HEALTH & PUBLIC
HEALTH Definition and
concepts
DEFINITION OF PUBLIC
HEALTH
Public health is the science of protecting and improving the health
of people and their communities.
This work is achieved by promoting healthy lifestyles, researching
disease and injury prevention, and detecting, preventing and
responding to infectious diseases.
Overall, public health is concerned with protecting the health of
entire populations. These populations can be as small as a local
neighborhood, or as big as an entire country or region of the world.
CONCEPTS OF HEALTH
An under standing of health is the basis of all healthcare
Perception varies among community members and professional groups.
Constant change leads to new health concepts.
Health evolved from an individual concern to a global social goal.
It encompasses the entire quality of life.
[Link] CONCEPT
Traditional view of health: Health is seen as the absence of
disease, based on the "germ theory of disease."
Medical profession views human body as a machine, disease as a
consequence of the breakdown.
Health became the ultimate goal of medicine.
Critics argue the biomedical concept minimizes environmental,
social, psychological, and cultural determinants of health.
Despite its success in treating disease, the biomedical model is
inadequate in solving major health problems like malnutrition,
chronic diseases, accidents, drug abuse, mental illness,
environmental pollution, and population explosion.
[Link] CONCEPT
• Ecologists view health as a dynamic equilibrium between man and
environment, with disease as maladjustment.
• Dubos defines health as the absence of pain and continuous
adaptation to the environment.
• Human, ecological, and cultural adaptations determine disease
occurrence, food availability, and population growth.
• The concept raises issues of imperfect man and environment.
• Improvement in human adaptation to natural environments can
lead to longer life expectancies and improved quality of life, even
without modern health services.
3. PSYCHOSOCIAL CONCEPT
Recent advancements in social sciences have shown that health is
not merely a biomedical phenomenon but is also shaped by the
social, psychological, cultural, economic, and political factors
affecting individuals.
These elements should be considered when defining and
measuring health, making it both a biological and social
phenomenon.
4. HOLISTIC CONCEPT
• Synthesizes social, economic, political, and environmental
influences on health.
• Viewed as a multidimensional process involving the well-being of
the whole person in their environment.
• Complies with ancient views of health requiring a sound mind,
body, family, and environment.
• Involves all sectors of society, including agriculture, animal
husbandry, food, industry, education, housing, public works, and
communications.
• Emphasizes promotion and protection of health.
CHANGING CONCEPTS IN PUBLIC
HEALTH
A. Disease Control Phase (1880-1920)
• Public health primarily focused on sanitary legislation and reforms.
• Measures included control of physical environment like water supply and
sewage disposal.
• Lack of technical knowledge led to lack of disease control.
• Despite limitations, these measures improved health through disease and death
control.
B. Health promotional phase (1920-1960)
• The 20th century saw the emergence of the concept of "health promotion,"
recognizing the State's responsibility for individual health.
• This concept was introduced as personal health services, including maternal,
child, school, industrial, mental health, and rehabilitation services.
• Public health nursing emerged as a direct offshoot of this concept.
• C.E.A. Winslow defined public health as "the science and art of preventing
disease, prolonging life, and promoting health and efficiency through organized
community effort."
• Two major movements initiated for human development were the provision of
"basic health services" through primary health centres and subcentres for rural and
urban areas.
• The Community Development Programme was another significant movement
promoting village development through active community participation.
• Despite the program's failure due to inadequate resources, it provided the
necessary infrastructure of health services, especially in rural areas.
C. Social Engineering Phase (1960-1980)
• Advances in preventive medicine and public health led to a shift in disease patterns.
• New chronic diseases emerged, including cancer, diabetes, cardiovascular diseases,
alcoholism, and drug addiction.
• Traditional public health approaches like isolation, immunization, and disinfection were
insufficient.
• The concept of "risk factors" emerged as determinants of these diseases.
• These diseases placed a chronic burden on society, necessitating a shift towards social
objectives.
• The "social engineering" phase in the 1960s prioritized social and behavioral aspects of
disease and health.
• Public health moved into preventive and rehabilitative aspects of chronic diseases and
behavioral problems.
• The goals of public health and preventive medicine became identical: disease
prevention, health promotion, and life prolongation.
• The term "community health" was preferred due to its expanded scope and focus on
services to the population.
D. “Health for All” phase (1981-2000 A.D.)
• Despite advancements in medicine, health disparities in developed and
developing countries remained stark.
• Developed countries and elites have access to all determinants of good health,
including income, nutrition, education, sanitation, safe drinking water, and
comprehensive healthcare.
• Only 10-20% of the population in developing countries have access to health
services.
• John Bryant's book "Health and the Developing World" highlighted the inequalities
in health, stating that over half of the world's population lack access to healthcare.
• The global conscience arose, leading to a call to narrow the health gap between
rich and poor.
• The WHO pledged in 1981 to provide "Health for All" by 2000, aiming for a level of
health that allows all people to lead a socially and economically productive life.
THANK YOU Reference- K. Park’s PSM
27th edition