Hannan 9. Kukull and James Bowen 9. Knight and Hester J. Ward 9. Kamb and John M. Douglas, Jr. Morrow and William J. Moss 9. Heymann Section 10 Prevention and control of public health hazards Bettcher,1 Jonathan Samet, Krishna M. Des Jarlais and Robert L. Hubbard Hyder Sidel and Barry S. Levy Montgomery Interpersonal Relationships and Health: Social and Clinical Psychological Mechanisms Gathering leading thinkers in social and clinical psychology, public health, medicine, and sociology, Interpersonal Relationships and Health considers theoretical and Springer, Allen Rubin State-of-the-art, Early Intervention in Psychiatry: EI of nearly everything for better mental health Early intervention EI is the single most important advance in mental health care in recent decades, representing a key shift During my tenure as President, in Infectious Diseases and Rural Livelihood in Developing Countries This book focuses on the effects of rural livelihood and the impact of infectious diseases on health and poverty.
Socio-Ecological Dimensions of Infectious Diseases in Southeast Asia This book pursues a multidisciplinary approach in order to evaluate the socio-ecological dimensions of infectious diseases in Southeast Asia. Southern states Helminth Infections and their Impact on Global Public Health Helminths are long-lived multicellular organisms that have co-evolved with humans over many thousands of years. They are responsible for infections Handbook of Helminthiasis for Public Health Written by internationally respected experts, Handbook of Human Helminthiasis provides information essential in the development of an integrated approach to Malaria in South Asia: Eradication and Resurgence During the Second Half of the Twentieth Century Malaria is one of the most widespread and devastating infectious diseases in the world.
More than half the world population Emerging Issues in Prison Health This volume recognizes and addresses the health care issues of prisoners, to establish best practices and to learn about approaches Aids and Religious Practice in Africa This volume explores how AIDS is understood, confronted and lived with through religious ideas and practices, and how these, in Handbook of Global Tuberculosis Control: Practices and Challenges This ambitious reference surveys worldwide efforts at controlling the spread of tuberculosis, with special emphasis on the developing world.
Advances in Microbiology, Infectious Diseases and Public Health: Volume 7 This book series focuses on current progress in the broad field of medical microbiology, and covers both basic and applied Global Management of Infectious Disease After Ebola The Ebola outbreak in West Africa shocked the world with its devastation and its rapid migration to multiple continents Regulation of Inflammatory Signaling in Health and Disease Advances in Experimental Medicine and Biology This book discusses recent research in innate immunity, which has revealed a large number of receptors that sense the presence It raises important questions The number of clinical trials reported by A Century of Homeopaths: Their Influence on Medicine and Health As the values of integrative medicine continues to grow, alternative points of view and treatments are increasing in acceptance and Accreditation of Health Care Facilities.
Section 4 : Social, Behavioral and Communication Sciences. An understanding of the ways in which these factors interact to cause disease or promote health in different communities, is basic to the decisions to be made in the care and protection of the community For these reasons, community medicine must be concerned with and relate to, the community behaviour and its environment and not solely restrict itself to the health services, which, very frequently, is otherwise the principal interest of the Institutional unit responsible.
As a professional movement, in USA, community medicine first appeared when some medical schools began to establish a new department or rename an existing Dept of Preventive Medicine and to charge it with functions of defining the health problems of a community in the vicinity of the college, or an adopted community and to suggest solutions, maintain surveillance and monitor progress.
Many hospitals also established department of community medicine to bring together responsibility for the professional direction and coordination of a range of ambulatory programs in OPD and emergency, personal health, outreach satellite elements and other services. Evolution of Contemporary Public Health From Shattuck and Chadwick in Mid-Nineteenth Century to Twenty-First Century 14, 15 In the late nineteenth and early twentieth century, concern with control of epidemics was at the centre of medical and public attention.
Measures for protection of the community through environmental health appeared first and with the establishment of effective sanitary services, the modern era of public health was born. Later, towards end of nineteenth century, microbiology expanded greatly and laid down new and scientific basis of infectious disease control. When it become clear that an organized effort to apply these sanitary and bacteriologic techniques was needed, the responsibility of governmental health departments, to control the communicable diseases, was given the status of law; and since treatment of infected individuals was also a part of control of infectious diseases, this also become a responsibility of public health.
Later public health responsibility was further extended for organized maternal and child health services, thus extending public responsibility into the realm of personal care of individuals. As a result, organized programs for prevention usually public funded but often by voluntary, non govt. In the first half of the 20th century, personal preventive services in large numbers began to be publicly financed, while the personal curative services, for the most part, remained privately supported.
As a result the personal health services become compartmentalized into two different medical practice settings - one largely preventive and the other largely curative. However, later on, as the concept of comprehensive health care came in, the traditional dichotomy between preventive and curative medicine become less and less differentiable.
For example, the concept of prevention has been, in recent times, extended into curative settings in the form of secondary prevention, as one form of response to the rising frequency of chronic, non-communicable diseases and diseases of special groups mothers, children, old people and industrial workers.
Under this new strategy, clinicians are being urged to think more regularly about preventive management in diseases and to incorporate more of a preventive outlook in their daily practice. Similarly, public health physicians are being invited to move from their preoccupation with primary prevention, to undertake administrative involvement in health care systems. By doing so, they could relate to the total range of health care and take part in the planning, operation and evaluation of any or all of the health services.
In fact, according to one of the contemporary views, Medical Care Administration has been advocated as a legitimate concern of public health authorities. While mostly public health activities are funded and regulated by the Govt. National or State the work of voluntary health agencies is also very much part of public health activities since they represent an organized community effort and systematic social action.
Contemporary Views on the Definition, Role, Principles, Core Activities and Components of Public Health Definition : The Definition of Public health, as enunciated by Winslow 11 and which has been presented earlier, though more than 80 years old now, has stood the test of time and is very well accepted among the public health fraternity as the most standard definition.
Another definition given by the Institute of Medicine USA also echoes the same ethos : Public Health is a mission for the fulfillment of societys interest in assuring the conditions in which people can be healthy, through organised community efforts aimed at the prevention of disease and the promotion of health, using activities undertaken within the formal structure of government as well as the associated efforts of private and voluntary organizations and individuals In fact, the present text-book has been organized addressing, in a section-wise manner, the various core-competencies as enlisted above.
These major sciences required for the practice of public health can be grouped into five major core competency areas, viz. The details of these core areas are given in Table - 1. Core Principles Underlying Public health Practice: Contemporary thinking indicates that the principles underpinning the concepts of public health are as follows and the public health specialist must develop the mental attitude to adopt these core principles in her activities 17 : The emphasis on collective responsibility for health.
An envisaged major role of the state in protecting and promoting the publics health. A focus on whole populations and not on individuals. An emphasis on prevention, especially primary prevention, while not losing track of the importance of curative medicine also.
Readiness to undertake partnership with populations being served. In our national context, we can think of the One Dozen core activities of public health, as follows : 1 Protecting the environment, food and water. General Epidemiology Field Epidemiology, including outbreak investigations and public health surveillance systems Bio-statistics including statistical software Health Research Methodology Database Management and other core issues of Information Technology b Environmental Sciences.
A concern for underlying socio-economic determinants of health and disease as well as more proximal determinants, such as health care. A multi-disciplinary basis; the readiness to work, in a team, with different and diverging disciplines concerned with human health and development. Attitude to incorporate qualitative and quantitative methods, as appropriate, in the area of work. A very peculiar situation which all specialists in public health and community medicine realize after just a few years of practice, is the wide gap between theory and actual practice in this specialty.
Such gaps occur in all other medical specialties too, but only to a limited extent - a patient of typhoid or one with ante-partum haemorrhage will show variations as regards clinical presentation and response to treatment when compared to what is written in the standard textbooks, but only to a limited, understandable extent.
In public health practice, the practitioner is faced, everyday, with challenging situations, for addressing which she has to work out innovative solutions, which may not be at all described in her standard textbooks in fact, that is why it is difficult to have a standard textbook in public health; one could only have guidelines!
The reason is that in community medicine and public health, we do not deal with a patient; we rather deal with human groups, who are apparently healthy at least that is the way they feel themselves to be. Human groups or communities have their own attitudes and practices and their own diverse ways of assessing and responding to situations. For the aforesaid reasons, the author would, based on own.
It is felt that putting these guiding principles into day to day practice may help bridging the gap between theory and practice, thereby deriving more satisfaction out of our specialty work.
A dozen of such guiding principles are as follows : 1. The Doctor who cures such a person has achieved a real, recognizable benefit and the patient is grateful; public health cannot point to the people who have been spared illness by its efforts.
Public health and preventive medicine lead to silent, unrecognized victories. This silence accounts in large parts, for the relative lack of attention paid to public health by decision makers and the general public in comparison to the attention paid to medical care.
So, remember, that while Public health may not be as glamorous a specialty as Cardiac Surgery or Imaging, it has tremendous potential to improve the quality of life of innumerable human beings - to give you a proof, the major improvements in health and quality of human life during the last one century have actually come from clean food and water, sanitary housing and immunization rather than all the other glamorous medical specialties put together.
Despite this, preventive medicine and public health is often at the receiving end of insults as Sewer drain doctors insect catchers or people who could never make it to the clinical world. You have to learn how to bear with such humiliations, but do not lose heart - be tenacious, keep moving forward - you have indeed selected the most humane specialty. Stick to the facts - preferably based on quantitative evidence : Public health, with its very important tools of epidemiology and statistics, is an evidence based specialty and is dependant on collecting, analyzing and interpreting the data in a valid manner and making use of good quantitative and qualitative evidence.
Good public health practitioners should collect good knowledge about topics they are dealing with, whether it is the incidence of ARI among children in their area of jurisdiction or it is concerning the amount of risk that tobacco carries for IHD.
Good amount of reading into latest journals, reports or text books and discussion with experts is a must for public health practitioners. Develop the art of communicating : Remember that unless data are turned into stories which are understood by all, people would not show concern for your reasoning.
Having command on communication skills, both verbal and written, is an art which is a compulsory requirement for public health practitioners and this art should be developed very diligently and methodically. Walk well and talk well : A successful public health specialist is one who changes shoes every month or two, since constant walking, seeing for herself and making assessments of environment and the communitys conditions, tears off the shoe - sole very fast.
This is the typical shoe - leather epidemiology. So keep moving in your area, talk to the community members. Develop Multi - Disciplinary Team approach : Always remember that in public health, you have to build an effective team, comprising of people from various disciplines - Statisticians, Clinicians, Social Scientists, Entomologists, Pathologists, Civil Engineers, Management experts, Administrators, Politicians and so on.
No public health specialist can be successful by working in isolation. Learn how to form an effective team; have respect for others, listen to their advice and take decisions in consultation with them after logical reasoning and not by arguing or bulldozing. Always prepare very well before you meet people : Whenever you go to attend a conference, be it of administrators and specialists from allied specialties, or else a focus group discussion with school - teachers, make sure to always read the agenda and its details very well.
Apply your thought to the issues under discussion, think what do you want to achieve and how you will be best placed to do so, with those present. Focus on long term but take action on short term also : The objectives of public health whether through an immunization program or purification of community water supply, etc.
They would, naturally, like to demonstrate some results within the limited span of a couple of years. Hence, in public health practice, while gaining support for achieving the long term goals should be definitely an objective, it is equally essential to have some very readily identifiable strategies to demonstrate progress towards these long term goals, in a shorter period of time - the so called strategy of Early Victories.
Understand the Politics : Very often we find public health specialists talking about ways of influencing Policy Makers. This means getting to know your chief administrative boss and other influential people and how he or she works. Public health specialists should also keep themselves well aware of the political climate - not only international and national but, also the local politics and even the political climate in their own office.
It is essential, in public health, to have good political antennae. Moreover, in any organization or office, it is essential to understand as to who wields the power - this may not only be the chief executive, but may be some lower level staff officer also.
It is also very paying to have good relationships with colleagues. Dont take on too much : Failure to deliver is one of the biggest potential risks for public health and you should remember that one important reason for landing in this pitfall is when you take on too many jobs, well beyond your capabilities.
You should learn how to say No to tasks which you feel are getting on too much; or else, if it is something that has to be done, then decide what is going to be dropped off your agenda. Next, once you take on a job, then keep track of its progress. Develop Your Staff : A clinician may still do well without improving his staff and without delegating; conversely, in public health practice you must constantly endeavour to develop your staff and subordinates as regards their technical and managerial competence.
If you try to do everything yourself, in public health practice, you will get bogged down and become inefficient pretty soon. Always Know of Specialists who can do the Jobs : The wide activity of public health inevitably means that you will not be able to retain all the necessary skills at any one time, though you may have been trained to some extent in all these disciplines as entomology, epidemiology, statistics, database management, etc.
Always Be There : Though stated in the last, this twelfth golden principle is one of the most important. Remember that the world is run by people who are physically there at the place of action; the first rule of politics is to be there.
It is surprising how scant attention is paid to this very simple dictum. So, for being a successful public health specialist, never miss a meeting, a workshop, any function, a sports meet or even any street play to which you have been invited.
And, finally, keep the highest regards for your specialty - it is the biggest asset you have in the changing fortunes of time; Keep perseverance and faith alive, for, despite all its drudgery and sham, it is still a beautiful world Summary The last two decades of the 20th century saw a renewal of the world populations interest in public health, in disease prevention, communicable and chronic disease control, health protection and health promotion.
During the 20th century, many lives have been saved and diseases prevented by simple public health measures as safe water supply, sanitary excreta disposal, vaccination and insect-vector-control measures. Widely used definition of health by WHO states that Health is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity. This definition is commonly seen as the statement of an ideal towards which nations should aspire.
Operational definition of health, one drawn from the above ideal definition, has been forwarded, by a technical study group of WHO. This concept of health is viewed as being of two orders - first, in a broad sense, health can be seen as a condition or quality of the human organism in given conditions : Genetic and environmental. A widely accepted definition of medicine by Henry Sigerist defines medicine as Medicine, by providing health and. Preventive Medicine is that branch of medicine which deals with promoting health and preventing disease.
Preventive Medicine is a branch of medicine which deals with promoting health and preventing disease. Community Medicine is a branch of medicine, which addresses certain selected aspects of health promotion, disease prevention, health restoration by curative steps and rehabilitation of the former patients, in the community, usually, from an Institutional Community Base which is usually either an Academic Department in a medical college or through a curative centre.
Major sciences required for the practice of public health can be grouped into five major core competency areas, viz. Health is a state of complete , and well being and not merely the absence of or This was the definition given by Two unique features of public health are and When preventive medicine starts focusing on population groups rather than individuals and utilises the approach of it takes the shape of Match the Following 1.
CEA Winslow. Lemuel Shattuck e. During the ancient Egyptian period developments such as toilets and bathing were introduced, but this was on a private level. While Egyptian religious beliefs encouraged washing the body, thereby improving the health of the population, this was not part of a public health programme.
The Greeks encouraged. Match the Following : 1-d; 2-c; 3-e; 4-b; 5-a. Richardson, BW. Shattuck, L. Report of the sanitary commission of Massachusetts - Cambridge, , Harvard university Press. US Public health service. For a healthy nation : returns on investments in public health. Bunker JP. Improving Health : Measuring effects of medical care. Milbank quarterly ; 72 : - Soanes C. Oxford Dictionary. Oxford University press, Oxford 9th ed, Engel GL. The need for a new medical model.
A challenge for biomedicine. Science ; : page World Health Organization. The constitution of World Health Organization. WHO Chron ; 1 : page Measuring the levels of health : Report of a study Group. Sigerist HE. New York; Oxford University Press, Winslow C-E,A. The untilled fields of public health, Science ; 51 : page An introduction to public health. New York, Macmillan.
Kark SL, Cobb S. From medicine in the community to community medicine. JAMA ; : page Horton R. Lancet ; : - 2. Hamlin C, Sheard S. Revolutions in Public Health : and ? BMJ ; : - Institute of Medicine USA. The Future of Public health. Report of Committee for the study of the future of public health. Washington, DC. National Academy press, : 40 - Beoglehole R, Bonita R.
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