Picture these: Out of ten babies born in a day in one part of the world, two die in another. A single mother who works long days at local store as a cashier and even at night selling herself, pushing her body to its limits to make ends meet yet barely making enough and she is refused health care and is fired from her job. Families living below the poverty level who resort to whatever they can to alleviate whatever pain they would feel. Citizens from Africa who die each day that passes and maybe even more.
What is missing? Is it because disease is inevitable and that we cannot do anything about it? Could they have been avoided? Facts from studies have shown and proven that direct medical care is sometimes not enough to eradicate a disease and therefore is inadequate in improving over- all a community’s heath status, Furthermore, studies made during the late 1970’s and early 1990’s by Center for Disease Control and Prevention have shown that one out of 10 premature deaths due to personal risk exposure and environmental factors could have been avoided if delivery of health care services are improved. Lasker, Medicine & Public Health: the Power of Collaboration
) This is where public health comes in. Public health was defined by Winslow from Modern Medicine in 1920 as “the science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organisations, public and private, communities and individuals. ” How important and significant then is public health? Starting with its history, it will prove how this science and art had greatly contributed to the promotion of health.
During the time of the Roman Greeks, public health was adopted by building sewers to wash away wastes, aqueducts for supply of fresh water and even infrastuctures such as public hospitals and baths. Even during the following centuries that followed particulary 5th to 15th centuries AD, epidemic diseases such as bubonic plague, smallpox, leprosy and more spread all across Europe. Removing bodies of the dead simply wasn’t enough; the concept and practice of “quarantine” was applied, burning any objects the diseased may have used and have stations in which they monitored affected areas.
They also became conscious of their human wastes and garbage that was carelessly discarded attracting flies, germs, rats or anything that brought upon such diseases. As the 20th century rolled in, there was a decrease in the prevalence of infectious disease with programs and policies such as vaccination, control of diseases, effective safety policies, safe drinking water, anti-smoking measures, and programs designed to decrease chronic disease which greatly improved life span.
Public health began to focus more on population health, bringing diseases and its risk factors to population level issues such as poverty, education and inequality. No longer did it advocate for individual behavioral change but rather to a change among a population. It was also then realized that there was such a thing as “social determinants of heatlh”. These so- called determinants such as including where we live, genetics, our income, our educational status and our social relationships have great affect on our lives especially our health.
It is apparent that those who live below and at poverty level have the worst health but even those who are in the middle class suffer worse than that of higher classes (WHO, 2003). Then there is a need to address such health inequalities by striving for population-based policies that can improve the health of the whole population. This “modern” public health was established to address daily public health issues such as increase of HIV- AIDS, increase in prevalence of childhood obesity, other communicale and non- communicable infectious diseases, social, mental and health issues and more.
It also administers heath education, programs and policies and conducting researches and studies to eradicate and prevent diseases and their risk factors. Although countries have public health policies and agencies that concentrate on domestic public health issues, some countries such as the United States do not have a universal health care. Universal health care must also be defined with public health. Universal health care mandates that every resident in a country be provided and given health care at a reasonable cost. Why else do we still persevere to have a public health system?
Why should we move for health? Again, let some facts such as chronic, noncommunicable diseases (NCDs) cause 60% of global deaths and 47% of burden of disease (World Health Report 2002) and estimates that may increase to 73% and 60% respectively by 2020 reiterate the need for public health. New viruses that are yet undiscovered may pose threats to the health and as global population increases twice as fast as before, there will also be a growing need provisions of basic needs as well as a need for health promotion and improvement.
Also public health puts emphasis on more than the diagnosis and treatment of one patient, it emphasizes on the heatlh of the whole coomunity in which its paradigm is not only on medical care but also of interventions is aimed at environment, human behavior and lifestlye. It also holds organizational lines of specialization with skills in assessment, policy development and health assurance rather than just on etiology, pathophysiology and other technical and diagnostic skills.
Health systems are a must for it is a system that comprises all the organizations, institutions and resources that are devoted to producing health actions. It more than educates the people, it empowers them to choose and stay healthy. There is a mobilization of community partnerships where communities work together to alleviate health and eradicate diseases. There is an assurance of which laws are mandated in providing care and there is an assurance in competent workforces that leads to evaluate and research the interventions made for the policies and laws developed.
This was health is monitored and even incidence of diseases and the prevalence of mortalilty rates and causes can be decreased further and life expectancy be increased. What else do health systems do? Nowadays modern health systems are more than just about access to health care, relief of pain from mental disorder and physical limitations and protection from diseases known and unknown no matter what economic or social background one comes from.
Public health systems have been modified to raise awareness regarding the impact that industrialization, environmental damage, globalization of trade and road transport has on health. Who would have thought also that people would turn to public health systems to consult regarding as to how one should diet, raise children or even behave sexually? These systems have a responsibility to protect their patients from the costs of whatever disease that may come upon them. They aim to treat patients with the dignity they deserve.
Everything these systems follow are based on three main objectives: one is to protect people from illnesses or whatever that may bring upon harm to them, second is to provide financial protection from these illnesses and third is to rise to occasions and respond to people’s expectations. They aim to improve both life span and quality of life for people; any progress that a country may show or any regress it may also experience can be attributed to the health of its citizens.
In the long run, “people around the world will live safer, healthier and longer lives through health promotion, health protection, and health diplomacy” (CDC, 2007). This is always something that should be kept in mind that people may stay in good health with clean environments through prevention. As quoted once before, “an ounce of prevention is always better than a pound of cure”. Now that is one time and memorial saying in which public health system brings to life.