Understanding Public Health

What is Public Health?

• Public health is a multi-faceted field that focuses on preventing disease, prolonging life, and promoting health, as defined by Charles-Edward A. Winslow.
• It involves organized community efforts, education on hygiene, medical services for early diagnosis and treatment, and social machinery to ensure a healthy standard of living for everyone.

Three Core Functions of Public Health

• Assessment: Evaluating the health of the community to identify health issues and their causes.
• Policy development: Creating policies and programs to address health concerns.
• Assurance: Ensuring the availability of essential public health services to all members of the community.

Benefits of Public Health Programs

• Public health programs significantly reduce medical costs by preventing disease and promoting healthy lifestyles.
• Public health contributes more to the overall health of the population than medicine alone.
• Life expectancy in America has increased significantly from 45 to 75 years in the 20th century due to improvements in public health, contributing more than the medical care system.

Public Health and Politics

• Implementing public health policies requires acceptance from the public and political support.
• Public health is funded through taxes, so communities need to be convinced about the value of public health initiatives.
• This can involve making decisions about limitations on individual freedom for the greater good, which can be a controversial topic.
• Government control on policy implementation limits individual and community liberty, however, politics help prevent overconsumption of resources.

Epidemiology

• The study of the distribution and determinants of health-related states or events in specific populations.
• Used to understand disease patterns, identify risk factors, and develop public health interventions.
• Examples of use: investigating disease outbreaks, studying the causes of chronic diseases, evaluating public health interventions.

Responsibilities of Public Health

• Educate the public about health and encourage them to support public health efforts.
• Public health officials have a vital role in maintaining and improving public health.
• This relies heavily on the public accepting the knowledge and recommendations provided.

Early Disease Spread in Canada

• Before confederation, Canada faced numerous challenges in managing disease spread.
• Poor sanitation, limited resources, and lack of trust in social hygiene programs hampered efforts.
• Disease transmission was facilitated by travel, with transport methods like carriages, trains, and boats.
• Quarantine was implemented in 1721 due to fears of the Black Plague spreading from Europe.
• Incidence (new cases) and prevalence (proportion of population with the disease) are key indicators used to track disease spread.

Inoculation and Vaccination

• Alexander Stewart of Palmerston was a key figure in early vaccination efforts.
• He produced the smallpox vaccine in 1890, and Ontario established the first public health laboratory in North America.
• Vaccinations have been vital in controlling infectious diseases.

Diphtheria

• A serious bacterial infection that was prevalent in the late 19th century.
• The causative bacteria and endotoxin were identified in the late 1880s.
• NYC Department of Health produced and administered the first diphtheria antitoxin in North America in 1895.

Pushing for Progress in Public Health

• Sanitary reformers advocated for public health initiatives at the federal level.
• This involved convincing the government about the economic benefits of preventing disease.
• Arguments included the cost of treating individual cases compared to public health interventions.
• Criticism of animal vaccination for disease spread, advocating for human-focused research.

Education and Scientific Knowledge

• The Canadian Medical Association emphasized the importance of using science and technology to find the sources of illnesses.
• Public education remained crucial for public health crusades, even with scientific advancements.
• Old beliefs about infectious diseases persisted in rural areas, such as the miasma theory (illness from bad air).

Transformation and World War I (1910-1919)

• Funding prioritised war efforts over public health research and programs.
• Polio emerged as a new epidemic.
• Polio and rabies are both viral diseases affecting the central nervous system, with confusing symptoms.
• Tuberculosis cases declined, while polio cases increased due to the shift in focus to warfare.

Tuberculosis and Typhoid Persistence in Canada

• Charles Hodgetts, the Medical Advisor, focused on the persistent occurrence of typhoid fever due to contaminated water in Canadian cities.
• Conference recommendations included:
  • Research and vaccine production labs.
  • Strengthened federal legislation to prevent water pollution.
  • Funding for tuberculosis sanatoriums and educational campaigns.

Canadian Public Health Association (CPHA)

• Founded in 1910 by Peter Bryce and colleagues, aimed to establish professional public health standards.
• Objectives included: promoting social welfare, eugenics (selective breeding), and international public health cooperation.

Typhoid in Ottawa

• Outbreaks highlighted the shortcomings of the city's sewage system.
• The second epidemic prompted significant action to address the issue.

Push for Education

• Science advancements and preventive medicine became key in public health disease control strategies.
• Art exhibits and public education campaigns became widely used.
• Focus on identifying common causes of illness: houseflies, public drinking cups, and kissing.
• Houseflies were perceived as "germs with legs", spreading diseases.
• Public was advised to screen doors and windows and protect food from flies.
• E.L. Stone succeeded Dr. Peter Bryce as Medical Superintendent General.
• Bryce's outspoken criticism of the federal government's failure to provide healthcare for First Nations impacted his career.

Indigenous Health

• High rates of tuberculosis in Indigenous communities were widely recognized in the mid-1920s.
• The Canadian Tuberculosis Association conducted a study in B.C., highlighting the prevalence of the disease.
• The first federal health services for Indigenous people in the north began in 1922 with the appointment of Dr. L.D. Livingston.
• Missionaries operating small hospitals were often criticized for hindering Livingston's efforts.

Lapses in Oversight: Smallpox and Typhoid

• Lack of public health action and local government neglect contributed to epidemics of typhoid and smallpox.
• Anti-vaccination sentiments, sometimes fueled by improper storage and administration of vaccines, hindered prevention efforts.
• Toronto faced hesitancy in implementing compulsory vaccinations during a smallpox outbreak.
• The U.S. required proof of smallpox vaccination for border crossing, resulting in quarantine restrictions for Toronto.
• Over 200,000 voluntary vaccinations eased the outbreak in Toronto.
• No vaccinated individuals contracted smallpox in Windsor, highlighting the effectiveness of vaccination.

This quiz delves into the essentials of public health, including its definition, core functions, and benefits. Learn about the organized efforts required to promote health and prevent disease in communities. Assess your knowledge of the key aspects that contribute to the overall health of the population.