Concept & Principles of Public Health

Nuning MK Masjkuri

Definitions
Concept: General idea underlying a class of things Principles: Guiding rules

Public Health?
Infant mortality Maternal mortality Life expectancy Crude death rate Crude birth rate Physician population ratio Access to health services

Public Health?
1. Provision of save water supply & sewage disposal 2. Immunization program 3. Screening for breast cancer 4. Prohibit smoking in public places 5. Mandatory use of seat belt & helmet

6. Chlorination of drinking water 7. Promote breast feeding 8. Promoting healthy diet 9. Promoting safer sex 10. Infectious disease control

 Health state of the community (population/public) Intervention to promote the health state of the community (population)

The natural history of disease

H
E A L T

Public?
Public = Population = Everybody 1. People living in a place 2. The whole collection of units from which a sample is taken 3. A group of people that can be clearly defined

PH Concept
Objective & Interventions are Public

Dari KITA untuk KITA

Herd Immunity

Need community participation

Other examples
1. Not drinking and driving 2. Practicing safer sex 3. Participating in mass screening 4. Participating in immunization 5. Balance between diet & exercise 6. etc 7. etc

Difference
Clinical

Public Health

Difference
Treatment

Clinical

Medication: Drugs/injection
Programs

PH :

Three core PH functions

1. Assess & monitor health of communities & pop at risk health problems & priorities 2. Formulate public policies (with community & gov. leaders) to set priority & solve 3. Assure that all pop. have access to appropriate & effective care, including health promotion & disease prevention & evaluate effectiveness of the care

Disease process
Pre-pathogenesis period Pathogenesis period

To reduce new occurrence

To reduce duration & severity

To reduce complication & disability

Principles
1. Based on the population (a collection of individuals) 2. Focusing on Health Promotion & Disease Prevention without belittling curative & rehabilitative measures 3. Involving the community (community participation/empowerment) 4. Through organized effort

Definition of PH
The science & art of preventing disease, prolonging life & promoting physical health & efficiency through organized community efforts for the sanitation of the environment, the control of community infections, the education of the individual in the principles of personal hygiene, the organization of medical & nursing service for the early diagnosis & preventive treatment of disease, and the development of social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health (Winslow 1920)

 What we as a society, do collectively to assure the conditions in which people can be healthy (Institute of Medicine 1988)

The science & art of preventing disease, prolonging life & promoting health through organized effort of society (Acheson 1988)

 Society obligation to assure the conditions for peoples health (Gostin 2001) Government intervention in PH involves public officials taking appropriate measures pursuant to specific legal authority . to protect the health of the public . The key element in PH is the role of the govt its power and obligation to invoke mandatory or coercive measure to eliminate a threat to the publics health (Rothstein 2002)

Government?
Only successful if: 1. The health of the pop is threatened 2. Government has power or expertise 3. The action of the gov. will be more efficient/ beneficial

Medical care & PH

In the end
Patients need medical care when they are sick Medical care is needed only part of the time Public health professionals monitor and diagnose the health concern of entire communities & promote healthy practices & behaviors in individuals to keep the population healthy communities need public health all of the time in order to stay healthy

C. Everett Koop