Public Health Definitions

• AGN4520 Public Health and Nutrition - S2a. Definitions, March 2022
• Session Objectives include understanding the definition, role, and functions of public health

Definition of Terms

• The fundamental terms that will be defined include: Public, Health, Public Health, Epidemiology, Nutrition, and Public Health Nutrition.

Public

• Public pertains to what applies to the state, nation, or whole community, concerning all citizens or a large portion.

Health (WHO, 1946)

• The word 'health' comes from the Old English word 'hoelth', representing a state of being sound, generally inferring body soundness.
• A commonly quoted definition is WHO's, describing health as a complete state of physical, mental, and social well-being, not merely the absence of disease or infirmity.
• All three (physical, mental, social) aspects must prevail at the same time.
• This definition has implications for Zambians.
• Critics argue that the WHO definition is utopian/ideal, inflexible, and unrealistic, described as impractical, idealistic, perfect, and supreme.
• The inclusion of "complete" in the definition makes it unlikely anyone would be healthy for any reasonable period of time.
• 'A state of complete physical, mental, and social well-being' corresponds more to a state of happiness than health itself
• The words 'health' and 'happiness' are distinct life experiences whose relationship is neither fixed nor constant but context-specific.
• Failure to distinguish happiness from health implies that any disturbance in happiness, however minimal, may be perceived as a health problem

Health (Hippocrates c 460-377 BC)

• Hippocrates perceived it as a divine gift, and he encouraged a focus on sanitation, hygiene and balanced diets, using "let food be thy medicine or let medicine be thy food."
• He theorized health as the delicate balance of four body fluids: blood, yellow bile, black bile, and phlegm.
• Hippocrates is credited with moving away from divine reasoning, and moving toward observation as the basis for health knowledge.

Other Accepted Definitions of Health

• Bircher's definition says it is a "dynamic state of well-being characterized by physical and mental potential, satisfying the demands of life commensurate with age, culture, and personal responsibility."
• This takes into account changing needs in relation to age, culture, and personal responsibility.
• Health Belief Systems, as a function of age, culture, and personal responsibility, strongly influence one's experience of health and ill-health.
• Saracchi's definition says it is a "condition of well-being, free of disease or infirmity, and a basic and universal human right."
• This provides an intermediate linking the WHO ideal to human rights, equity, and justice issues.
• Australian Aboriginal people define health as more than physical well-being, also to social, emotional, spiritual and cultural well-being of the whole community.
• This incorporates community and spiritual well-being.
• Seedhouse (1986) defines health as a state in which people can work towards attaining their realistic chosen and biological potentials.
• Seedhouse's definition is practical and recognizes the goal that can be achieved.
• These definitions are valuable concepts for enriching and revising WHO definitions, but what is health in the 21st century?
• The Ottawa Charter (1986) calls health a resource for everyday life, not the objective of living, a positive concept emphasizing social and personal resources, as well as physical capacities.

Epidemiology

• Epidemiology studies factors determining the frequency, distribution, and strength of disease in a population.
• Epidemiology involves the study of health statistics (data) on populations being investigated.
• Data obtained for planners is used for government and other stakeholders such as academics, NGOs, and CSO's to formulate interventions.

Public Health

• Public health is concerned with total systems and not only about eradication of a particular disease, which is the reason to work in multi-sectorial teams.
• The three main functions of public health are to assess and monitor health risks, formulate public policies, ensure populations have access to appropriate care.
• Ensuring appropriate care includes health promotion and disease prevention services such as information, water reticulation systems, sanitation and health care services.
• Public Health professionals monitor and diagnose health concerns of entire communities and promote healthy practices and behaviours to keep populations healthy
• Notable public health campaigns include vaccinations (vitamin A capsules), iron and folic acid for pregnant mothers, control of infectious diseases (water chlorination), motor-vehicle safety, safer workplaces, safe drinking water, healthier mothers/babies and family planning.

Public Health Nutrition

• Public health nutrition includes problems related to inadequate quantity and quality of the habitual diet.
• It includes problems related to excessive intake of the habitual diet and food additives (colour in Hungarian sausage, drinks) and supplements
• It concerns food safety problems that affect the health and function of a large percent of the population as well as environmental/lifestyle risk factors.
• Nutrition problems are prevented by risk factor identification/early detection by screening.

10 Essential Public Health Services

• Monitor health status of the community and investigate/diagnose health problems and hazards.
• Inform and educate people, mobilize to solve community problems, support plans to achieve goals, enforce regulations, and link people to personal health services.
• Ensure a competent workforce, evaluate effectiveness, and research innovative solutions.

Nutrition

• Nutrition studies food/nutrients with digestion, absorption, and metabolism including effects on health and disease.
• How does this definition fit in with that of health, public, public health, epidemiology, and public health nutrition?
• What is the relationship among the terms, and where is the point of departure?

Conclusion

• 'Health' is context-specific, meaning different things to different people depending on the situation and purposes.

Definitions, roles, and functions of public health, covering fundamental terms such as Public, Health, Public Health, Epidemiology, Nutrition, and Public Health Nutrition. It highlights WHO's definition of health and its implications.