Introduction to public health and preventive medicine
Story of life expectancy Mortality Rate
CIA World Factbook 2007 Estimates for Life Expectancy at birth (years).
Major Reasons for Increased Longevity Improved sanitation Provision of clean water Universal immunization programs Health education and prevention practices Improved treatment of chronic diseases (for recent advances)
Healthy life expectancy Disability Adjusted Life Expectancy
How it is caculated? Morbidity and Mortality of commen diseases Living habits Social Violence Dietary pattern Substance abuse(drug,alcohol) Medical facilities Environment Climate And How many year been disability in average (subtract this number from life expectancy)
Sources: UN Healthy Life Expectancy Ratings
J.P.Bunker’ s report(1994 published) Life expentancy from 45-75 years Medical care contributes to only five years Improvement of public health contributes to the rest
Spending in 1992 Average medical care cost for each person: $3007 Public health spending for each person: $34 Distribution of national health dollars on public health: About 1%
Spending in 2001 Total national healthexpenditures: $1,424.5 billion Public health activities: $46.4 billion Distribution of national health dollars: 86.8% to personal health services/supplies 3.3% to government PH activities
Requirements for survival 1.air 2.water 3.food 4.shelter 5.care
Health The United Nations' World Health Organization defines health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."
What is Public health? In 1920, C.E.A. Winslow defined public health as "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals."
The history of public health Public health is an old concept, dating back to when people first began living in communities. Through the ages, governments have shown varying degrees of concern for the public health.
The ancients Greeks, and the Romans after them, tried to ensure the health of their citizens by providing a supply of clean water (via aqueducts and pipelines), managing the disposal of waste working to control disease by hiring public physicians to treat the sick.
During the late 1800s European governments began turning their attention to matters of public health in an effort to control the spread of disease. (Because Epidemics of leprosy, the plague, cholera, and yellow fever).
In the United States, the public health became an official concern when in 1866 a cholera epidemic struck the nation-for the eighteenth consecutive year
What is Public health? "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals."
The 'science' is concerned with making a diagnosis of a population's health problems, establishing their cause, and determining effective interventions. The 'art' is to address these problems creatively.
This definition underscores the broad scope of public health and the fact that public health is the result of society’s efforts as a whole, rather than that of single individuals.
In 2003, Detels defined the goal of public health as: The biologic, physical, and mental well-being of all members of society regardless of gender, wealth, ethnicity, sexual orientation, country, or political views. (This definition or goal emphasizes equity and the range of public health interests as encompassing not just the physical and biologic, but also the mental well-being of society.)
Both WHO and Detels’ goals depict public health as being concerned with more than merely the elimination of disease. To achieve the WHO goal of ‘health for all’, it is essential to bring many diverse disciplines to obtain the optimal health （physical, biologic, and social sciences）. The field of public health has adapted and applied these disciplines for the elimination and control of disease, and the promotion of health.
1988<the future of public health> Mission: Substance: Organizational framework: Core functions:
mission The fulfillment fo society’s interest in assuring the conditions in which people can be healthy
Substance Organized community efforts aimed at the prevention of disease and the promotion of health
Organizational framework Bothe activities undertaken within the formal structure of government and the associated efforts of private and voluntary organizations and individuals
Core functions Assessment Policy development Assurance
Monitor Health Status to Identify and Solve Community Health Problems • Diagnose and Investigate Health Problems and Health Hazards in the Community • Inform, Educate and Empower People About Health Issues • Mobilize Community Partnerships to Identify and Solve Health Problems • Develop Policies and Plans That Support Individual and Community Health Efforts
Enforce Laws and Regulations That Protect Health and Ensure Safety • Link People to Needed Personal Health Services and Assure Health Care When Otherwise Unavailable • Assure a Competent Public Health and Personal Health Care Workforce • Evaluate Effectiveness, Accessibility, and Quality of Personal and Population- Based Health Services • Research for New Insights and Innovative Solutions to Health Problems
5 steps process 1. Define the health problem 2. Identify the risk factors associated with the problem 3. Develop and test community-level interventions to control or prevent the cause of the problem 4. Implement interventions to improve the health of the population 5. Monitor those interventions to assess their effectiveness
The science of Public health Epidemiology and statistics Biomedical sciences Social and behavior sciences Environmental sciences Health policy and management Health management
Ten Great Achievements in Public Health 1900-1999 Vaccination. Motor-vehicle safety. Safer workplaces. Control of infectious diseases. Decline in deaths from coronary heart disease and stroke. Safer and healthier foods. Healthier mothers and babies. Family planning. Fluoridation of drinking water. Recognition of tobacco use as a health hazard. CDC, Morbidity and Mortality Weekly Report, December 24, 1999 / 48(50); 1141.
Leading causes of death,worldwide2001 Source: WHO 2002
Leading infectious killers, worldwide 2001 Source: WHO 2002