1. Population Health for Health Professionals

2. Module 1 The Perspective of Public Health

3. Module I Purpose l Present the public health perspective on health and illness at community level l Introduce basic vocabulary of public health l Establish framework for understanding specific skills and practices of public health in later modules

4. OBJECTIVES l Describe mission, responsibilities and core functions of public health systems l Identify essential services l List key infrastructure components l Identify important historical figures l Describe future trends

5. Part 1 The History Of Public Health

6. Definition of Health l The state of complete physical, mental and social well-being and not merely the absence of disease or infirmity WHO, 1947

7. Definition of Public Health l Activities that society undertakes to assure the conditions in which people can be healthy, including organized community efforts to prevent, identify and counter threats to the health of the public.

8. Public Health System Activities l Health promotion l Disease prevention

9. Prevention Triangles Population Oriented Prevention Clinical Preventive Services Primary Medical Care Secondary Medical Care Tertiary Medical Care Tertiary Prevention Secondary Prevention Primary Prevention

10. Ethical Values of Public Health l Beneficence l Non-malfeasance l Autonomy l Social justice l Truth-telling

11. Balancing Ethical Conflicts l Public health practice is always struggling to find the correct balance between respect for individual autonomy and decision-making and the need for limitations on individuals in order to achieve social justice.

12. Key Events in the History of Public Health

13. Key Events Did you know that... l South Carolina had the first provincial health officer in America, in 1712? l South Carolina had its first water protection regulations in 1671?

14. Key Events Snow and Cholera l Epidemiology: mapping cases of cholera and household use of water sources revealed pattern involving a single water pump l Removing the handle from the Broad Street pump ended the epidemic

15. Death Rates From Cholera 1853-54

16. Did you know that... l In an 1881 report the SC Board of Health identified swamp drainage as an important tool in stopping malaria, 10 years before the mosquito was identified as the specific vector of the disease?

17. Massachusetts and the Shattuck Report Massachusetts and the Shattuck Report l Massachusetts and the Shattuck Report s 1850 review of sanitation practices and the potential for improving health status by enforcement of a sanitary code led to creation of local board of health in Massachusetts. This movement spread to other localities. l SC State Board of Health s Established in 1898.

18. US Public Health Service l Marine Hospital Service s Created from concern for protection against imported infectious diseases and need to care for sick seamen l US Public Health Service s Uniformed service on call for local, national or international service in the protection of the public’s health

19. The Muckrakers and New Agencies l Food and Drug Administration created to administer Pure Food, Drug and Cosmetic Act l Superfund administered by the Environmental Protection Agency l U.S. Department of Agriculture l Occupational Safety & Health Act

20. Great Public Health Achievements of This Century l Vaccination l Motor vehicle safety l Safer workplaces l Control of infectious diseases l Decline in deaths from coronary heart disease and stroke l Safer, healthier food l Healthier mothers and babies l Family planning l Flouridation of drinking water l Recognition of tobacco as a hazard

21. Discussion Time l What has been your personal awareness of public health? l Have you ever visited a public health program? Used a public health service? l What are current public health issues in your community?

22. Summary of Module 1, Part 1 Public Health: l Services were developed to address the health needs of communities. l Has developed a world view of health. l Focuses on populations rather than individuals.

23. Module Author Kristine M. Gebbie, DrPH, RN Columbia University School of Nursing Center for Health Policy