PREVENTIVE MEDICINE

1. Public health
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2. Health
• The World Health Organisation defines Health
(of an individual) as the state of complete
physical mental and social well-being and not
merely the absence of disease or infirmity.
• World Health Organisation, however, does not
define Public Health.

3. Death
• Death, on the planet Earth, is inevitable.
• A large number of deaths are premature.
• A substantial proportion of deaths can be
avoided.
• Public Health is related to preventing premature
and unavoidable deaths.

4. A Model of Health
Exposure to Risk
Factors
Body resistance
Poor Health
Manifestation
Disease Condition
Disability Death

5. Public Health
• If the disease condition is avoided, the
probability or the chance of death or
disability can be reduced.
• Public Health is therefore described as the
science and art of preventing diseases,
prolonging life and promoting health (of
individuals) through organised efforts and
informed choices.

6. Public Health
• Public Health deals with the group of people
rather than individuals.
• Dimensions of public health
– Health promotion
– Disease prevention
– Early diagnosis and prompt treatment
– Disability limitation
– Rehabilitation

7. • Public health is as old as the
man itself.
• In primitive time ,since the
knowledge was limited, man
attributed disease to the
wrath of gods, the invasion
of body by evil spirits and
the malevolent influence of
stars and planets.
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8. – Supernatural theory of
disease
– Disease and human
sufferings & calamities
were attributed to the
wrath of god
– Influence of evil spirits,
stars & planets
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9. • After the fall of Rome,
Christian faith entered the
world
• Implicit faith on Christ was
the only method of
treatment of disease
• Christ was the supreme
healer, the savior of body &
soul
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10. • Because of this the enquiry into the diseases became
unnecessary & even culpable.
• A doctor curing patients by rational methods was
considered to be committing sin & using medicine was
seemed to be lack of faith in God.
• The scientific medicine suffered greatly & was fully
dormant.
• All classes of people were treated alike. 10

11. • Crowding, poor nutrition and sanitation, lack of
water sources and drainage, unpaved streets,
keeping of animals in towns, and lack of organized
waste disposal created conditions for widespread
infectious diseases
• All these were threat for the public health
• Although physicians provided services for those
able to pay but medical knowledge was a mix of
pragmatism, mysticism and sheer lack of scientific
knowledge
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12. • The practice of separating people with disease from
the healthy population is an ancient one.
• By the 7th century, China had a well-established
policy of detaining sailors and foreign travellers
suffering from plague.
• The term “quarantine” dates back to the late 14th
century
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13. • From the 14th century,
European doctors visiting
plague victims wore
– protective clothing
– mask and
– a beak
containing strong-smelling
herbs.
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14. • Smallpox is one of the oldest known human
diseases.
• There are evidences that during the 18th
century, Smallpox killed every seventh child born
in Russia, and every 10th child born in France
and Sweden
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15. • Edward Jenner’s
experiment in 1796
brought hope that
the disease could be
controlled.
He carried out the
first vaccination with
cowpox virus in 1796
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16. • Following 1500 AD
• Fracastorius envisaged the transfer of infection via
minute invisible particles and explained the cause
of epidemics(Theory of contagion)
• He became the founder of epidemiology.
• Sydenhem made differential diagnosis of scarlet
fever, malaria, dysentery ,cholera.
• He is also regarded as the first distinguished
epidemiologist.
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17. • A milestone in the history of public health is great
Sanitary awakening which took place in England in
mid-nineteenth century and gradually spread to
other countries.
• Industrial revolution of the 18th century sparked of
numerous problems, i.e. creation of slums,
overcrowding with all its ill effects.
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18. • Great cholera epidemic of 1832 led the birth of
public health in England around 1940.
• John Snow, studied the epidemiology of cholera in
London from 1848 to 1854 and established the role
of polluted drinking water in its spread.
• The great cholera epidemic of 1832 drew attention
of the people and govt. on urgent need to improve
public health……led to enactment of the Public
Health Act of 1848, in England.
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19. • A comprehensive piece of legislation was brought
into force in England, the Public Health Act of 1875,
for the control of man’s physical environment.
• By the beginning of 20th century, the broad
foundation of public health …..clean water, clean
surroundings ,wholesome condition of houses,
control of offensive trades etc., were laid in all the
countries of the western world.
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20. • Preventive medicine really dates back to the 18th
century.
• It developed as a branch of medicine distinct
from Public Health.
• Preventive Medicine got a firm foundation after
the discovery of causative agents of disease and
establishment of the Germ Theory of disease.
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21. • Modern Preventive
Medicine:
defined as…
“ the art and science of
health promotion, disease
prevention, disability
limitation and
rehabilitation”
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22. Curative Medicine Public Health /
Preventive Medicine
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23. • Term Public Health came in to general use around
1840’s
• It arose from need to protect the public from the
spread of communicable diseases
• In1848 the Public Health Act in England crystallized
the efforts organized by the society to protect,
promote & restore the public health
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24. • C.E.A. Winslow (1920) gave definition of public
health: “the science & art of preventing disease,
prolonging life & promoting health & efficiency
through organized community efforts”
• This summarizes the philosophy of public health,
which remains largely true even today
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25. • Disease control phase (1880-1920)
• Health promotional phase (1920-1960)
• Social engineering phase (1960-1980)
• Health for All phase (1981-2000AD)
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26. • 1880-1920
• Sanitary legislation and sanitary reforms
• Less available technical knowledge
• Aimed at the control of man’s physical
environment (water supply, sewage disposal) & not
at the control of any specific disease
• Improvement in the health of people due to disease
and death control
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27. • In addition to disease control activities one
more goal was added to public health i.e. health
promotion of the individuals
• It was initiated as personal health services such
as
Introduction of Mother & Child health services
School health services
Industrial health services
Mental health
Rehabilitation services
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28. • Two great movements were initiated for
human development :
a) provision of basic health services through
the medium of PHCs & Sub-centers
b) community development programme to
promote village development through active
participation of whole community
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29. • Change in pattern of disease
• Public Health entered in new phase called “social
engineering phase”
• It moved towards preventive & rehabilitative
aspects of chronic diseases & behavioral problems
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30. • Goals of public health & preventive medicine
which had already considered overlapping
became identical, namely prevention of
disease, promotion of health & prolongation
of life
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31. • Health gap between rich & poor, within & between
countries
Health for all phase
• Include provision of health care to all by reducing
the inequalities within & between the population
so that individual will lead a socially & economically
productive life
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32. • With the adoption of Health for All (1978), a new
concept of Public Health became evident
worldwide, which may be defined as….
“the organized application of local, state, national &
international resources to achieve health for all, i.e.
attainment by all the people of the world by the
year 2000 of a level of health that will permit them
to lead a socially & economically productive life”
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33. • During 20th century the dramatic increase in
average span of life is credited to public health
achievements such as vaccination programs, control
of infectious diseases, better safety policy such as
motor vehicle and worker safety, improved family
planning, emphasis on safe drinking water.
• Now the focus is shifting more towards chronic
diseases such as cancer, AIDS, diabetes and heart
diseases
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34. • Vaccination
• Safer workplaces
• Control of infectious diseases
• Decline in deaths from coronary heart disease
and stroke
• Motor vehicle safety
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35. • Safer, healthier food
• Healthier mothers and babies
• Family planning
• Safe drinking water
• Recognition of tobacco as a hazard
• Improved sanitation
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36. • CARE-Co-operative for Assistance And Relief Everywhere
• UNICEF – United Nation International Children Emergency
Fund
• WHO – World Health Organization
• WORLD BANK
• GOARN- Global Outbreak Alert and Response Network
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37. • UNDP-United Nations Development Programme
• FAO – Food and Agriculture Organization
• UNFPA - United Nation Fund for Population Activities.
• Global fund to fight AIDS, TB, Malaria
• Bill and Melinda Gates Foundation
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38. • USAID :United States Agency for International
Development
• SIDA: Swedish International Development Agency
• DANIDA: Danish International Development Agency
• GAVI: The Global Alliance for Vaccines and Immunization
• INTERNATIONAL RED CROSS
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39. Essential Public Health Functions

40. Essential Public Health Functions in
India
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Health situation
Epidemiological surveillance
Health promotion
Regulation
Participation
Policy and planning
Evaluation
Human resources
Quality
Research
Management capacity
Emergencies and Distasters

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