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Rural Public Health Systems

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Division of Distance and Distributed Learning RURAL PUBLIC HEALTH SYSTEMS PHPM 601 INTRODUCTION AND THE HISTORY OF PUBLIC HEALTH MODULE 1 Introduction and History ... – PowerPoint PPT presentation

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Title: Rural Public Health Systems


1
Division of Distance and Distributed Learning
2
RURAL PUBLIC HEALTH SYSTEMS PHPM 601
  • INTRODUCTION AND
  • THE HISTORY OF PUBLIC HEALTH
  • MODULE 1

3
Introduction and History of Public
Health OBJECTIVES
  • Slides provide a brief exposure to the U.S.
    health system with a more detailed
    discussion/definition of public health.
  • Students gain first introduction to the
    population health perspective.
  • History of public health is described from its
    early roots in 19th century London.

4
Rural Public Health Systems
  • Individual introductions
  • Course introduction
  • Group Assignments
  • General discussion of the history of public
    health
  • Video James Burke The Day the Universe
    Changed Social Impacts of new Medical Knowledge
  • Brief intro to next session

5
Brief Introductions
  • Name
  • History
  • Job history or academic background
  • Experiences related to public health
  • Future
  • Why interested in PH, where going
  • Department affiliation
  • What you want to do when you grow up!

6
COURSE INFORMATION
  • Description
  • Objectives
  • Requirements
  • Exams, Presentations, Thought Papers, Rural
    Health Policy Analysis
  • Readings
  • Miscellaneous
  • Course Outline

7
Public Health
  • What is public health?
  • Where did it come from?
  • What are some good examples of public health
    practices?
  • Who does these things?
  • Why is it important to us today?

8
WHAT IS PUBLIC HEALTH?
9
DEFINITIONS OF HEALTH/PUBLIC HEALTH
  • the science and art of preventing disease,
    prolonging life and promoting health and
    efficiency thru organized community effort
    (Winslow, 1920)
  • successive re-definings of the unacceptable
    (Vickers, 1958)
  • fulfilling societys interest in assuring
    conditions in which people can be healthy (IOM,
    1988)

10
DISEASE PREVENTION (SK, Ch. 1)
  • Primary prevention -- prevent the onset of
    disease
  • Secondary prevention identify disease processes
    are early as possible and intervene to prevent
    progression beyond early stage
  • Tertiary prevention rehabilitation or
    minimizing effect of disease

11
WHERE DID PUBLIC HEALTH COME FROM?
12
EARLY MODELS OF DISEASE
  • Disease as magic
  • Disease as divine punishment
  • Disease (individual and epidemic) as a function
    of environmental factors

13
History of Public Health
  • Consider childrens health
  • Could trace to Middle Ages
  • children essentially enslaved
  • Early Colonial Life (1600s)
  • kidnapped native children
  • imported Black slaves
  • apprenticed poor English white children

14
Plight of Infants
  • 1665-1714 Queen Anne (England) 18 births
  • 5 live born, 1 survived infancy
  • 1700s Infant Mortality Rates 400-600/1000
  • 1800s IMRs 200-600/1000
  • first studies of sanitary conditions
  • first evidence of schools and hospitals and
    workplace as sources of ill health

15
True Rise of Public Health
  • Early view--plague phenomena that simply had to
    be accepted
  • Impact of industrialization
  • crowded conditions
  • poor working conditions
  • poverty
  • giant germ culture

16
1700s
  • Waves of epidemics hit the urban areas
  • Particularly near ports
  • Disease isolation
  • fear, tradition, scientific speculation

17
1800s
  • Battles over isolation vs environmental clean-up
  • Introduction of early registries and public
    health datasets
  • Impact of French US civil wars on heath and
    medicine

18
1800s epidemiology
  • 1837 Chadwicks report on sanitary conds
  • 1848 Snows Broad Street pump
  • 1855 Lambert Water Company
  • 1858 Thames river flowing lavatory
  • 1864 Listers antiseptic
  • Kochs introduction of bacteriology
  • Far argued in favor of proximal variables

19
Revisit What is Public Health
  • The System Social Enterprise
  • The Profession
  • The Methods (knowledge and techniques)
  • Governmental Services
  • The Health of the Public

20
IOM public health mission
  • Fulfilling societys interest in assuring
    conditions in which people can be healthy.
  • Core values
  • improving health status of others provides
    benefits to all
  • assuring means vigilantly promoting and
    protecting everyones interests

21
Three core functions or What Public Health Does
  • Assessment
  • Policy development
  • Assurance

22
Winslows definition of Public Health
  • Science and art
  • organized community effort
  • birthright of health and longevity

23
As A System
  • Broad social enterprise
  • interdisciplinary approach
  • emphasis on prevention
  • linkage to government
  • components include
  • inputs, processes, outputs and outcomes

24
Unique Features
  • Basis in social justice
  • Inherently political nature
  • Dynamic, ever-expanding agenda
  • Link with government
  • Grounding in science
  • Preventive focus
  • Uncommon culture and bond

25
Vickers Definition of Public Health
  • The landmarks of political, economic and social
    history are the moments when some condition
    passed from the category of the given into the
    category of the intolerable. I believe that the
    history of public health might well be written as
    a record of successive re-definings of the
    unacceptable.

26
DO WE NEED PUBLIC HEALTH TODAY?
27
LIFE EXPECTANCY AT BIRTH AND INFANT MORTALITY
RATES
28
Roses Paradox
  • What do we know about Downs Syndrome?
  • What strategies would you use to impact the
    problem?
  • What subset of the population would you target?

29
Roses Paradox
30
What is Public Health ?
  • Tragedy of the Commons
  • Clean Water
  • 25 kids uninsured
  • Vast majority on death row African American males
  • Social Causation

31
Module 2
  • Determinants of Health and the Population Health
    Perspective
  • Readings
  • IOM Ch. 2
  • Glass McAtee
  • Optional Readings
  • SK Ch. 3
  • Lee Estes Ch. 2

32
Division of Distance and Distributed Learning
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