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CHANGING CONCEPTS in PUBLIC HEALTH
Dr. SASI KUMAR PJ M.D.
PUBLIC HEALTH
• Improving in health of populations
• Making people healthy
• Saving lives
Unites States
1900 ———> 1990
Life expectancy —— 30 years
25 years —— PUBLIC HEALTH
Health is a state of
complete Physical,
Mental and Social well-
being and not merely
the absence of disease
or infirmity.
The science and art of
Preventing disease,
Prolonging life and
Promoting health
through the organised
efforts of society.
Who is responsible for public health ?
• All sectors of society
• Health departments
• Other areas of government
• Private sector
• NGOs
• International organisations
Improve
Health
of
Public
1. Disease control phase (1880 - 1920)
2. Health promotional phase (1920 - 1960)
3. Social engineering phase (1960 - 1980)
4. Health for All phase (1981 - 2000)
CHANGING CONCEPTS in PUBLIC HEALTH
1. Disease control phase (1880 - 1920)
• Public health during the 19th century was largely a
matter of Sanitary legislation and Sanitary reforms
aimed at the control of man’s Physical environment,
e.g., water supply, sewage disposal, etc.
• Clearly these measures were not aimed at the control
of any specific disease
• However, these measures vastly improved the health
of the people due to disease and death control.
At the beginning of the 20th century, a new
concept, the concept of "Health Promotion"
began to take shape.
2. Health promotional phase (1920 - 1960)
• Mother and child health services,
• School health services,
• Industrial health services,
• Mental health and
• Rehabilitation services.
C.E.A. Winslow
“The science and art of
Preventing disease,
Prolonging life and
Promoting health
through the organised
efforts of society”.
•PHC’s and Sub centres
for rural and urban areas
•Important development
a) Provision of Basic Health Services
• Is an attempt to bring about a
social and economic
transformation of village life
through the efforts of the people
themselves
• Promote village development
• Active participation of whole
community
b) Community development programme, 1952
• With the advances in preventive medicine
and practice of public health, the pattern
of disease began to change in the
developed world.
• Many of the acute illness problems have
been brought under control.
3. Social engineering phase (1960 - 1980)
Chronic diseases
eg: cancer, diabetes,
CVD, alcoholism and
drug addiction.
• A new concept, the concept of "risk factors" as
determinants of these diseases came into
existence.
• The consequences of these diseases, unlike the
swift death brought by the acute infectious
diseases, was to place a chronic burden on the
society that created them. These problems brought
new challenges to public health which needed
reorientation more towards social objectives.
Public health entered a new phase in
the 1960s, described as the "social
engineering" phase
• Social and behavioural aspects of
disease and health .
• Public health moved into the
preventive and rehabilitative aspects of
chronic diseases and behavioural
problems.
NEW PRIORITY WERE GIVEN TO
4. Health for All (1981 - 2000)
• Most people in the developed countries, and the elite of
the developing countries, enjoy all the determinants of
good health - adequate income, nutrition, education,
sanitation, safe drinking water and comprehensive
health care.
• In contrast, only 10 to 20% of the population in
developing countries enjoy ready access to health
services of any kind.
• Death claims 60-250 of every 1000 live
births within the first year of life
• Life expectancy is 30% lower than in the
developed countries .
“Large no. of the worlds
peoples, perhaps more than
half, have no access to
health care at all, and for
many of the rest, the care
they receive does not
answer the problems they
have”.
In 1981 WHO pledged
“Health For All” by 2000 to
bridge the gap between
developing and developed
countries.
“To lead a Socially & Economically
productive life”
Disease
Disease control phase (1880 - 1920)
Poor sanitation
Health promotion phase (1920 - 1960)
Sanitary legislation &
sanitary reforms
Health promotion
Social objectives
Social engineering phase (1960 - 1980)
Gap between rich
& poor within
countries
WHO
Health For All phase (1981 - 2000)
THANK YOU

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Changing concepts in public health

  • 1. CHANGING CONCEPTS in PUBLIC HEALTH Dr. SASI KUMAR PJ M.D.
  • 2. PUBLIC HEALTH • Improving in health of populations • Making people healthy • Saving lives Unites States 1900 ———> 1990 Life expectancy —— 30 years 25 years —— PUBLIC HEALTH
  • 3. Health is a state of complete Physical, Mental and Social well- being and not merely the absence of disease or infirmity.
  • 4.
  • 5. The science and art of Preventing disease, Prolonging life and Promoting health through the organised efforts of society.
  • 6.
  • 7. Who is responsible for public health ? • All sectors of society • Health departments • Other areas of government • Private sector • NGOs • International organisations Improve Health of Public
  • 8.
  • 9. 1. Disease control phase (1880 - 1920) 2. Health promotional phase (1920 - 1960) 3. Social engineering phase (1960 - 1980) 4. Health for All phase (1981 - 2000) CHANGING CONCEPTS in PUBLIC HEALTH
  • 10. 1. Disease control phase (1880 - 1920) • Public health during the 19th century was largely a matter of Sanitary legislation and Sanitary reforms aimed at the control of man’s Physical environment, e.g., water supply, sewage disposal, etc. • Clearly these measures were not aimed at the control of any specific disease • However, these measures vastly improved the health of the people due to disease and death control.
  • 11. At the beginning of the 20th century, a new concept, the concept of "Health Promotion" began to take shape. 2. Health promotional phase (1920 - 1960)
  • 12. • Mother and child health services, • School health services, • Industrial health services, • Mental health and • Rehabilitation services.
  • 13. C.E.A. Winslow “The science and art of Preventing disease, Prolonging life and Promoting health through the organised efforts of society”.
  • 14. •PHC’s and Sub centres for rural and urban areas •Important development a) Provision of Basic Health Services
  • 15. • Is an attempt to bring about a social and economic transformation of village life through the efforts of the people themselves • Promote village development • Active participation of whole community b) Community development programme, 1952
  • 16. • With the advances in preventive medicine and practice of public health, the pattern of disease began to change in the developed world. • Many of the acute illness problems have been brought under control. 3. Social engineering phase (1960 - 1980)
  • 17. Chronic diseases eg: cancer, diabetes, CVD, alcoholism and drug addiction.
  • 18.
  • 19.
  • 20.
  • 21. • A new concept, the concept of "risk factors" as determinants of these diseases came into existence. • The consequences of these diseases, unlike the swift death brought by the acute infectious diseases, was to place a chronic burden on the society that created them. These problems brought new challenges to public health which needed reorientation more towards social objectives.
  • 22. Public health entered a new phase in the 1960s, described as the "social engineering" phase
  • 23. • Social and behavioural aspects of disease and health . • Public health moved into the preventive and rehabilitative aspects of chronic diseases and behavioural problems. NEW PRIORITY WERE GIVEN TO
  • 24.
  • 25.
  • 26. 4. Health for All (1981 - 2000) • Most people in the developed countries, and the elite of the developing countries, enjoy all the determinants of good health - adequate income, nutrition, education, sanitation, safe drinking water and comprehensive health care. • In contrast, only 10 to 20% of the population in developing countries enjoy ready access to health services of any kind.
  • 27. • Death claims 60-250 of every 1000 live births within the first year of life • Life expectancy is 30% lower than in the developed countries .
  • 28. “Large no. of the worlds peoples, perhaps more than half, have no access to health care at all, and for many of the rest, the care they receive does not answer the problems they have”.
  • 29. In 1981 WHO pledged “Health For All” by 2000 to bridge the gap between developing and developed countries.
  • 30.
  • 31. “To lead a Socially & Economically productive life”
  • 32.
  • 33. Disease Disease control phase (1880 - 1920) Poor sanitation Health promotion phase (1920 - 1960) Sanitary legislation & sanitary reforms Health promotion Social objectives Social engineering phase (1960 - 1980) Gap between rich & poor within countries WHO Health For All phase (1981 - 2000)