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HEALTH PROMOTION - NEW PUBLIC HEALTH

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HEALTH PROMOTION - NEW PUBLIC HEALTH

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This presentation describes what is new public health with adapted components from the previous eras of public health. Health promotion and evolution of public health is covered here.

This presentation describes what is new public health with adapted components from the previous eras of public health. Health promotion and evolution of public health is covered here.

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HEALTH PROMOTION - NEW PUBLIC HEALTH

  1. 1. THE NEW PUBLIC HEALTH
  2. 2. PROLOGUE From its origins, when public health was integral to societies’ social structures, through the sanitary movement and contagion eras, when it evolved as a separate discipline, to the “new public health” era, when health promotion projects like Healthy Cities appear to be steering the discipline back to society’s social structure, public health seems to have come full circle.
  3. 3. CONTENTS PREVIOUS ERAS OF PUBLIC HEALTH Health Protection Miasma Control Contagion Control Preventive Medicine Primary Health Care Health Promotion – NEW PUBLIC HEALTH
  4. 4. “the science and art of preventing disease, prolonging life and promoting health and efficiency through organized community effort” CEA Winslow (1920)
  5. 5. HISTORY 6 major approaches to public health practice implemented between ancient times and the contemporary era, defined more by important milestones than by convention.
  6. 6. Health Protection Contagion Control Miasma Control Preventive Medicine Primary Health Care Health Promotion ERAS OF PUBLIC HEALTH Antiquity --1830s 1840s — 1870s 1880s — 1930s 1940s – 1960s 1970s — 1980s 1990s– present
  7. 7. HEALTH PROTECTION ERA
  8. 8. DOMINANT PARADIGM Enforced regulation of Human Behavior mediated by ruling elites through society’s religious, political, cultural practices
  9. 9. Health related societal responses to the 1346 black death plague in venice and marseilles
  10. 10. HISTORY OF QUARANTINE BLACK DEATH IN ITALY -1347 - some ports began turning away ships suspected of coming from infected areas. - authorities in Venice were the first to formalise such protective actions against plague, closing the city’s waters to suspect vessels, and subjecting travellers and legitimate ships to 30 days’ isolation. This period was extended to 40 days some years later - hence the term QUARANTINE
  11. 11. LEVITICUS 13 The biblical laws of sanitation were clearly ahead of their time! People showing signs of sickness were to be isolated—quarantined— until examined by a priest and declared well.
  12. 12. ADAPTATIONSADAPTATIONS • Quarantine of illegal migrants. • Enforcement of some environmental protection laws. • Aspects of spirituality in prevention and coping with disease. • Some occupational and transport safety laws .
  13. 13. MIASMA CONTROL ERA
  14. 14. ENGLAND Industrial Revolution • Influence of filthy environmental conditions on adverse health outcomes. • The great cholera epidemic occurred in 1832.
  15. 15. THE GREAT SANITARY AWAKENING
  16. 16. SIR. EDWIN CHADWICK • Data to correlate sanitation trends with variations in mortality rates and economic status, thus laying the foundations of modern epidemiology and surveillance.
  17. 17. PUBLIC HEALTH ACT - 1848 Responsibility of the state for the health of its people. CHOLERA - FATHER OF PUBLIC
  18. 18. [Today] Cholera remains a global threat to public health and a key indicator of lack of social development The actual global burden is estimated to be 3-5 million cases and 1-1.3 Lakh deaths per year. Two vaccines are available , but the best control measures remain patient care, improved water and sanitation, and community response.
  19. 19. • Addressing unsanitary environmental conditions may prevent disease • Public health legislations • Foundations of modern epidemiology and surveillance • Minimum standards for drainage, sewage, and refuse disposal ADAPTATIONS
  20. 20. CONTAGION CONTROL ERA
  21. 21. ROBERT KOCH GERM THEORY (1882) Landmark study in the etiology of TB Proposed the germ theory postulates to demonstrate the parasitic nature of a disease.
  22. 22. DOMINANT PARADIGM Improved understanding of the pathogenesis of infectious diseases like cholera. Improved water filtration practices Advances in bacteriology Contemporary measures to control the outbreak of communicable diseases Laid a scientific basis for vaccination.
  23. 23. ADAPTATIONS Evidence based public health practice Ethical vaccination principles Foundations for modern chemotherapy
  24. 24. PREVENTIVE MEDICINE ERA
  25. 25. DOMINANT PARADIGM • Improved understanding of the pathogenesis of communicable and non communicable diseases • Focus on the prevention and cure of diseases in “High Risk groups”
  26. 26. • Disease “Vectors” • Identification of Useful microbes • Role of nutrient deficiencies
  27. 27. BRITAIN NATIONAL HEALTH SERVICE • Physician enhanced ability to shape political and public perceptions of health policy. • Professional / medical bias into the perspectives of key politicians and policymakers.
  28. 28. ADAPTATIONS • Focus on “high-risk groups” in the planning • And implementation of public health programs; • Improved understanding of the pathogenesis of communicable and non- communicable diseases.
  29. 29. PRIMARY HEALTH CARE ERA
  30. 30. ALMAATA DECLARATION “Health for All” Alma-Ata declaration 1978 Emphasis on Global Cooperation and peace Equity in health care Adapting health services to countries and communities Links b/w healthcare and socioeconomic development Inter-sectoral cooperation in health promotion and disease prevention
  31. 31. ADAPTATIONS Concepts underpinning multicultural health and Healthy Cities initiatives, health inequalities, and community participation in health promotion activities.
  32. 32. HEALTH PROMOTION ERA
  33. 33. DOMINANT PARADIGM • ADVOCACY FOR HEALTH. • ENABLING INDIVIDUALS AND COMMUNITIES TO ATTAIN OPTIMUM HEALTH. • Individuals and communities assisted by educational, economic, and political actions to increase control over and improve their health through attitudinal, behavioural, social and environmental changes.
  34. 34. “ Health Promotion ” Dr. Henry Sigerist Describes the health education interventions and related organizational, political and economic interventions that are designed to facilitate behavioral and environmental changes to improve Health. 3 Core Components Health Education Prevention Protection
  35. 35. OTTAWA CHARTER - 1986 5 key principles 1) Build healthy public policy 2) Create supportive environments 3) Strengthen community action 4) Develop personal skills 5) Reorient health services
  36. 36. WHATS NEW ABOUT THE NEW PUBLIC HEALTH?
  37. 37. LEGACIES AND INNOVATIONS IN HEALTH PROMOTION Health promotion as a distinct professional discipline.
  38. 38. QUARANTINE : WHAT CHANGED? Earlier – intense stigma and stifling autonomy Now – more humane and less stigmatizing measures.
  39. 39. AUSTRALIA’S QUARANTINE AMENDMENT BILL (2003) People ordered to be quarantined in Australia on health grounds will have the right to request independent medical assessment, thus protecting them against arbitrary retention. INDIVIDUAL AUTONOMY has been enhanced.
  40. 40. TOBACCO CONTROL Use of legislations to effectively implement contemporary public health activities.
  41. 41. SOCIAL DETERMINANTS OF HEALTH Current centralized systems of environmental protection owe a lot to Chadwicks initiatives. Attribution of the cause of ill health to environmental and social factors, rather than specifics of biology, constitutes the foundation of SOCIAL DETERMINENTS OF HEALTH
  42. 42. ENVIRONMENTAL PROTECTION LAWS • Most government agencies charge individuals and communities for environmental sanitation services such as garbage disposal. • Stiff penalties for those who breached environmental
  43. 43. MULTIDISCIPLINARY APPROACH Sociologists Health economists Health promotion specialists Dominance of the medical profession in public health, which characterized the preventive medicine era is being superseded by a multidisciplinary approach
  44. 44. CONCLUSION What is new about public health is not originality of strategies, but the manner in which health promotion discourse has adapted core doctrines of previous eras to address the public health threats of our era.
  45. 45. REFERENCES Awofeso N. What’s New About the “New Public Health”? American Journal of Public Health. 2004;94(5):705-709. Steinberg K. Wellness in Every Stage of Life: A New Paradigm for Public Health Programs. Preventing Chronic Disease. 2007;4(1):A02. Hanratty, Barbara et al. The new new public health: The Lancet , Volume 352 , Issue 9131 , 903 - 904 Graham H. Where Is the Future in Public Health? The Milbank Quarterly. 2010;88(2):149-168. doi:10.1111/j.1468-0009.2010.00594.x.
  46. 46. THANK YOU The river called PUBLIC HEALTH started as a small spring, a small tricklet from the timeless womb of humanity. It became a rivulet, then a stream and then a river; its journey towards the ocean called HEALTH FOR ALL is still on.

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