretary of MA Board of Education, called for mandatory programs of hygiene mid-1800s, most schools tax supported & attendance required 1850, Shattuck’s report called for teaching of physiology 1880-1890, all states passed law requiring teaching on evils of alcohol, narcotics, & tobacco because of pressure from Women’s Christian Temperance Union

School Heath in the U.S. (con’t.) 1910-1920 Health education characterized by inconsistency & awkward progress 1915, National TB Association introduced “Modern Health Crusade” Sally Jean Lucas, active leader in Child Health Organization of America, was responsible for changing name from hygiene education to health education WWI, 29% of men rejected for service on physical grounds; helped show need for school health

School Heath in the U.S. (con’t.) 1920s, 1930s, & 1940s Profession was moving forward A number of school health demonstration projects; showed habits could be changed & health improved 1937, American Association of School Physicians founded; later becomes American School Health Association A number of other professional organizations include school health in their title or mission WWII, 50% of men rejected for service

School Heath in the U.S. (con’t.) Demonstration projects completed; positive results 1964 School Health Education Study (SHES) Phase 1, Surveys of students & administrators: results were appalling Phase 2, Health curriculum: 10 conceptual areas 1978 Office of Comprehensive School Health established in USDE

School Heath in the U.S. (con’t.) Coordinated School Health Program

School Heath in the U.S. (con’t.) Coordinated School Health Program Comprehensive School Health Instruction

School Heath in the U.S. (con’t.) 1995 National Health Education Standards; health literacy Students will: comprehend concepts related to health promotion & disease prevention demonstrate the ability to access valid health information & health promoting products & services demonstrate the ability to practice health-enhancing behaviors & reduce health risks analyze the influence of culture, media, technology, & other factors on health demonstrate the ability to use interpersonal communication skills to enhance health demonstrate the ability to use goal-setting & decision-making skills to enhance health demonstrate the ability to advocate for personal, family, & community health

School Heath in the U.S. (con’t.) Today Schools still hold great promise for health education efforts 52 million K-12 students 100,000 schools 14 million college students CDC’s six critical behaviors Alcohol & drug use Injury & violence (including suicide) Tobacco use Nutrition Physical activity Sexual behaviors

The History of Health and Health Education Chapter 2 – The End