WHAT IS PUBLIC HEALTH? MS. SAMAH ALAGEEL Community Health CHS 212

Outline What is health? What is community? The definition of Public Health. History of Public Health. The importance of public health. The difference between public health and clinical medicine. Public Health approach. Example for illustration.

Definition of health Health is defined by the WHO as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.

Definition of community Community could be seen in two different ways: 1) Community can refer to a usually small, social unit of any size that shares common values. The term can also refer to the national community or international community. 2) in biology, a community is a group of interacting living organisms sharing a populated environment.

What is public health? In your opinion, what is Public Health?

What is public health? The Acheson Report (1988) defines Public health as: ‘The science and art of preventing disease, prolonging life, and promoting health through organized efforts of society’. “ Fulfilling society’s interest in assuring conditions in which people can be healthy”. (IOM,1988)

“You are only as healthy as the world around you” Pubic Health constitute of multidiscipline: epidemiology, biostatistics, environmental science, management science, behavioral science… etc.

History of public health 500 BC-500 AD Hippocrates (460 BC-380 BC) was the founder of Western medicine. He manifested an amazingly modern perspective in his treatise entitled On Airs, Waters, and Places that was published in the fifth century.

Cont. The Middle Ages ( ) The Middle Ages were also known as "The Dark Ages”. Health problems were considered to have spiritual causes and solutions. Illness was considered to be the result of sin thus stigmatizing the victim. Most importantly, this failure to consider the role of the environment in health led to epidemics and the inability to control them.

Cont. John Graunt The period saw an increased understanding of the need to collect qualitative data for the purpose of defining the state. The first solid use of data collection for the purpose of understanding health status came from John Graunt ( ), the father of demography and descriptive epidemiology. By studying London death data for the previous 75 years, Graunt found certain predictability of mortality with respect to natural events and phenomenon.

Cont Yellow Fever In 1793, Philadelphia was the scene of one of the worst outbreaks. The city was the capital then and the epidemic forced the evacuation of many of most prominent citizens, including George Washington, Thomas Jefferson and Alexander Hamilton.

Cont – 1900 John Snow ( ) John Snow was the first to link the cholera epidemic in London to one particular water source—the Broad Street Pump. When the pump handle was removed the disease incidence drastically decreased. This was the birth of applied epidemiology

Cont – 1900 The American Public Health Association In 1872, the American Public Health Association was founded. APHA is now the oldest and largest organization of public health professionals in the world.

As a result of the acceptance and understanding of public health, several actions were taken in , such as: Meat inspection. Addressing childhood labor. Family planning. The discovery of Penicillin. Centers for Disease Control and Prevention (CDC) was established The World Health Organization (WHO) was established

Cont. Water Fluoridation began in The first effective polio vaccine was developed. The development of the first highly effective contraceptive pills. A mysterious epidemic was identified as acquired immune deficiency syndrome (AIDS). In 1990, the Nutrition Labeling Education Act was signed into law.

Why Public Health is important toady? Reviewing public health achievements in USA: Enhance life expectancy at birth (47yrs in 1900 vs. 77 years in 2000) Reduce infant mortality rate (110 per 1000 live births in 1900 vs. 7 in 2000) Vaccination Motor-vehicle safety Control of infectious disease Safer workplace Decline deaths from heart diseases and stroke

Why Public Health is important toady? (Cont.) Safer and healthier foods. Decline in deaths from coronary heart disease and stroke. Healthier mothers and babies. Family planning. Fluoridation of drinking water. Recognition of tobacco use as a health hazard.

The difference between public health and clinical medicine: Public healthMedical care system Targeted to: Population healthIndividual health (sick) 1. Assessment: problem identification for a group of individuals 1. Diagnosis 2. Assuring necessary interventions are put into place 2. Treatment 3. Policy development: collectively deciding which intervention is the best for the problems identified. 3. Formulation treatment plan

Public Health Approach Define the health problem. Identify risk factors associated with the problem. Develop and test community-level interventions to control or prevent the cause or the problem.

Cont. Implement interventions to improve the health of the population. Monitor those interventions to assess their effectiveness.

Public Health Approach Problem Response Surveillance: What is the problem? Risk Factor Identification: What is the cause? Intervention Evaluation: What works? Implementation: How do you do it?

Now its time to do it yourself… According to Forbes, Saudi Arabia ranks 29 on a 2007 list of the fattest countries with a percentage of 68.3% of its citizens being overweight (BMI>25).