Historical Developments in Public Health and the 21st...

11

2CHAPTER

L E A R N I N G O B J E C T I V E S

To better understand the historical context of public health

To gain perspective on the role of public health in society

To grasp the key milestones in the evolution of public health practice and policy

To understand recent reform and its implications for the future of public health

Historical Developments

in Public Health and

the 21st Century

James A. Johnson, James Allen Johnson III, and Cynthia B. Morrow

C h a p t e r O v e r v i e w

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12 Chapter 2 Historical Developments in Public Health and the 21st Century

E a r l y H i s t o r y o f P u b l i c H e a l t h

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Early History of Public Health 13

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Hellenistic Health

Hip-

pocratic tradition

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humours

humours

On Airs, Waters, and Places

endemic

epidemic

On Airs, Waters, and Places -

On Airs, Waters, and Places

humours

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Latin Engineering and Administration

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The Middle Ages

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Quarantine -

Industrialization and the Influence of Great Britain

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The Emergence and Impact of Bacteriology

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P u b l i c H e a l t h i n t h e U n i t e d S t a t e s

The specters cholera, yellow fever, and smallpox recoil in fear as their way through the port of New York is blocked by a barrier

labeled “Quarantine” and by an angel holding a sword and a shield on which is written “Cleanliness.”28, p. 139

—Description of “At the Gates,” an etching printed by Harper and Brothers,

New York, September 5, 1885

The American Colonies and the Early United States

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Public Health in the United States 19

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Public Health in the 19th Century

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General Plan for the Promotion of Pub-

lic and Personal Health

sanitation

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health o"cer

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Public Health in the 20th Century

Exhibit 2.1

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Exhibit 2.1 Early In"uenza Warning

Source: Reproduced from National Library of Medicine. Of"ce of Public Health Historian.

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Exhibit 2.2 Surgeon General’s Warning

Source: CDC/Debora Cartagena.

A Counterblaste to Tobacco

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Exhibit 2.2

Exhibit 2.3

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Exhibit 2.3 Ten Great Public Health Achievements

1. Vaccines: Few treatments were effective in the prevention of infectious diseases in 1900. Now, smallpox, measles, diphtheria, pertussis, rabies, typhoid, cholera, and the plague are preventable through widespread use of vaccines.

2. Recognition of tobacco use as a health hazard: Since the 1964 surgeon general’s report on risks associated with smoking, smoking among adults has decreased, saving lives.

3. Motor vehicle safety: Improved engineering of vehicles and roads plus the use of seat belts, car seats, and helmets have reduced the number of deaths, as has decreased drinking and driving.

4. Safer workplaces: A 40% decrease in fatal occupational injuries (since 1980) has resulted through efforts to control work-related disease such as pneumoconiosis (black lung) and silicosis, which are associated with coal mining, and to improve safety in manufacturing, construction, transportation, and mining.

5. Control of infectious diseases: Efforts to protect the water supply and keep it clean with improved sanitation methods have greatly improved health, particularly curbing the spread of cholera and typhoid. The discovery of antimicrobial therapy has helped to control tuberculosis and sexually transmitted diseases (STDs).

6. Fewer deaths from heart disease and stroke: Smoking cessation, blood pressure control, early detection, and better treatments have resulted in a 51% decrease in death rates for coronary heart disease since 1972.

7. Safer and healthier foods: Major nutritional de"ciency diseases such as rickets, goiter, and pellagra have been virtually eliminated in the United States through greater recognition of essential nutrients, increases in nutritional content, food forti"cation, and decreases in microbial contamination.

8. Healthier mothers and babies: Better hygiene, nutrition, access to health care, antibiotics, and technologic advances have helped to reduce infant mortality by 90% and maternal mortality by 99%.

9. Family planning and contraceptive services: These services have altered the social and economic roles of women. Access to counseling and screening has resulted in fewer infant, child, and maternal deaths. Contraceptives have provided protection from human immunode"ciency virus and other STDs.

10. Fluoridation of drinking water: Nearly 150 million people have access to treated water, a safe and effective way to prevent tooth decay. Fluoridation has helped reduce tooth decay in children 40–70% and tooth loss in adults 40–60%.

Source: Adapted from Centers for Disease Control and Prevention. Ten great public health achievements—United States, 1900–1999. MMWR. 1999;48(12):1–3.

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Public Health in the 21st Century

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Figure 2.1

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Increasing

Population Impact

Increasing Individual

Effort NeededCounseling

and Education

Clinical

Interventions

Long-Lasting Protective

Interventions

Changing the Context to Make

Individuals’ Default Decision Healthy

Socioeconomic Factors

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‘health in all policies

Figure 2.1 Source:

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Primary Care and Public Health:

Exploring Integration to Improve Population Health -

Patient Protection and A"ordable

Care Act (ACA)

Box 2.1

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Box 2.1 Affordable Care Act Public Health Elements

Investments in public health and prevention:

Prevention and Public Health Fund (PPHF): Provides the greatest amount of funding for public health initiatives including Community Transformation Grants; Epidemiology and Lab Capacity Grants; National Public Health Improvement Initiatives; and National Diabetes Prevention Programs

National Prevention, Health Promotion, and Public Health Council: Establishes a council to coordinate and lead federal government’s prevention, wellness, and health-promotion efforts

Maternal, Infant, and Early Childhood Home Visitation Programs: Authorizes funds for evidence-based home visitation programs for this target population

Public health workforce:

Fellowship Training in Public Health (partially funded by PPHF)

Public Health and Preventive Medicine Programs (partially funded by PPHF)

Expansion of coverage, awareness, and access to clinical preventive services:

Contains numerous provisions to improve insurance coverage of family planning services and U.S. Preventive Services Task Force (USPSTF)–recommended services, in addition to many areas of expanded coverage under Medicare and Medicaid speci"cally

Authorizes funding for Personal Responsibility Education (adolescent abstinence, contraception, and prevention of sexually transmitted infections), Pregnancy Assistance Fund (support of victims of domestic violence and sexual assault), school-based health centers, and oral health activities

Provides recommendations with respect to the USPSTF and the Community Preventive Service Task Force (Community Guide) with funding from PPHF

Wellness programs:

Authorizes grants to small businesses to provide comprehensive workplace wellness programs

Requires the Centers for Disease Control and Prevention (CDC) to provide employers with assistance to evaluate worksite wellness programs

Public health research and data:

Directs the CDC to fund research on effectiveness of evidence-based practices that relate to public health initiatives

Authorizes funds for a childhood obesity demonstration project through the Centers for Medicare and Medicaid Services (CMS)

Other:

Requires the U.S. Department of Health and Human Services (HHS) to develop a national quality improvement plan

Requires nutrition labeling at restaurants with more than 20 locations

Source: Adapted from NACCHO. Public Health and Prevention Provisions of the Affordable Care Act. Available at: http://www.naccho.org/advocacy/upload/PH-and-Prevention-Provisions-in-the-ACA-Revised.pdf. Accessed February 8, 2013.

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Healthy and Safe

Community

Environments

Clinical

and Community

Preventive Services

Empowered

People Elimination of

Health Disparities

Increase the number of

Americans who are

healthy at every

stage of life.

Hea

lthy

Eating

Preventing Drug

Abuse a

nd

Excessiv

e A

lco

ho

l Use

Tobacco Free Living

Inju

ry a

nd V

iole

nce F

ree Living

Rep

rod

uctiv

e a

nd

Sexu

al H

ealth

Mental and Emotional Wellbeing

Active Livin

g

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D i s c u s s i o n Q u e s t i o n s

Figure 2.2 Source:

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References 29

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R e f e r e n c e s

A History of Public Health, Expanded Edition

. Health, Civilization and the State: A History of Public Health from Ancient to Modern Times

Health and the Rise of Civilization#e Origin of Human Disease

CIBA Foundation Symposium.

Plagues and PeoplesMagic, Reason and Experience

Healing and Resonance in Ancient EgyptWestern Journal of Medicine

Biblical and Talmudic MedicineAn Introduction to the History of Medicine

#e Hippocratic Tradition#e Water Supply of Ancient Rome. A Study of Roman Imperial Administration. -

Ancient Rome City Planning and Administration

#e Town and State Physician in Europe

Service in the Roman Army -

A History of Public Health#e Control of Plague in Venice and Northern Italy, 1348–1600

Living and Dying in London

Annu Rev Public HealthA History of Public Health in New York City, 1866–1966.

Public Health: Its Promise for the FutureIsr J Med Sci

BMJClio Medica

Hives of Sickness

Oxford Textbook of Public Health

Encyclopedia of Pestilence, Pandemics, and Plagues

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Epidemics in Colonial AmericaControl of Communicable Diseases in Man

Bull Hist MedClio Medica

General Plan for the Promotion of Public and Personal Health.

J Hist Med Allied Sci#e Untilled Fields of Public Health -

Yale J Biol MedMo Med

Am J Public HealthFor a Healthy Nation: Returns

on Investment in Public Health. Executive Summary

J Health Care FinanceAIDS Programs and Initiatives in Education and Prevention

AIDS Education and Prevention

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J Public Health Management Practice.

Health A$airs.Am J Public Health.

. For the Public’s Health: #e Role of Measurement in Action and Accountability

For the Public’s Health: Revitalizing Law and Policy to Meet New Challenges. -

For the Public’s Health: Investing in a Healthier Future

Primary Care and Public Health: Exploring Integration to Improve Population Health

Introduction to Public Health Management, Organizations, and Policy

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Additional Resources 31

A d d i t i o n a l R e s o u r c e s

#e Future of Public Health.Milbank Q. 1994

A Treatise on the Cannon of Avicenna, Incorporating a Translation of the First Book.

Avicena in Renaissance Italy. #e Canon and Medical Teaching in Italian Universities after 1500.

Trans Stud Coll Physicians Phila#e Relations of Medicine and Surgery to the End of the Sixteenth Century -

#e Disease of the Soul: Leprosy in Medieval LiteratureDisease and Representation: Images of Illness from Madness to AIDS

Companion Encyclopedia of the History of Medicine, 2 vols

A History of Public Health

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