Philosophy of Public Health

Ramadhan
Tosepu.,SKM.,M.Kes.,Ph.D
 OBJECTIVE
—  To state definitions of health
—  To state definitions and scopes of public health,
preventive medicine, social medicine, &
community medicine
—  To describe scientific approaches used in public
health
—  To describe goals and strategies of public health
Definition of Health ….
a state of relative equilibrium of body form and
function which results from its successful dynamic
adjustment to forces tending to disturb it. It is not
passive interplay between body substance and forces
impinging upon it but an active response of body forces
working toward readjustment (Perkins, 1938)

something positive, a joyful attitude toward life, and

acheerful acceptance of the responsibilities that life
puts upon the individual (Sigerist, 1941)
Definition of Health ….
a state of complete physical, mental, and social
well-being and not merely the absence of disease or
infirmity (WHO, 1948)

a state characterized by anatomic integrity, ability

to perform personally valued family, work, and
community roles; ability to deal with physical,
biologic, and social stress; a feeling of well-being;
and freedom from the risk of disease and untimely
death (Stokes et al., 1982)
Definition of Health …
a state of equilibrium between humans and the
physical, biologic, and social environment,
compatible with full functional activity (Last, 1987)

keadaan sejahtera dari badan, jiwa dan sosial yang

memungkinkan setiap orang hidup produktif secara
sosial dan ekonomis (a state of physical, mental and
social well-being that enables any individual to
achieve socially and economically productive life)
(Act No. 23, 1992)
 DEFINITION OF PUBLIC HEALTH
the science and the art of:
(1) preventing disease,
(2) prolonging life, and
(3) promoting physical health and efficiency through organized
community efforts for:
(a)   the sanitation of the environment,
(b)   the control of community infections,
(c)    the education of the individual in principles of
personal hygiene,
(d)   the organization of medical and nursing service for
the early diagnosis and preventive treatment of disease, and
(e)   the development of the social machinery which will
ensure to every individual in the community a standard of living
adequate for the maintenance of health so organizing these
benefits as to enable every citizen to realize his birthright of
health and longevity

(Winslow, 1920)
 DEFINITION OF PUBLIC HEALTH (cont’d)

♦  efforts organized by society to protect, promote and restore

the people’s health. It is the combination of science, skills and
beliefs that is directed to the maintenance and improvement of
the health of all people through collective or social actions
(Last, 1988)

♦  what we, as a society, do collectively to assure the conditions

for people to be healthy (IOM, 1988)

♦  the organization and application of public resources to

prevent, dependency, which would otherwise result from
disease or injury (Pickett & Hanlon, 1990)
 PREVENTIVE MEDICINE
is the science & art of
preventing disease,
prolonging life, &
promoting physical & mental health
& efficiency

For individuals & families by

For groups & community by
private health practitioners
public health practitioners
(general practice of PM)
(specialized practice of PM)
MEDICAL & DENTAL
PUBLIC HEALTH PRACTICE
PRACTICE

Through
Intercepting disease
Processes by community
& individual action

Leavell & Clark, 1958

Preventive Medicine:

a specialized field of medical practice composed of

distinct disciplines which utilize skills focusing on the
health of defined populations in order to promote
and maintain health and well-being and prevent
disease, disability, and premature death (Last, 1987)
Social Medicine :
a term used to emphasize the importance of
man’s environment to his health. In this sense,
environment includes the human society in
which man lives and the multitude of complex
interpersonal relationships that so profoundly
affect his health
(Leavell & Clark, 1958)
 COMMUNITY MEDICINE
—  a field of knowledge and practice concerned with the interaction of the individual
and the world with regard to health and illness. Its activities are expressed in
teaching, research and service with special attention to the health of human
populations in communities where thy live. Certain characteristics distinguish the
field:
—  it integrates knowledge from various disciplines, e.g. the physical, biological, and
behavioural sciences in order to understand health and illness both in individuals and in
communities;
—  it also attempts to apply that knowledge explicitly in regard to taking action to promote
health and alleviate illness in the population; and
—  the achievement of both the integration and application requires that it have an
interdisciplinary focus in the identification and resolution of health care problems in
communities

—  (Coe & Pepper, 1978)

COMMUNITY MEDICINE (cont’d)
that branch of medical science which is concerned with
the health needs and interventions of population groups
of known size and composition. That is, it is concerned
with health of what is commonly known as defined
population groups
(Lathem, 1979)
Scientific approaches in Public
Health

—  Epidemiology
—  Biostatistics
—  Environmental health
—  Social sciences
—  Demographic science
 Ultimate goal of public health
—  The prevention of disease
—  The promotion of health

Different between developed & developing countries

Prevention can be achieved
through:

—  Emphasizing preventive aspects of medical care

—  Health education & behavioral modification
—  Control of the environment for health
—  Cultivating political will for public health initiatives
 Public Health Strategies
1.  Surveillance

2.  Intervention:
1.  reducing the number of individuals
2.  susceptible to infectious & chronic disease
3.  treating people early in the course of disease
4.  modifying the environment
5.  promoting healthy behavior of both

3.  communities & individuals

4.  Evaluation
Thank you for your attention