INTRODUCTION TO

PUBLIC HEALTH
SPH-I
Absalat Serawit
M.D,M.P.H
Objectives
After this lecture , you will be able to:
• Define the term health, community, community health and
public health.
• Briefly describe the five major determinants of health.
• Listand discuss the factors that influence a community’s
health.
• Recognize the core functions and essential services of public
health.
• Describe features of Public health
Course outline
• Introduction to public health (Definition :
Public ,Health ,Public Health ,Community ,Community
health )
• Determinants of health
• Factors that affect the health of the community
• Brief overview of the history of public health
• Functions of public health /core functions of public health
• Features of Public health
Introduction to public health
• Public

• Health

• Public Health
• Community

• Community health
Definitions
Public
• Publicis about the what of belonging to the people; relating
to, or affecting, a nation, state, or community; opposed to
private.
What does health means to you?
Definitions (cont..)
Health
• The WHO defines health as ‘a state of Complete physical,
mental, and social wellbeing and not merely the absence of
disease, or infirmity’.
What do you think will determine one’s health?
Determinants of health
How do you think public health differs from
clinical medicine?
Cont…
Public Health:
• Publichealth is defined as "the science and art of preventing
disease, prolonging life and promoting physical health and mental
health and efficiency through organized efforts and informed
choices of society, organizations, public and private, communities
and individuals”. (C.E.A. Winslow In 1923)
• Clinical medicine is concerned with diagnosing and treating
diseases in individual patients.
• Prevention, treatment and management of illness and the
preservation of mental and physical well being through the services
offered by medical and allied health professions, also known as
health care.
The mission of Public health
Mission:
• Thefulfillment of society's interest in assuring the conditions
in which people can be healthy ( Institute of Medicine)

• Public health aims to provide maximum benefit for the

largest number of people. ( WHO)
Organizational framework of
Public Health
• Encompasses both activities undertaken within the formal
structure of government and the associated efforts of private
and voluntary organization and individuals .
Definitions (cont..)
Community
• Community is “a collective body of individuals identified by
common char­acteristics such as geography, interests,
experiences, concerns, or values.”
Community health

• Community health, a field within public health, that

concerns itself with the study and betterment of the health of
communities.
What do you think will affect the health of a
community?
How does your community influence your
health?
Factors that affect the health of
the community
History of public health
• Publichealth has a long and rich history that dates back to
ancient civilizations , where communities implemented
various measures to prevent disease and promote health

• The history of public health is marked by a gradual

understanding of the relationship between the environment,
living conditions, and health, leading to organized efforts to
improve community health.
Key Milestones in Public Health
• Cholera,a fatal intestinal disease, was rampant during the
early 1800s in London, causing death to tens of thousands of
people in the area. Cholera was commonly thought to be
caused by bad air from rotting organic matter.
John Snow
• Is best known for his work
tracing the source of the
Cholera outbreak and is
considered the father of
modern Epidemiology
Epidemiology
– What is the
problem?
• Cluster of Cholera
cases, London-1854
Risk factor
identification
– What is the
Cause?
• Cluster of Cholera
cases and Pump site
locations, London-
1854
Cluster of Cholera
Cases, London- 1854
• Cluster of Cholera cases
and pump site locations
• Through continuous
research, Snow
understood what
interventions were
required to
 Stop exposure to the
contaminated water supply
on a larger scale and
 Stop exposure to the entire
supply of contaminated water
in the area
Implementatio
n
John Snow’s research
convinced the British
government that the
source of Cholera was
water contaminated
with sewage
Development of Vaccines
• Edward Jenner’s work on the smallpox vaccine in the late
18th century laid the foundation for immunization programs
that have saved millions of lives.

• The continued advancement of vaccines, including the

development of the polio vaccine by Jonas Salk in the 1950s,
has been pivotal in controlling infectious diseases globally
Eradication of Smallpox
• Smallpox was one of the deadliest diseases in human history.
Through a coordinated global vaccination campaign led by
the World Health Organization (WHO), smallpox was declared
eradicated in 1980. This achievement stands as one of the
greatest successes in public health, demonstrating the power
of vaccination and international cooperation.
Evolution of Public Health
Practices over time
• Sanitation and Hygiene (19th Century): The 19th
century saw the rise of sanitation movements, particularly in
Europe and North America. Improvements in water supply,
waste disposal, and urban planning reduced the spread of
infectious diseases and set the stage for modern public
health infrastructure.
Evolution Cont…..
• Emergence of Epidemiology (Late 19th to Early 20th
Century): The field of epidemiology emerged as a scientific
discipline, focusing on the study of disease patterns, causes,
and effects in populations. This period also saw the
establishment of health departments and the
implementation of disease surveillance systems.
Evolution Cont…..
• Shift to Chronic Diseases (Mid 20th Century Onwards):
With the decline of infectious diseases due to improved
sanitation, vaccination, and antibiotics, public health began
to focus more on chronic diseases such as heart disease,
cancer, and diabetes. Public health campaigns started to
address lifestyle factors like smoking, diet, and physical
activity
Evolution Cont.
• Global Health and Modern Public Health (21st
Century): The 21st century has brought new challenges and
opportunities in public health, including the rise of global
health as a field. Issues such as pandemics, climate change,
and health disparities require coordinated international
responses and a renewed focus on social determinants of
health
Functions of Public Health
Core Functions
• Assessment

• Policy Development
• Assurance
Assessment
• Every public health agency regularly and systematically
collect, assemble, analyze, and make available information
on the health of the community, including statistics on
health status, community health needs, and epidemiological
and other studies of health problems.
• Monitor health status to identify community health problems
• Diagnose and investigate health problems and health
hazards in the community
• Evaluate effectiveness, accessibility, and quality of personal
and population‐based health services
The ten essential services of
public health
1. Monitor health status to identify and solve community
health problems
2. Diagnose and investigate health problems and health
hazards in the community
Policy Development
• Everypublic health agency exercise its responsibility to serve
the public interest in the development of comprehensive public
health policies by promoting use of the scientific knowledge
base in decision making about public health and by leading in
developing public health policy.
• Developpolicies and plans that support individual and
community health efforts
• Enforce laws and regulations that protect health and ensure
safety.
• Research for new insights and innovative solutions to health
problems
The ten essential services of
public health
3. Inform, educate, and empower people about health issues
4. Mobilize community partnerships and action to identify and
solve health problems
5. Develop policies and plans that support individual and
community health efforts
Assurance
• Public health agencies assure their constituents that services
necessary to achieve agreed upon goals are provided, either by
encouraging actions by other entities (private or public sector),
by requiring such action through regulation, or by providing
service directly.
• Link people to needed personal health services and assure the
provision of health care when otherwise unavailable
• Assure a competent public health and personal health care
workforce
• Inform, educate, and empower people about health issues
• Mobilize community partnerships to identify and solve health
problems
The ten essential services of
public health
6. Enforce laws and regulations that protect health and ensure
safety
7. Link people to needed personal health services and ensure
the provision of health care when otherwise unavailable
8. Assure competent public and personal health care
workforce
9. Evaluate effectiveness, accessibility, and quality of
personal and population-based health services
10. Research for new insights and innovative solutions to
health problems
Features of Public health
1. Social justice: is the central pillar of public health
2. Inherently political nature
3. Expanding agenda
4. Link with government
5. Grounded in science
6. It focuses on prevention
7. Uncommon culture
Social justice philosophy
• Justiceindicates that there is fairness in the distribution of
benefits and burdens
• How each member of society is allocated his or her fair share
of collective burdens and benefits
• Factorsthat affect the fair distribution of benefits and
burdens: social class, racism, disability , etc...
• Collectiveaction is necessary to neutralize or overcome
those barriers
• Public health works to overcome those barriers
Inherently political nature
• Public health is both public and political in nature
• The social justice component of public health stimulates
political conflict
• Governmental public health agencies seeking to serve the
interest of both government and public are frequently caught
in the middle
Expanding agenda
• Prior to 1900, the primary problems addressed by public
health were infectious diseases and related environmental
risks.
• After
1900, the focus expanded to include problems and
needs of children and mothers
• Middle of the century: chronic disease prevention and
medical care fell into public health
• Later, substance abuse, violence, injuries
• Recently:Bioterrorism, other disaster preparedness are also
added to the public health agenda
Link with Government
• Public health is linked with government in two ways:
1. Issuing policies that govern the health of the population
2. Directly provide programs and services that are designed
to meet the health needs of the population
Grounded in Science
• Often five basic science of public health are
identified:
o Epidemiology,
o biostatics,
o Environmental science
o management sciences and behavioral sciences.
o Occupational Health
o Nutrition and Maternal and Child Health

• Epidemiology and biostatics are essential tools of

public health.
Focus on prevention
• Preventionis the purpose of public health and is aimed at
preventing disease;
• However we are also preventing ,
o deaths,
o hospital admissions,
o days lost from school and work
o consumption of human and fiscal resources; etc
Uncommon culture
• Public health is unique in that many different sciences, art
and methods can contribute towards the same outcome.
• Vast majority of public health workers are not formally
trained in public health.
• As a result public health professionals include professionals
from different disciplines, like anthropologiste, sociologist,
psychologistes, physicians, nurses , nutritionist, lawyers ,
mangers
Conclusion
• Public health : the science and practice of preventing disease,
promoting health, and extending life among populations through
organized efforts and informed choices.
• Core functions of public health : assessment, policy development
and assurance
• The significance of public health extends beyond individual health,
influencing social and economic outcomes by ensuring healthier
populations that contribute to a more productive society
• In summary, public health is a dynamic and vital field dedicated to
improving population health through prevention, education, and
policy. Its importance cannot be overstated, as it underpins efforts
to create healthier communities and a more resilient society.
Thank you