Expanding the Concept

of Public Health.
Chapter 2: The New Public Health.

Speaker: Maria Camila Montúfar Pantoja.

Global Health Risk Management & Hygiene Policies Master Student
  WHO 1946: “ Health is a state of complete physical, mental and
social well-being and not merely the absence of disease or
infirmity”.
Health
 EQUILIBRIUM: biological, physical and social environment →
maximum functional capability.
Disease
Natural
History of
Disease.
* PH can change the course.
  PREVIOUS CENTURIES:
 Studies and implements measures for control of Communicable
diseases : sanitation and vaccination.

Public Health  NOWADAYS:

 Multidisciplinary field (sciencie, education, social science,
Concepts. economics…) promote welfare of the individual and community:
interdependence of mind and body

 Holistic New Public Health : equilibrium

Public Health  WHO definition
Definition.
Changes in Public
Health

 Factors that create new paradigms:

 *chronic disease and disabilities
 * pandemics : Covid
 * Lifestyle: Cardiovascular diseases.
  Must be Adaptable
Health  Demographic and epidemiological changes.
Systems  Based in Public health policies: not only health services.
Society and
Health

Poverty and diseases

  Social Determinants of Health
 Poverty and bad sanitation, housing, and working conditions =
high mortality.
 Social conditions affects diseases distribution: migration,
Society and unemployment, politic change, lifestyle
Health  Health insurance systems and health access.
 Deal with inequalities
 GAP
  1978
 Primary health care
ALMA-ATA  Health as a Human Right
 Social GAP
 Governments : responsible to fulfill
 Equity
ALMA-ATA
  Populations according to risks
 Interventions to impact morbidity and mortality
Risk  New programs development
Approach  Identify need measuring incidence or prevalence
 Define targets to reduce risks.
  Health resources: public responsibility
 Investment in public health: integral part of socioeconomic
development.
Political  Government responsable.
Economy  Now: private health insurance
 US: Insure only highest risk group people( elderly, poor)
  1976: Thomas Mckeow → epidemiological analysis
 Continue decrease mortality in England
Medical Care in  30 per 1000 population in 1541 to 12 per 1000 in 1851
Public Health
 Why? : Effective medical care (limitation of family size, increased
food supplies, nutrition, sanitation, preventive measures)
  1950 Peter Drucker : “management by objective”
 US 1970-1990: National Health Objectives
 1987 CDC: 18 health indicators
Health Targets
 Medical services alone would not achieve better health results.
  2000 UN: 8 MDG
 Adopted by 120 nations
 Focus MIC LIC

 US 2000 Targets: increase healthy lifespans, reduce health

disparities , access to preventive health care for ALL
Americans.

 WHO European Region: Health 21- Health for All in the 21st
Century.
  New emerging concept
 Equity and sustainable development.
 Environmental: ecologic (pollution), deforestation, climate
change.
The New  Increasing of longevity and aging
 Chronic diseases take more importance.
Public Health  Disabilities
 Inequalities
 Health concerns: Individual and community
  Mission: maximize human health and well-being for individuals,
communities
New Public  Promotion and disease prevention essential
Health  Scientific, political, economic, social advances
 Global village: Health Globalization.
  Tulchinsky, T., & Varavikova, E. (2015). The New Public Health.
Literature Academic Press.