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Public Health is an aspect of Health Services concerned with threats to the overall health of the population of a community based on population health analysis. It generally includes surveillance and control of infectious disease and promotion of healthy behaviours (health promotion ),among members of the community. Both vaccination programs and free distribution of condoms are Public Health measures. Public Health promotes not simply the absence of disease but mental, physical, and emotional well-being. The WHO sets standards and provided global surveillance, but national bodies such as the Centers for Disease Control and Prevention in Atlanta, Georgia in the U.S.A. and their local affiliated Medical Officer of Health are usually the lead in responding to Public Health threats. In many ways, Public Health is largely a modern concept, although it has roots in antiquity. In order for public health policies and programs to develop, it was necessary for governments to gain some understanding of the causes of disease. Early on, it was recognized that polluted water and lack of proper waste disposal were implicated in spreading vector-borne diseases. By Roman times, it was well-understood that proper diversion of human waste was a necessary tenet of public health in urban areas.
The Chinese developed the practice of variolation following a smallpox epidemic around 1,000 B.C. Inhaling the dried crusts of lesions or later, innoculation of a scratch on the forearms of chidren with the pus from a lesion. This practice was not documented in the West until the early 1700s and was utilized on a very limited basis. The practice of vaccination did not become prevalent until the 1820s, following the work of Edward Jenner.
During the 14th century Black Death in Europe, it was believed that removing the bodies would prevent further spread of the disease. Unfortunately, this did little to stem the plague, which was spread by rodent-borne fleas. Burning areas of cities resulted in much greater benefit, since it removed the rodent infestations.
The science of epidemiology was founded by John Snow's identification of a polluted public water well as the cause of an 1854 cholera outbreak in London. John believed in the germ theory of disease as opposed to the prevailing miasma theory, which taught correctly that disease was a result of poor sanitation, but was based only upon the prevailing theory of spontaneous generation. This was the case, even though Redi showed in the 17th century that fly eggs were required for maggots to be generated in dung heaps and Lazzaro Spallanzani, in 1768, proved that microbes came from the air, and that regeneration could be prevented by boiling in a hermetically sealed container.
Microorganisms were first observed around 1680 by Anton van Leeuwenhoek, but it was not until the 1880s, that the culmination of the germ theory of Robert Koch and Louis Pasteur and the production of artificial vaccines, revolutionized the study of infectious disease and introduced the modern era of public health.
Now most governments recognize the importance of public health programs in reducing the incidence of disease, disability, and the effects of aging. Public health programs providing vaccinations have in recent years have successfully all but eradicated smallpox. Certainly, one of the most important public health issues of the present is that of AIDS.
A controversial aspect of public health is that related to the control of smoking, which is often described as "the most important public health issue". Many states are planning or implementing major initiatives to cut smoking, such as increased taxation and bans on smoking in some or all public places. Proponents argue that smoking is one of the major killers in all developed countries, and that they have a duty to reduce the death rate, both through limiting passive smoking and by providing less opportunities for smokers to smoke. Opponents say that this undermines individual freedom and personal responsibility, in the UK at least often using the phrase nanny state, and worrying that the state may take power to remove more and more choice in the name of statistically averaged good health. It is likely that public health initiatives throughout history were attended by similar controversies, that history has forgotten.
- Antony van Leeuwenhoek (1632-1723) http://www.ucmp.berkeley.edu/history/leeuwenhoek.html
- Introduction to Virology http://www-micro.msb.le.ac.uk/109/introduction.html
- John Snow http://www.ph.ucla.edu/epi/snow.html : Mode of Communication of Cholera http://www.ph.ucla.edu/epi/snow/snowbook.html
- U Leicester Online Tutorials http://www-micro.msb.le.ac.uk/Tutorials/Tutorials.html
- Centers for Disease Control http://www.cdc.gov : Public Health Information Network http://www.cdc.gov/phin/
Last updated: 02-16-2005 09:22:27
Last updated: 04-25-2005 03:06:01