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HISTORY OF PUBLIC HEALTH Recurring Issues

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HISTORY OF PUBLIC HEALTH. Recurring Issues. Movement of people(s) ... Social Security Act (1935) Federal Security Agency (1939) ... – PowerPoint PPT presentation

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Title: HISTORY OF PUBLIC HEALTH Recurring Issues


1
HISTORY OF PUBLIC HEALTHRecurring Issues
  • Movement of people(s)
  • Influence of war on disease and public health
    concerns
  • Early historical examples
  • Mongol invasions from the East
  • Crusades in Middle Ages
  • Colonization invasions
  • Civil War in the United States
  • Spanish-American War
  • World War II

2
HISTORY OF PUBLIC HEALTHRecurring Issues
(contd.)
  • Influence of colonization/immigration on disease
    and public health concerns
  • Influence of commercial trade on disease and
    public health concerns

3
HISTORICAL PERSPECTIVE
  • Primitive societies
  • Classical Cultures
  • Middle Ages
  • Renaissance and the Age of Reason
  • Development of Public Health in the United States
  • English Influence
  • Colonial America
  • 19th Century in America
  • The Shattuck Report (1850)
  • Creation of Federal and State Environmental
    Agencies

4
HISTORICAL PERSPECTIVE (contd.)
  • Childrens Bureau (1912)
  • Food and Drug Administration (FDA)
  • Social Security Act (1935)
  • Federal Security Agency (1939)
  • Department of Heath, Education, and Welfare
  • Department of Health and Human Services
  • Hill-Burton Act (Hospital Survey and Construction
    Act (1946)
  • National Institutes of Health (NIH)
  • Medicare and Medicaid

5
Roman Civilization -- Public Health Achievements
  • Roman civilization that succeeded the Athenian is
    well known for its engineering and administrative
    arrangements affecting public health
  • E.g., inspection and removal of dilapidated
    buildings, elimination of dangerous animals and
    foul smells, supervision of weights and measures,
    supervision of public bars and taverns,
    supervision of houses of prostitution, regulation
    of building construction, etc.
  • E.g., supply of good and cheap grain guaranteed
    to the poor

6
Roman Civilization -- Public Health Achievements
(contd).
  • E.g., many streets were paved and had gutters
    that helped to drain by a network of underground
    conduits
  • E.g., provision was made for the cleaning and
    repair of streets and for removal of garbage and
    rubbish
  • E.g., public baths were constructed and
    extensively used
  • E.g., an adequate and relatively safe water
    supply was made available by construction of
    magnificent aqueducts and water tunnels
  • Many of these are still in use today, having been
    incorporated into the present-day water and
    sewage systems of Rome and other cities

7
MIDDLE AGES
  • Negative reactions to Greek/Roman influence
  • Disregard of personal hygiene and sanitation
  • Rise of pandemics -- e.g., cholera
  • Leprosy
  • Laws to isolate affected individuals lack of
    treatment or care
  • The Black Death (Bubonic Plague)

8
HISTORICAL PERSPECTIVE
  • Primitive societies
  • Classical Cultures
  • Middle Ages
  • Renaissance and the Age of Reason
  • Development of Public Health in the United States
  • English Influence
  • Colonial America
  • 19th Century in America
  • The Shattuck Report (1850)
  • Creation of Federal and State Environmental
    Agencies

9
FOUR ERAS IN THE DEVELOPMENT OF PUBLIC HEALTH IN
THE UNITED STATES
  • Colonial Era ? Early 19th Century Characterized
    by the appearance of boards of health, mainly in
    port cities
  • The Shattuck Era (c. 1950) ? Characterized by
    the development of organized health departments
    and the impact of the new biological sciences on
    health
  • Early 20th Century Characterized by the
    development of state and local health departments
    serving most of the population of the United
    States

10
FOUR ERAS IN THE DEVELOPMENT OF PUBLIC HEALTH IN
THE UNITED STATES (contd.)
  • Late 20th Century Characterized by the
    expansion of public health concerns into medical
    care, community mental health, chronic diseases,
    and health behavior, and a new concern with the
    impact of environment on health
  • Y2K ? Who knows? Likely, considerable
    wrestling with a growing national awareness of
    limited resources and nearly insatiable demands
    for improved health

11
  • 1800-1850 Although the United States expanded
    greatly in population, public health measures
    remained essentially stationary
  • Life expectancy in Boston decreased from27.9
    years in 1820-1825 to 21.4 years in 1840-1845
  • In 1950, in Massachusetts the tuberculosis death
    rate was over 300 per 100,000 population, and
    infant mortality was about 200 per 1,000 live
    births

12
THE SHATTUCK REPORT -- Report of the Sanitary
Commission of Massachusetts (1850)
  • Report of a legislative committee on sanitation
    and health problems in Massachusetts
  • A signal event in the development of public
    health in the United States
  • In effect, it charted health pathways for future
    generations
  • A remarkable document with considerable
    contemporary relevance in its various
    recommendations
  • Results started to appear in 1969, when
    Massachusetts establish its first state board of
    health

13
RECOMMENDATIONS OF THE SHATTUCK REPORT(1850)
  • Establishment of state and local boards of health
  • System of sanitary police or inspectors
  • Collection and analysis of vital statistics
  • Routine system for exchanging data and
    information on public health matters
  • Sanitation programs for towns and buildings
  • Studies of the health of school children
  • Studies of tuberculosis
  • Control of alcoholism

14
RECOMMENDATIONS OF THE SHATTUCK REPORT(1850)
contd.
  • Supervision of mental disease
  • Sanitary supervision and study of problems of
    immigrants
  • Erection of model tenements, public bath houses
    and wash houses
  • Control of smoke nuisances
  • Control of food adulteration
  • Exposure of nostrums -- I.e., panaceas,
    elixirs, eetc.
  • Preaching of health from pulpits
  • Establishment of nurses training schools

15
RECOMMENDATIONS OF THE SHATTUCK REPORT(1850)
contd.
  • Teaching of sanitary science in medical schools
  • Inclusion of preventive medicine in clinical
    practice
  • Routine physical examinations and maintenance of
    family records of illness

16
DEVELOPMENT OF PUBLIC HEALTH AGENCIES AND
LEGISLATION IN THE UNITED STATES
  • Local Health Departments
  • State Health Departments
  • Early Federal Health Agencies
  • Marine Hospital Service (est. 1798) -- first
    national health initiative
  • Port Quarantine Act (1878)
  • Public Health and Advances in Bacteriology
  • United States Public Health Service
  • Stems from the Marine Hospital Service
  • 1902 -- Renamed the Public Health Marine
    Hospital Service
  • 1912 -- renamed the U.S. Public Health Service

17
DEVELOPMENT OF PUBLIC HEALTH AGENCIES AND
LEGISLATION IN THE UNITED STATES
  • American Public Health Association (est. 1872)
  • Pure Food and Drug Act (1906) -- FDA
  • Childrens Bureau (est. 1912)
  • Sheppard-Towner Act (Maternal and Infancy Act)
    (1921)
  • Social Security Act (1935)
  • Hill-Burton Act (Hospital Survey and Construction
    Act (1946)
  • National Institutes of Health
  • Medicare and Medicaid (1935)
  • Federal and State Environmental Agencies (1970s)

18
PUBLIC HEALTH AND ADVANCES IN BACTERIOLOGY
  • Between 1877 and the end of the 19th century, the
    identity of numerous bacterial disease agents was
    established
  • These agents included those causing gonorrhea,
    typhoid fever, leprosy, tuberculosis, cholera,
    diphtheria, tetanus, pneumonia, plague, and
    dystentery
  • The subperiod (1875-1900) has been termed by
    some as the bacteriological period of public
    health
  • Examples
  • 1862 -- In France, Louis Pasteur proposed his
    germ theory of disease

19
PUBLIC HEALTH AND ADVANCES IN BACTERIOLOGY
(contd.)
  • Prior to this, miasmas (bad vapors) were
    thought to be thsource of many diseases
  • 1890 -- Pasteurization of milk introduced
  • 1891 -- Meat inspection inititiated
  • 1895 -- Septic tanks for sewage treatment were
    introduced

20
SUMMARY OBSERVATIONS
  • Public health services as last resort, safety
    net, etc.
  • Continuing separation of medical care and (1)
    public health, and (2) mental health
  • Recent reorganization of responsibility fot
    environmental health, with inception of the
    Environmental Protection Agency (EPA)
  • To understand public health and its
    administration in the United States, must
    understand our intergovernmental system
  • Some disarray in public health, partly due to the
    broad spectrum of concerns definable as public
    in scope
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