1. Missouri Association of Local Boards of Health (MALBOH) Presents

2. TEN GREAT ACHIEVEMENTS OF PUBLIC HEALTH (WHY WE DO THE THINGS WE DO)! Modules developed by Ross McKinstry, MPH; Sheila Guice, MPH; and Mahree Skala, MA

3. ACHIEVEMENT #2: Prevention and Control of Infectious diseases

5. At the beginning of the 20th Century Infectious diseases such as influenza, smallpox, diphtheria and measles were prevalent They took many lives, especially among children Pneumonia, tuberculosis and diarrhea were the top 3 causes of death in 1900 Very few prevention measures or treatments were available to control the spread of diseases

6.  Control of infectious diseases has come from:  Clean drinking water  Improved sanitation  Vaccinations  Animal control regulations and services  Improvements in laboratory testing  Antibiotic treatments

7. Quarantine Sign of Yesterday...

8. Iron Lung

9. 1918 - Spanish Flu – at least 20 million died 1957 - Asian Flu - 70,000 died ⁻Took officials 6 months to detect 1968 - Hong Kong Flu - 34,000 died ⁻Took officials 3 months to detect 1977 - Russian Flu 2009 – H1N1

10. World War I Soldiers - Home from the front

11. The Spanish Flu of 1918 killed more people in U.S. (675,000) than all the wars of the 20th century combined

12. Community - Mass Immunizations

13. We must be vigilant to safeguard our water supplies through source protection, proper disinfection and filtration Outbreaks of E. Coli 0157 in the 1990’s were traced to contaminated ground water in New York and Wyoming, and such incidents continue The World Health Organization estimates 2,000,000 children worldwide die each year from diarrheal diseases due to contaminated water

16. Sewage draining to open ditch

17. Contaminated Ground Water

18. Chlorination Of Water Supplies for Communicable Disease Control… Began in New Jersey in 1908 Dramatically decreased the number of water- borne diseases Currently 98% of water treatment facilities in the US disinfect with chlorine

19. Water testing is important to monitor for diseases…

20.  Sanitation and hygiene measures  Vaccination  Antibiotics  Serologic (blood) testing  Sophisticated laboratory testing methods  Surveillance (disease reporting) laws and systems ALL THESE MEASURES HAVE GREATLY REDUCED DISEASE TRANSMISSION

21. 2001-2010 New Tuberculosis cases ⁻ Declined from 6.6 in 1998 to 4.2 2008 Hospital-acquired bloodstream infections from central IV lines ⁻ Declined from 5.5 in 1995-98 to 1.6 in 2009 Efforts to extend HIV testing ⁻ Expand screening of persons aged 13--64 years to enable earlier access to life-saving treatment Implementation of new blood donor screening ⁻Interdicted 3,000 potentially infected U.S. donations from blood supply

22. POLICY CHALLENGES State law is not strict enough to protect the public from contamination from onsite sewage systems. (Discharges to road ditches) Ground and surface water contamination continue to be sources of communicable disease

23. ACHIEVEMENT #3: Safer And Healthier Foods

25. Today E. Coli 0157, Staphylococcus, Campylobacter, Listeria and Salmonella are the common food-borne diseases No longer are Trichinosis and Botulism the prevalent threats, thanks to advances in food production and processing

26. Decreased microbial contamination and food-borne disease Improved food handling methods - refrigeration Improved nutritional value of foods, crops Identifying essential micronutrients and deficiency conditions Folic acid and other new disease- preventing functional food elements

27. Five-A-Day Programs

28. Increase in nutritional content Establishment of food-fortification programs ⁻ (vitamin fortification, WIC, Summer Food, etc) Close to eliminating major nutritional deficiency diseases in U.S. ⁻ (e.g. Rickets, Beri-Beri, Goiter, Pellagra)

29. Mistakes are made—LPHAs must maintain vigilance through inspections, food recall enforcement, disease surveillance Mass food production and distribution means more multi-state outbreaks and recalls

30. Farm-to-Table programs to promote locally grown, healthy foods in schools and childcare Support for policies that help improve the nutritional content of food for children Improve access to label information that will help people make good choices Maintain food protection laws and rules already on the books!

31.  Ten Great Achievements of Public Health in the 20 th Century Morbidity and Mortality Weekly Report April 2, 1999 / 48 (12);241-243 http://www.cdc.gov/mmwr/preview/mmwrhtml/0005679 6.htm http://www.cdc.gov/mmwr/preview/mmwrhtml/0005679 6.htm  Update, May 20, 2011 / 60(19);619-623 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6019a5.ht m

32.  Achievements in Public Health, 1900-1999: Control of Infectious Diseases Morbidity and Mortality Weekly Report July 30, 1999 / 48 (29);621-629 http://www.cdc.gov/mmwr/preview/mmwrht ml/mm4829a1.htm http://www.cdc.gov/mmwr/preview/mmwrht ml/mm4829a1.htm

33.  Achievements in Public Health, 1900-1999: Safer and Healthier Foods Morbidity and Mortality Weekly Report October 15, 1999 / 48 (40);905-913 http://www.cdc.gov/mmwr/preview/mmwrht ml/mm4840a1.htm

34. Thanks! Questions