Public Health

An Introduction

Renata

What Is Public Health?

It is often easier to talk about examples of
public health initiatives, such as
vaccination programs and milk
pasteurization, than to describe exactly
what public health is.
http://www.youtube.com/watch?v=R1aloiS
Y3dI

What Are You Studying?

Suppose your Uncle Joe stops you and
asks you what is Public Health?
What would you tell him?

Uncle Joe

Public Health Accomplishments: A

Field That Makes A Difference
Technology, science, the arts: Lots of
disciplines improve and enrich our lives.
But none can match public health in
extending the length and improving the
quality of life in the United States over
the past century.

Increased Years of Life

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000

How did we add 30 years in one

century?
Mostly through the accomplishments of
public health.
Five of the 30 years can be attributed to
improvements in medicine and drugs.
The other years are due to various public
health initiatives.

Contributions to Increase Life

Expectancy

Public Health Accomplishments

1. Vaccination
2. Motor-vehicle safety
3. Safer workplaces
4. Control of infectious diseases
5. Decline in deaths from coronary
heart disease and stroke
6. Safer and healthier foods
7. Healthier mothers and babies
8. Family planning

The Evolving Need for Public

Health 1700s-1800s

The Age of Industrialization

People moved from the farms to the cities
Small pox inoculations - Lady Mary Wortley Montagu
Development of the smallpox vaccine - Edward Jenner
Introduction of epidemiology John Snow
The Germ Theory of Disease - Louis Pasteur
The four postulates of infectious disease Robert Koch
The unhealthy conditions of New York City tenements Lillian Wald

Lady Mary Wortley Montagu

Lillian Wald

Snow: The Initial Investigations

Snow on Cholera
http://www.ph.ucla.edu/epi/snow/Snowpart1_files/frame.
htm
The Initial Investigations
http://breeze.unc.edu/p60491740/
Next Steps http://breeze.unc.edu/p15812471/
Snow Takes Action http://breeze.unc.edu/p24403330/
Further Investigation http://breeze.unc.edu/p17552645/
The Case of the Hampstead Widow
http://breeze.unc.edu/p35464436/

The Evolving Need for Public

Health 1900s to the Present
1918 Influenza Pandemic
In 1964, the U.S. Surgeon General report
on cigarette smoking and its connection
with cancer
In 1981, the HIV-AIDS virus was first
recognized
In 1990, as awareness of the relationship
between diet and disease increased
In 2001, the threat of bioterrorism

Development of the U.S. Public

Health Infrastructure
1798. The U.S. Public Health Service
The first marine hospital owned
by the Federal Government was
purchased from the State of
Virginia in 1801 and was located
at Washington Point in Norfolk
County.

Other Public Health Infrastructure

Developments
1798: First local public health board
1870s: State boards of health created
Late-1800s: Shift to social reform as
strategy for public health
1970s 1990s: Public healths
responsibilities broaden to include chronic
diseases
Lemuel Shattuck

New York, New York. Bread line beside

the Brooklyn Bridge approach, 1930s.

What Are the Leading Health

Indicators?
Will be used to measure the health of the
Nation over the next 10 years.
Each of the 10 Leading Health Indicators
has one or more objectives from Healthy
People 2010 associated with it.
Each were selected on the basis of their
ability to motivate action, the availability of
data to measure progress, and their
importance as public health issues.

What Are the Leading Health

Indicators? (continued)

Physical Activity
Overweight and Obesity
Tobacco Use
Substance Abuse
Responsible Sexual Behavior
Mental Health
Injury and Violence
Environmental Quality
Immunization
Access to Health Care

Who is Responsible for the

Publics Health?
Government agencies
federal,
state and
local

Non-governmental agencies, such as nonprofit organizations.

Overview of Health and Human

Services
Responsible for protecting the health of
Americans and providing essential human
services, especially for citizens least able to help
themselves
it is charged with most (but not all) public health
activities.
The Secretary of Health and Human Services
serves as a member of the President's Cabinet.
is appointed by the President and must be
approved by the U.S. Senate.

National Organizations For Public

Health Professionals
American Public Health Association
Association of State and Territorial Health
Officials
National Association of City and County
Health Officers
HRSA Public Health Training Centers
Network

State Authority and Responsibilities

The more complete and coordinated
structure for public health activities is at
the state and local levels.
Various states have taken different
approaches to organizing and
administering public health.
Centralized vs. decentralized

Local Health Departments and

Boards of Health
Each community has its own unique local public
health system
Generally, public health decisions at the local
level are made by professionals at regional or
county health departments and by their boards of
health.
Public health practitioners at these departments
are responsible for ensuring that all members of
the community are served. Generally, a local
board of health has primary responsibility and
legal authority for public health decisions.

Role of Non-Governmental Entities

Organizations that are not part of the
government also play a vital role in the U.S.
public health infrastructure.
These organizations include hospitals, health
care providers in private practice, and health
plans.
Private, non-profit organizations, too, contribute
to public healths mission. Among them are the
United Way, American Red Cross and American
Cancer Association.

Summary of Public Health

Organizational Structure
Primary responsibility and authority for public
health in the U.S. is assigned to federal, state
and local public health agencies
Federal agencies set policy and standards and
provide guidance and funding;
State agencies define policies and establish and
help fund local or regional public health
initiatives; and
Local/regional health departments implement
public health programs.