Public Health Historical and Constitutional Underpinnings of Public
Public Health Historical and Constitutional Underpinnings of Public Health and the Role of Government HST 2200 JCD/REC
Public health is concerned with threats to the overall health of a community. l Public health consists of many subcategories, e. g. : l l Epidemiology l Biostatsticscs l Health Services l Environmental Health l Social and Behavioral Health l Occupational Health 10/16/2021 HST 2200 JCD/REC 2
Focus of public health – Usually prevention, rather than treatment. l Examples of public health measures: l l Vaccination l Condom distribution l Smoking bans in public places l Others? ? ? 10/16/2021 HST 2200 JCD/REC 3
Public Health Initiatives l Hierarchy: l At the federal level, The United States Public Health Service (Surgeon-General) l State and local health departments 10/16/2021 HST 2200 JCD/REC 4
History of Public Health l l Early civilizations recognized the connection between polluted water and lack of proper waste disposal in the spread of disease. Behavior regulated through religion, e. g. l l Type of food eaten Alcohol consumption Sexual relations Government – established to ensure stability, prosperity, and to maintain order l 10/16/2021 Later expanded to include the development of public health policies and programs. HST 2200 JCD/REC 5
Early public health interventions l Chinese (1000 BC) l Smallpox epidemic l Some measure of immunity by inhaling l “Inoculation” Romans – disposal of human waste l Vaccination l l Edward 10/16/2021 Jenner (1820), smallpox HST 2200 JCD/REC 6
l 14 th century – “Black Death” in Europe l Removing dead bodies ineffective l Burning – effective since it removed rodents with fleas carrying the disease Quarantine l Miasma Theory of disease causation: l l Sanitation l Circulation of air l Spontaneous generation 10/16/2021 HST 2200 JCD/REC 7
l John Snow l Cholera outbreak (1854) l Science of Epidemiology Modern era of public health began in 1880’s l Robert Koch l l Germ l Theory Louis Pasteur l Vaccines 10/16/2021 HST 2200 JCD/REC 8
Modern Public Health l l As the rate of infectious diseases in the developed world decreased through the 20 th century, public health began to put more focus on chronic diseases such as cancer and heart disease. Since the 1980 s, the growing field of population health has broadened the focus of public health from individual behaviors and risk factors to population-level issues such as inequality, poverty, and education. 10/16/2021 HST 2200 JCD/REC 9
Modern Public health l l Address determinents of health across a population, rather than advocating for individual behavior change. Factors affecting health: l l l l Where people live Genetics/family history Income Educational status Social relationships Others? ? Known collectively as social determinents of health. 10/16/2021 HST 2200 JCD/REC 10
Public health today seeks to address health inequalities by advocating for population-based policies that improve the health of the whole population in a fair and equitable manner. l Health Economics l l How do we best spend limited public resources to either save lives or increase the quality of life for a population? 10/16/2021 HST 2200 JCD/REC 11
Constitutional Underpinning for Public Health Basis for public health imbedded in the U. S. Constitution: l “promote the general welfare” (preamble) l Interpreted to grant broad powers l Regulate commerce between states and foreign nations l l International and interstate quarantines l Sanitary supervision l Vital statistics 10/16/2021 HST 2200 JCD/REC 12
Current Public Health Issues Tuberculosis l HIV/AIDS l Smoking l l Controversial l Increased l Opponents taxation and public smoking bans to such measures l Undermines individual freedom and personal responsibility l “Nanny 10/16/2021 state” HST 2200 JCD/REC 13
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