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To understand the basic concepts of the philosophy of public health.
Prior to World War II, illness and disability were viewed as an array of various diseases. Physicians and other health professionals applied diagnostic skills and technology to detect and limit disease transmission. Emphasis was focused on: the nature of disease causation, the demonstration of the efficacy of preventive measures by the provision of safe water, milk and food, sanitation of the environment, and personal hygiene practices. The public generally accepted these practices as policy with little opposition.
There have been significant changes in public health attitudes since the 1960's. An increasing amount of legislation has been aimed at controlling the environment and has been accompanied by the public's examination of government's role and the uses of science and technology. There are areas in which science can strengthen health advocacy but if distorted in the public's perception becomes suspect. The present view is that communities should express concern about the problems they face, participate in decisions about those concerns and take part in programs aimed at dealing with them.
The fundamental nature of public health work has not changed. This work entails a holistic approach to health enhancement. Public health depends upon the effective use of several core disciplines:
The basic analytical science in public health focusing on the distribution of determinants in health and disease in a population. The goal is to provide information leading to a better understanding of the causes of diseases and improvement in health care.
Is concerned with the influence of the physical and chemical environment on health and disease. Of particular importance is the quality of air, water and other components of the environment.
The cornerstone of sound public health practices. Focuses on the quantitative aspects of health problems and services.
A discipline focusing on disease-producing agents and their interaction with the host.
The planning, organization and management of delivery systems to a defined target population. An understanding of behavioral science theories, such as health administration, health education, health systems analysis, and health care economics is most important.
Principles of healthful living have an ancient origin. The endless concern with improvement of air and water quality as well as the promotion of personal hygiene and physical fitness underlie past and present concepts of health and a healthy environment. There is a direct relationship between a nation's economic and industrial might and the health of its citizens. Some decades ago, the World Health Organization defined health as a state of complete physical, mental and social well-being and not merely the absence of disease. Recently, this definition has been modified to include the ability to function. However, performance and the capacity to perform are difficult to assess. Health is difficult to define since the perception of health is a subjective matter. The individual's state of health may be viewed as a dynamic interaction between the individual and the environment. Figure 1 reveals some influential factors that play a role in the well-being of an individual. Disease affects communities because of incomplete knowledge of its causes, inappropriate life styles and socioeconomic factors.
It is important to note that the health and well-being of humans and other animals cannot be separated. The term 'veterinary public health' has been the subject of numerous debates. Some feel that the term is misleading. Some define it as an organized community effort, influenced by veterinary arts and sciences, applied to the prevention of disease, protection of life, promotion of well-being and efficiency of mankind. The interrelationship between humans and animals is significant. This relationship must be recognized. Figure 2 is an example of an integrated animal/human health model.
Personal health service rendered by health practitioners for the purposes of treating illness, or mitigating the course of illness. The practice of curative medicine is rooted in the American tradition of free enterprise.
The classical elements that historically have been associated with this type of medical care are still applicable today, i.e., environmental sanitation, forbearance of the common vices, proper nutrition and physical fitness. There may be important differences in the practice of preventive medicine when viewed from the perspective of the private practitioner and the public health specialist with relations to economic factors and the target population.
The goal of public health practices is to minimize early death and elevate an interest in promotive health through organized community effort. Public medical care is a needs and revenue seeking system.
Several important questions arise concerning medical care services.
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1.Who will get medical care? |
The following are essential elements of primary health care: education focused on prevailing health problems and strategies for their prevention and control; the promotion of food supply and proper nutrition; an adequate supply of safe water; basic sanitation; and augmenting maternal and child health care, including family planning. In the interest of the world's health, it is germane that primary health care become intimately associated with public health. The most effective means of disease prevention and improving the health status of a community lies outside of the medical care process and is related to reducing hazards in the environment, improving nutrition, and adopting appropriate life styles.
A progressive public health agenda for the future should include:
The resources of medical research and health service institutions directed toward disease eradication,
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