History of Community Public

Health
460 BC-380 BC

•Hippocrates
• founder of Western medicine.
• Greeks
• practice of community sanitation.
• Romans
• improved upon Greek engineering in the building of aqueducts to
protect water supplies.
• first hospital.
Roman Times
• it was well understood that proper diversion of
human waste was a necessary tenet of public health
in urban areas
1000 BC
• The Chinese developed the practice of
variolation following a smallpox epidemic
500-1500 Middle Ages/Dark Ages

• ending of Roman ideology

• Health problems were considered to have
spiritual causes and solutions.
Germ Theory of Disease
• Diseases, they thought, were caused by:
14th century Black Death in Europe
• it was believed that removing bodies of the dead would further
prevent the spread of the bacterial infection… Burning parts of cities
• The development of quarantine in the medieval period helped
mitigate the effects of other infectious diseases
• Polizeiwissenschaft ("Science of police")
• "social medicine" (which focused on flux, circulation of air, location of
cemeteries, etc.)
• "biopower“ (miasma theory of disease ;management of populations)
Spontaneous Generation
• Theory that life just “spontaneously” developed from
non-living matter
• living things arise from non-living things

• Example:
• toads, snakes and mice - moist soil
• flies and maggots - manure and decaying flesh
1680
• Anton Van Leeuwenhoek
• Microscope
• microorganisms
1700-1800/Age of Discovery/Epidemiology
Views of Epidemics:
• Miasmic: This theory held that epidemics stemmed
from certain atmospheric conditions and from
miasmas rising from organic materials.
• Contagion: This theory held that epidemics resulted
from transmission of germs.
1820s
• The practice of vaccination became prevalent,
following the work of Edward Jenner to treat
smallpox.
between 1829 and 1850s
• The science of epidemiology was founded by
John Snow's identification of a polluted public
water well as the source of an 1854 cholera
outbreak in London
1880s
• Modern era of public health
• Robert Koch's germ theory
• Louis Pasteur's production of artificial vaccines.
• Other public health interventions:
• latrinization
• building of sewers
• regular collection of garbage followed by incineration or disposal in a
landfill
• providing clean water
• draining standing water to prevent the breeding of mosquitoes
20th century
• public health began to put more focus on chronic diseases
such as cancer and heart disease.
• An emphasis on physical exercise was reintroduced.
• In America, public health worker Dr. Sara Josephine Baker
lowered the infant mortality rate using preventive methods.
20th century (con’d)
• the dramatic increase in average life span is widely credited
to public health achievements, such as:
• vaccination programs and control of infectious diseases,
• effective safety policies such as motor-vehicle and
occupational safety,
• improved family planning,
• fluoridation of drinking water,
• anti-smoking measures, and
• programs designed to decrease chronic disease.
This 1963 poster featured CDC’s national symbol of public health, the
"Wellbee", encouraging the public to receive an oral polio vaccine.
• Since the 1980s, the growing field of population
health has broadened the focus of public health from
individual behaviors and risk factors to population-
level issues such as inequality, poverty, and education.
21st Century
• Diseases: Ebola, HIV/AIDS, tuberculosis, CVDs, Cancer
• Bioterrorism
• Globalization:
• Interconnectedness of nations
• Fall of trade barriers
 CONCEPTS ABOUT HEALTH IN
TH
THE 20 CENTURY AND BEYOND
"social determinants of health"
• Where we live
• Genetics
• Income
• Educational status
• Social relationships
“Health Equity”
• A social gradient in health runs through society, with those
that are poorest generally suffering the worst health.
However even those in the middle classes will generally have
worse health outcomes than those of a higher social
stratum. The new public health seeks to address these health
inequalities by advocating for population-based policies that
improve the health of the whole population in an equitable
fashion.
1978 – the Declaration of Alma-Ata
• sought the commitment of the Member States of the WHO
to the target of health for all by year 2000
• To be achieved by the strategy of primary health care
• Promotion of greater and more effective community
participation in services and structures designed to bring
better health care to the millions of people who lacked even
basic access to such facilities
1985 - CIH
• WHO convened in an interregional meeting on the subject of
community involvement in health (CIH)
• CIH was used explicitly as the term to describe a basic
principle of health care and promotion
1989 – WHO Study Group
• Helped to clarify the concept of CIH and describe
how it is put into practice in many diverse
contexts
Modern Concepts in Public Health:
• Public Hygiene
• Economics of Public Health
• Public Health Research
• Community based participatory research
• Education and training in Public Health
Public Hygiene
• Public hygiene includes public behaviors individuals can take to
improve their personal health and wellness.
• Topics include public transportation, food preparation and public
washroom use.
• These are steps individuals can take themselves. Examples would
include avoiding crowded subways during the flu season, using gloves
when touching the handrails and opening doors in public malls as well
as going to clean restaurants.
Economics of Public Health
• The application of economics to the realm of public
health has been rising in importance since the 1980s.
• Economic studies can show, for example, where
limited public resources might best be spent
Public Health Research
• Public health investigates sources of disease and
descriptors of health through scientific methodology.
• This can lead to a public health solution to an
epidemic, or a community based intervention for
chronic diseases. Either way, research can provide the
link between cause and effect for public health issues.
Community based participatory research
• CBPR investigates community-based etiology, involves community
leaders, and overall respects the forces under which the community
and its participants preside toward promoting and sustaining public
health matters.
• This have been difficult to accomplish because communities in
poorer, less well developed areas often distrust researchers and
scientists from "outside."
Education and training in Public Health
• The Master of Public Health (MPH), Doctor of Public Health (DrPH),
Master of Healthcare Administration (MHA) and Professional Further
Education in Clinical Pharmacy and Public Health are examples of
degrees which are geared towards people who want careers as
practitioners of public health in health departments, managed care
organizations, community-based organizations, hospitals, consulting
firms, international agencies, state and federal agencies, among
others.
Education and training in Public Health
• Academic degrees are more oriented toward students wishing to seek
a career in teaching at a college or university or conducting research
at a university or other settings. Examples of academic degrees are
the Master of Science (MS), Doctor of Philosophy (PhD), and Doctor
of Science (ScD).