Concept & Principles of Public HealthNuning MK Masjkuri

DefinitionsConcept:General idea underlying a class of things

Principles:Guiding rules

Public Health?Infant mortalityMaternal mortalityLife expectancyCrude death rateCrude birth ratePhysician population ratioAccess to health services

Public Health?

1. Provision of save water supply & sewage disposal2. Immunization program3. Screening for breast cancer4. Prohibit smoking in public places5. Mandatory use of seat belt & helmet

6. Chlorination of drinking water7. Promote breast feeding8. Promoting healthy diet9. Promoting safer sex10. Infectious disease control

Health state of the community (population/public)Intervention to promote the health state of the community (population)

The natural history of diseaseHEALTH

Public?Public = Population = Everybody1. People living in a place2. The whole collection of units from which a sample is taken3. A group of people that can be clearly defined

PH ConceptObjective & Interventions are Public

Dari KITA untuk KITA

Herd ImmunityNeed community participation

Other examples1. Not drinking and driving2. Practicing safer sex3. Participating in mass screening4. Participating in immunization5. Balance between diet & exercise6. etc7. etc

DifferenceClinicalPublic Health

DifferenceTreatment

Clinical Medication: Drugs/injection

PH : Programs

Three core PH functionsAssess & monitor health of communities & pop at risk health problems & prioritiesFormulate public policies (with community & gov. leaders) to set priority & solve Assure that all pop. have access to appropriate & effective care, including health promotion & disease prevention & evaluate effectiveness of the care

Disease processPre-pathogenesis Pathogenesis periodperiod

To reduce new To reduce duration To reduce complication occurrence & severity& disability

Principles1. Based on the population (a collection of individuals)2. Focusing on Health Promotion & Disease Prevention without belittling curative & rehabilitative measures3. Involving the community (community participation/empowerment)4. Through organized effort

Definition of PHThe science & art of preventing disease, prolonging life & promoting physical health & efficiency through organized community efforts for the sanitation of the environment, the control of community infections, the education of the individual in the principles of personal hygiene, the organization of medical & nursing service for the early diagnosis & preventive treatment of disease, and the development of social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health (Winslow 1920)

What we as a society, do collectively to assure the conditions in which people can be healthy (Institute of Medicine 1988)

The science & art of preventing disease, prolonging life & promoting health through organized effort of society (Acheson 1988)

Society obligation to assure the conditions for peoples health (Gostin 2001)

Government intervention in PH involves public officials taking appropriate measures pursuant to specific legal authority . to protect the health of the public . The key element in PH is the role of the govt its power and obligation to invoke mandatory or coercive measure to eliminate a threat to the publics health (Rothstein 2002)

Government?Only successful if:The health of the pop is threatenedGovernment has power or expertiseThe action of the gov. will be more efficient/ beneficial

Medical care & PH

In the end Patients need medical care when they are sick Medical care is needed only part of the time

Public health professionals monitor and diagnose the health concern of entire communities & promote healthy practices & behaviors in individuals to keep the population healthy communities need public health all of the time in order to stay healthy

C. Everett Koop