History of Public Health Revised 22 september 2007 (http://www.phs.ki.se/socmed/postdoc/OH-presentations.html) KAROLINSKA INSTITUTET Institutionen för folkhälsovetenskap Avd för socialmedicin Bo J A Haglund professor

Introductionary remarks What are the major health problems? What are the causes of these problems? What health promotion activities may reduce these problems? How do we know whether we have been effective in solving these health problems? We need to create credence and provide knowledge based information about what we know on the relationship of health and determinants and who can make something about it!

”Public Health Movement” i England from about 1840 to 1920 Edwin Chadwick: ”Report on The Sanitary Conditions of Labouring Population” (1842) Life expectancy in England/London: Social groups Number of year Upper and middle class 43 Worker 22 The public health movement was born in Europe about 1840. Industrialism was developed with drastical changes for the populations of the european nations. Urbanisation without proper food and sanitary conditions evolved. History of Public Health ”Public Health Act” (1848)

John Snows Death in Cholera in Sohodistrict, London, 1854 The classical pump with infected water was one of the first environmental examples of the old public health History of Public Health

History of Public Health In Sweden there has been three waves of pattern of diseases during the last 100 years. But in order to understand why the pattern has changed you have to analyse also the structural changes of the Swedish society as presented in next slide. History of Public Health

History of Public Health Around 1960 the Swedish society went in to the post industrial period. History of Public Health

History of Public Health Three waves of Public Health Industrialism evolving Goal: environment and individual Measures: health policy reforms Ekonomical growth Goal: Individual and environment Mesuresl: programes Postindustrial society Measure: Supportive environments for helath Related to the societal changes also the public health initiatives has changed with goals and measures. During the first period of evolving industrialism the Old public health with its focus on environmental issues and policy reforms dominated. In the post-industrial society with its New public health movement again environment was focused, now as supportive environments for health. History of Public Health

Public Health Movement (1840s-1920s) The Rise of the new public health Public Health Movement (1840s-1920s) Health education (1920s-1970s) Health Promotion (1940s-1990s) New Public Health (1980s-2000) History of Public Health after Bunton&Macdonald 1992 Health Promotion Discipline and Diversity

History of Public Health The old public health 1842 Edvin Chadwicks´s report on the sanitary conditions of the labouring population of England is published 1843 The Royal commision on the health of Towns is established 1848 Public Health Act for England and Wales requires local authorities to provide clean water supplies and hygienic sewage disposal systems, and the appointment of medical officers of health for towns 1854 John Snow controls cholera outbreak in London by remowinga contaminated local water supply. 1866 Sanitary Act- LA had to inspect their districts 1868 Housing Act – LA could ensure owners kept their properties in good repair 1871 Local Government Board (later Ministry of Health 1919) was established 1906 Education Act- established the provisison fo school dinners 1907 Eduction Act established the school medical service. Naidoo and Wills has developed the discussion about the old and new public health. History of Public Health

History of Public Health The new public health 1974 Lalonde Report A new perspective on the health of Canadians identifies environment as cruisal for health 1985 WHO launches the Health fo All programme 1986 Ottawa Charter 1988 Adelaide conference 1991 Sundvall Conference 1992 The Association of public health a mulitdisciplinary organization to promote public heatlh policy, is creataed 1992 Rio Earth Summit and Agenda 21 1997 Jakarta 2001 Mexico 2005 Bangkok Charter History of Public Health

History of Public Health Well being & Health Possibilities Strenthening factors Actors Settings Causes In the new public health a new focus was presented on positive health factors and possibilities to create supportive environments for health Public Health Problem History of Public Health