1114237 – Jones & Bartlett Learning ©
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LEARNING OBJECTIVES By the end of this chapter, the student will be able to:
identify multiple ways that public health affects daily life. define eras of public health from ancient times to the early 2000s. define the meaning of population health. illustrate the uses of health care, traditional public health, and social interventions in population health. identify a range of determinants of disease. identify ways that populations change over time, which affects health.
I woke up this morning, got out of bed, and went to the bathroom, where I used the toilet, washed my hands, brushed and flossed my teeth, drank a glass of water, and took my blood pressure medicine, cholesterol medication, and an aspirin. Then I did my exercises and took a shower.
On the way to the kitchen, I didnt even notice the smoke detector I passed or the old ashtrays in the closet. I took a low-fat yogurt out of the refrigerator and prepared hot cereal in the microwave oven for my breakfast.
Then I walked out my door into the crisp clean air and got in my car. I put on my seat belt, saw the light go on for the airbag, and safely drove to work. I got to my office, where I paid little attention to the new defibrillator at the entrance, the no smoking signs, or the absence of asbestos. I arrived safely in my well-ventilated office and got ready to teach Public Health 101.
It wasnt a very eventful morning, but then its all in a mornings work when it comes to public health.
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1114237 – Jones & Bartlett Learning ©
This rather mundane morning is made possible by a long list of achievements that reflect the often- ignored history of public health.1 We take for granted the fact that water chlorination, hand washing, and indoor plumbing largely eliminated the transmission of common bacterial diseases, which so often killed the young and not-so-young for centuries. Do not overlook the impact of prevention on our teeth and gums. Teeth brushing, flossing, and fluoridation of water have made a dramatic impact on the dental health of children and adults.
The more recent advances in the prevention of heart disease have been a major public health achievement. Preventive successes include the reduction of blood pressure and cholesterol, cigarette smoking prevention and cessation efforts, the use of low-dose aspirin, an understanding of the role of exercise, and the widespread availability of defibrillators. These can be credited with at least half the dramatic reductions in heart disease that have reduced the death rate from coronary artery disease by approximately 50% in the United States and most other developed countries in the last half century.
The refrigerator was one of the most important advances in food safety, which illustrates the impact of social change and innovation not necessarily intended to improve health. Food and product safety are public health achievements that require continued attention. It was public pressure for food safety that in large part brought about the creation of the U.S. Food and Drug Administration. The work of this public health agency continues to affect all of our lives from the safety of the foods we eat to the drugs and cosmetics we use.
Radiation safety, like radiation itself, usually goes unnoticed, from the regulation of microwave ovens to the reduction of radon in buildings. We rarely notice when disease does not occur.
Highway safety illustrates the wide scope of activities required to protect the publics health. From seat belts, child restraints, and airbags to safer cars, highways, designated driver programs, and enforcement of drunk driving laws, public health efforts require collaboration with professionals not usually thought of as having a health focus.
The physical environment too has been made safer by the efforts of public health. Improvement in the quality of the air we breathe both outdoors and indoors has been an ongoing accomplishment of what we will call population health. Our lives are safer today because of interventions ranging from installation of smoke detectors to removal of asbestos from buildings.
However, the challenges continue. Globalization increases the potential for the spread of existing and emerging diseases and raises concerns about the safety of the products we use. Climate change and ongoing environmental deterioration continue to produce new territory for old diseases, such as malaria and dengue fever. Overuse of technologies, such as antibiotics, has encouraged the emergence of resistant bacteria.
The 1900s saw an increase in life expectancy of almost 30 years in most developed countries, much of it due to the successes of public health initiatives.2 We cannot assume that these trends will continue indefinitely. The epidemic of obesity already threatens to slow down or reverse the progress we have been making. The challenges of 21st century public health include the protection of health and continued improvement in quality of life, not just quantity of years individuals are living.
To understand the role
