1st session

Introduction to Public Health

Presented by
Kherailah Khodeda
2nd Class
1st semester
2023-2024

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 Health Definitions
What is Health? we consider definitions from lay point of view,
professional, World Health Organization (WHO).
Lay Point of view: Persons are healthy when they are doing their activities
with no apparent symptoms of disease in them.
The New oxford Dictionary of English describes
Health as ‘the state of being free from illness or injury’.
Professional points of view: From this point, health is defined as s a
measure of the state of the physical bodily Organs, and the ability of the body
as a whole to function. It refers to freedom from medically defined diseases
WHO definition: The world Health Organization (WHO) described Health
in1948, in the preamble to its constitution, as “A state of complete physical,
mental, and social well-being and not merely the absence of disease or
infirmity”.

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 Public Health Defined
“The science and art of preventing disease,
prolonging life, and promoting health through the
organized efforts and informed choices of society,
organizations, public and private communities, and
individuals.” CEA Winslow
“The process of mobilizing and engaging local,
state, national, and international resources to assure
the conditions in which people can be healthy” The
Oxford Textbook of Public health

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 Public Health Defined
“The science and practice of protecting and
improving the health of the community, as by
preventive medicine, health education, control of
communicable diseases, application of sanitary
measures, and monitoring of environment hazards”
The American Heritage Dictionary of Public Health
“Public health is a science and art of saving the lives
of millions of once by single decision or
interventions.

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 Health Policy
Policy: A definite course of action adopted as
expedient, or from considerations, e.g. a business
policy. American Heritage Dictionary
 Evolution of Health Policy
• Common Wisdom- Learned from direct observation
• Age of Discovery- Application of the scientific method
• Prospective Age- population based analysis.

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 Health Policy
Policy Development is the means by which
problem identification, technical knowledge of
possible solutions, and societal values join to set
course of action (IOM)

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 Policy Development

 Problem Identification • Law

• Anecdote • Health behavioral theory- psychology
• Media (in the news)  Social Values
• Public health data (data tells a story) • Political process
• Epidemiology (epidemiology points • Legislatives, judicial and executive
to the answers) expression
 Technical Knowledge of Solutions • Social and political sciences
• Interest groups
• Basic sciences
• Town hall meetings
• Clinical studies
• Blogs, web pages
• Economics
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 Prevention Through Policy
• Book of Leviticus (The world’s first written health code).
• Tobacco Laws (Laws banning smoking in public places).
• Obesity (Food labeling and promotion of physical activity).

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 Prevention
Prevention:- refers to the goals of medicine that are to promote, to preserve,
and to restore health when it is impaired, and to minimize suffering and distress.
There are three levels of prevention:
• Primary prevention
• Secondary prevention
• Tertiary prevention

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 Prevention
Primary Prevention:- refers to those activities that are
undertaken to prevent the disease and injury from
occurring. It works with both the individual and the
community.
It may be directed at the host, to increase resistance to
the agent (such as immunization or cessation of
smoking), or may be directed at environmental
activities to reduce conditions favorable to the vector
for a biological agent, such as mosquito vectors of
malaria.

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 Prevention
Secondary Prevention:- is the early diagnosis and management
to prevent complications from a disease. It includes steps to
isolate cases and treat or immunize contacts to prevent further
epidemic outbreaks.
Tertiary Prevention:- Involves activities directed at the host but
also at the environment in order to promote rehabilitation,
restoration, and maintenance of maximum function after the
disease and its complications have stabilized.
Providing a wheelchair, special toilet facilities, doors, ramps,
and transportation services for paraplegics are often the most
vital factors for rehabilitation.

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 Public Health Approach

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Public Health Approach
Public Health Model Medical Model
• Population • Individual
• Disease prevention • Diagnosis
• Health promotion • Treatment
• Intervention (environment, • Intervention (Medical care)
human behavior) • Private (some public)
• Public (some private)

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 The Health Field Concept
According to the “Health field” concept. There are four major determinants of health or
ill health
A. Human Biology: Every Human being is made of genes. In addition, there are factors,
which are genetically transmitted from parents to offspring.
a. Genetic Counseling: For instance, during marriage parents could be made aware of
their genetic component in order to overcome some risks that could arise.
b. Genetic Engineering: may have a role in cases like Breast cancer.
B. Environment: is all that which is external to the individual human host. Those are
factors outside the human body. Environmental factors that could influence health include:
a. Life support: food, water, air etc.
b. Physical factors: climate, Rain fall
c. Biological factors: microorganisms, toxins, Biological waste,
d. Psycho-social and economic e.g. Crowding, income level, access to health care
e. Chemical factors: industrial wastes, agricultural wastes, air pollution, etc.
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 The Health Field Concept
C. Life style (Behavior): is an action that has a specific frequency, duration,
and purpose, whether conscious or unconscious. It is associated with practice. It
is what we do and how we act. Recently life style by itself received an
increased amount of attention as a major determinant of health. Life style of
individuals affects their health directly or indirectly.
For example:
• Cigarette smoking
• Unsafe sexual practice
• Eating contaminated food

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 The Health Field Concept
D. Health care organization
Health care organizations in terms of their resource in human power, equipment’s,
money and so on determine the health of people.
It is concerned with
a. Availability of health service: People living in areas where there is no access to
health service are affected by health problems and have lower health status than
those with accessible health services.
b. Scarcity of Health Services: leads to inefficient health service and resulting in
poor quality of health status of people.
c. Acceptability of the service by the community
d. Accessibility in terms of physical distance, finance etc.
e. Quality of care that mainly focuses on the comprehensiveness, continuity and
integration of the health care.
The other view of the determinants of health is from the ecological perspective.
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 The Factors Affecting Health

Physical
determinant

Health of
Community Socio-
organization
the cultural
Community

Behavioral
determinant

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 The Factors Affecting Health

1. Physical Determinants: The physical factors affecting the health of a

community include: the geography (e.g. high land versus low land), the
environment (e.g. manmade or natural catastrophes) and the industrial
development (e.g. pollution occupational hazards).
2. Socio – cultural determinants:
The socio- cultural factors affecting the health of a community include the
beliefs, traditions, and social customs in the community. It also involves the
economy, politics and religion in the community.
3. Community organization: Community organization include the community
size, arrangement and distribution of resources (“relations of productions’)
4. Behavioral determinants: The behavioral determinants affecting health
include individual behavior and life style affecting the health of an individual
and the community, e.g. smoking, alcoholism and promiscuity
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 The Core Functions of Public Health

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Ten Great Public Health Achievements

• Vaccination • Safer and healthier foods

• Motor- vehicle safety • Healthier mothers and babies
• Safer workplaces • Family planning
• Control of infectious diseases • Fluoridation of drinking water
• Decline in deaths from coronary • Legislation of tobacco use of
heart disease and stroke health hazards

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Public Health Problems and Diseases

• Communicable diseases • Influenza

• Non-communicable diseases • Poliomyelitis
• Environmental pollution • Tuberculosis
• Maternal child health problems • Cholera
• Malnutrition and micronutrient • Dengue
deficiency • Malaria
• Municipal and hospital waste • HIV/ AIDS
• Geriatric health problems • Obesity
• Population problems • Cancer
• Measles • Diabetes
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 Core Activities of Public health

1. Preventing epidemics.
2. Protecting the environment, work place, food and water.
3. Promoting healthy behavior.
4. Monitoring the health status of the population.
5. Mobilizing community action.
6. Responding to disasters.
7. Assuring the quality, accessibility, and accountability of medical care.
8. Reaching to develop new insights and innovative solutions.
9. Leading the development of sound health policy and Planning.

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 Major Disciplines in Public Health

1. Nutrition: is the science of food, the nutrients and other substances there in,
their action, interaction and balance in relation to health and disease.
2. Reproductive health: health in all matters relating to reproductive system
and to its functions and process.
3. Environmental Health: The basic approach to environmental control is
first to identify specific biologic, chemical, social and physical factors that
represent hazards to health or well-being and to modify the environment in
a manner that protects people from harmful exposures. The principal
components of environmental health are water sanitation, waste disposal,
etc.
4. Health Education: is defined as a combination of learning experiences
designed to facilitate voluntary actions conducive to health. It is an essential
part of health promotion.
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 Major Disciplines in Public Health

5. Epidemiology is the study of frequency, distribution, and determinants of

diseases and other related states or events in specified populations. The
application of this study to the promotion of health and to the prevention and
control of health problems is evident.
6. Health Economics is concerned with the alternative uses of resources in the
health services sector and with the efficient utilization of economic resources
such as manpower, material and financial resources.
7. Biostatistics is the application of statistics to biological problems;
application of statistics especially to medical problems, but its real meaning is
broader.
8. Health Service Management is getting people to work harmoniously
together and to make efficient use of resources in order to achieve objectives.

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 Major Disciplines in Public Health

9. Ecology: is the study of relationship among living organisms and their

environment. It is the science, which deals with the inter-relationships between
the various organisms living in an area and their relationship with the physical
environment. Human ecology means the study of human groups as influenced
by environmental factors, including social and behavioral factors.
10. Research is a conscious action to acquire deeper knowledge or new facts
about scientific or technical subjects. It is a systematic investigation towards
increasing knowledge. It aims at the discovery and interpretation of facts,
revision of accepted theories, or laws in the light of new facts or practical
application of such new theories or laws.
11. Demography is the study of population, especially with reference to size
and density, fertility, mortality, growth, age distribution, migration, and the
interaction of all those with social and economic conditions.
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 Thank you for your attention

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