Philosophy and purpose of public health

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Philosophy and purpose of public health

• Dadi s Argadiredja

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LEARNING 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

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DEFINITION OF HEALTH (1)

• 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 a cheerful acceptance of the
  responsibilities that life puts upon the
  individual (Sigerist, 1941)

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DEFINITION OF HEALTH (2)
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)
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DEFINITION OF HEALTH (3)

• 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)

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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)

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DEFINITION OF PUBLIC HEALTH (contd)

• efforts organized by society to protect, promote
  and restore the peoples 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)

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PREVENTIVE MEDICINE is the science art of
preventing disease, prolonging life, promoting
physical mental health efficiency
For groups community by public health
practitioners (specialized practice of PM) PUBLIC
HEALTH PRACTICE
For individuals families by private health
practitioners (general practice of PM) MEDICAL
DENTAL PRACTICE
Through Intercepting disease Processes by
community individual action
Leavell Clark, 1958
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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)

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Social Medicine

• a term used to emphasize the importance of mans
  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)

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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
• (1) 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
• (2) it also attempts to apply that knowledge
  explicitly in regard to taking action to promote
  health and alleviate illness in the population
  and
• (3) 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)

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COMMUNITY MEDICINE (contd)

• 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)

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Scientific approaches in Public Health

• Epidemiology
• Biostatistics
• Biological physical sciences
• Social sciences
• Demographic science

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Ultimate goal of public health

• The prevention of disease
• The promotion of health
• Different between developed developing countries

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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

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Public Health Strategies

• Surveillance
• Intervention
• - reducing the number of individuals
• susceptible to infectious chronic
• disease
• - treating people early in the course of
• disease
• - modifying the environment
• - promoting healthy behavior of both
• communities individuals
• Evaluation

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Reading assignment

• 1. Leavell HR, Clark EG. Preventive medicine
  for the doctor in his community an epidemiologic
  approach. 2nd ed. New York McGraw-Hill Book
  Company Inc. 1958, p. 7-13.
• 2.  Detels R, Breslow L. Current scope and
  concerns in public health. In Detels R, Holland
  WW, McEwen J, Omenn GS, editors. Oxford Textbook
  of Public Health. New York Oxford University
  Press 1997, p. 10-17.
• 3. Schutchfield FD, Keck CW. Chapter 1
  Concepts and Definitions of Public Health
  Practice. In Principles of Public Health
  Practice. 2nd edition. New York Delmar Learning
  2003

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Thank you