This document provides an introduction to public health, including definitions of key terms, the history and evolution of public health, and the core functions and approaches of public health. It defines public health as organized community efforts to prevent disease and promote health. Key points include: - Public health aims to provide maximum health benefits to the largest number of people through community-wide prevention efforts, in contrast to medicine which focuses on treating individuals. - Major milestones in the history of public health include advances in sanitation and hygiene in ancient Greece and Rome, the germ theory of disease in the 19th century, and the establishment of public health systems and agencies in the 19th-20th centuries. - The

1. INTRODUCTION TO PUBLIC HEALTH

2. CONTENTS
1.1. What is Public Health and Dental Public health?
2. History of Public Health
3. How Public Health is different from Medicine?
4. A Public Health Approach
5. Core Functions and Essential Services of Public Health
6. Principles of Public Health
7. Conclusion

3. WHAT IS HEALTH?
Health is a state of complete physical, mental and social well-being and not
merely the absence of disease or infirmity.
-World Health Organization(WHO)

4. WHAT IS PUBLIC HEALTH?
Public Health is the “science and art of preventing
disease, prolonging life, and promoting health and
efficiency through organized community efforts”.
— CEA Winslow (1920)

5. WHAT IS DENTAL PUBLIC HEALTH?
Dental public health is “the science and art of preventing and controlling dental
diseases and promoting dental health through organized community efforts. It is
that form of dental practice that serves the community as a patient rather than the
individual. It is concerned with the dental education of the public, with applied
dental research, and with the administration of group dental care programs as well
as the prevention and control of dental diseases on a community basis”.
-American Board of Dental Public Health (ABDPH)
By adapting Winslow’s definition (1976)

6. “Public health aims to provide maximum
benefit for the largest number of people.”
MISSION

7. HISTORY OF PUBLIC HEALTH

8. ANCIENT GREEKS
500-323 BC
HIPPOCRATES
460 BC
PLAGUE
ROMAN EMPIRE
23 BC – 476 AD
MIDDLE AGES
476-1450 AD
RENAISSANCE
1400-1600 AD
AGE OF REASON AND
ENLIGHTENMENT
1650-1800 AD
GREAT SANITARY AWAKENING
1800s-1900s

9. HIPPOCRATES
• Father of Western medicine
• Believed that illness had a physical
and rational explanation
• Causal relationships
• Disease and climate, water,
lifestyle, and nutrition
• Coined the term epidemic
• Epis (“on” or “akin to”)
• Demos (“people”)
ROMAN EMPIRE
• Adopted Greek health values
• Great engineers
• Sewage systems
• Aqueducts- to carry fresh
water to the city of Nimes.
• Administration- Collected taxes
• Public baths
• Water supply
• Markets
1348 - 1530+ AD
The PLAGUE (The Black Death)
-Worst from 1348-1352
•Killed at least 25 million people in Europe (1/3 of the
population)i.e, Death of 25% to 50% of population
•Killed more than 60 million worldwide.
MIDDLE AGES
• Shift away from Greek and Roman
values
• Physical body less important
than spiritual self
• Decline of hygiene and
sanitation
• Beginnings of public health tools-
An understanding that isolating ships and
diseased individuals could help prevent the
spread of disease.
GREAT SANITARY AWAKENING
• Growth in scientific knowledge
• Humanitarian ideals
• Connection between poverty
and disease
• Water supply and sewage removal
• Monitor community health status
1800s
AGE OF REASON AND ENLIGHTENMENT
• Birth of Modern Medicine
• William Harvey-1628 theories of the
heart and circulatory system
• Edward Jenner-1796- cowpox
experiment .
Coined the word vaccine from the Latin
word -vacca for cow
Industrialization and
Urbanization
RENAISSANCE
• Global Exploration
• Explorers and traders
unknowingly spread diseases like
smallpox
• This method of the spread of
disease still exists today e.g.,
spread of SARS across countries
• Killed 90% of indigenous people
in New World
ANCIENT GREEKS
• Personal hygiene
• Physical fitness
Olympics
• Naturalistic concept
Disease caused by imbalance between
man and his environment
• Hippocrates
500-323 BC 460 BC 23BC-476AD 476-1450 AD 1400-1600 AD 1650-1800 AD 1800s-1900s

10. • Dr. John Snow
(1813-1858)
• Epidemiology
(1854)-with the
discovery of
source of cholera
outbreak
GROWTH
IN
SCIENTIFIC
KNOWLEDGE
• Louis Pasteur (1822-
1895)
• 1862--
Development
leading to the
germ theory of
infection
• 1888 first public
health lab
GROWTH
IN
SCIENTIFIC
KNOWLEDGE
• Robert Koch (1843 –
1910)
• 1883 identified the
vibrio (water
bacteria) that
causes cholera, 20
years after Snow’s
discovery
• Discovered the
tuberculosis
bacterium
• showed that
anthrax is caused
by a specific
organism.
SANITARY
REFORM
• ENGLAND
• 1842 Edwin
Chadwick’s
researched and
published “Survey
into the Sanitary
Condition of the
Labouring Classes
in Great Britain”
• Landmark research
• Graphic
descriptions of filth
and disease spread
in urban areas
• 1848-
Establishment of
General Board of
Health
SANITARY
REFORM
• U.S.
• 1850 Lemuel
Shattuck’s (1793-
1859) Had
published “Report
of the Sanitary
Commission of
Massachusetts”
• 1869 –
establishment of
State Board of
Health
• First to identify
major public
health issues like
the development
of a vaccination
program, the study
of tuberculosis and
many more.
MODERN PUBLIC HEALTH
GREAT SANITARY AWAKENING (1800s-1900s)
Industrialization and Urbanization

11. Late Nineteenth Century: Enter Bacteriology
• The Development of State and Local Health
Department Laboratories
• The Successes of Bacteriology
Early Twentieth Century: The Move Toward
Personal Care
• Further Development of State and Local Health
Agencies
• The Growth of Federal Activities in Health
Mid-Twentieth Century: Further Expansion of the
Governmental Role in Personal Health
• Federal Activities
• State and Local Activities
The Late Twentieth Century: A Crisis in Care and
Financing

12. THE “NEW PUBLIC HEALTH”
The mission of the New Public Health is to
maximize human health and well-being and
to help redress societal and global
inequities.
The New Public Health (NPH) is an
integrative approach to protecting and
promoting the health status of both the
individual and the society.

13. 10 GREAT ACHIEVEMENTS IN PUBLIC HEALTH, 1900-1999
Vaccination.
Motor-vehicle safety.
Safer workplaces.
Control of infectious diseases.
Decline in deaths from coronary heart disease and stroke.
Safer and healthier foods.
Healthier mothers and babies.
Family planning.
Fluoridation of drinking water.
Recognition of tobacco use as a health hazard.
-CDC's Morbidity and Mortality Weekly Report (MMWR), 1999

14. 10 PUBLIC HEALTH ACHIEVEMENTS OF FIRST DECADE OF 21ST CENTURY, (2001-2010)
Vaccine-Preventable Diseases
Prevention and Control of Infectious Diseases
Tobacco Control
Maternal and Infant Health
Motor Vehicle Safety
Cardiovascular Disease Prevention
Occupational Safety
Cancer Prevention
Childhood Lead Poisoning Prevention
Improved Public Health Preparedness and Response
-CDC's Morbidity and Mortality Weekly Report (MMWR), 2011

15. PUBLIC HEALTH MEDICINE
HOW PUBLIC HEALTH IS DIFFERENT FROM MEDICINE?
Population focus Individual patient focus
Public health ethic Personal service ethic
Prevention or public
health emphasis
Diagnosis and treatment
emphasis
Field involvement Patient involvement
Clinical sciences peripheral to
professional training
Clinical sciences essential to
professional training
Public sector basis Private sector basis

16. Access to
health
services
INDIVIDU
AL Job
Money
Education
Safe
Well maintained
Safe roads
vision
HOW?
WHY?
Alcohol
Drugs
Clinician
https://www.youtube.com/watch?v=t_eWESXTnic
Source:

17. UPSTREAM VS DOWNSTREAM THINKING
the level of interventions to
positively impact on public health.
‘Upstream’ and
‘Downstream’
UPSTREAM DOWNSTREAM
• At the population (upstream)
level, public health works to
address the determinants of
health which relate to the
conditions under which
people live .
• At the individual (downstream)
level, people may be treated
for a condition using targeted
strategies (McKinlay, 1979).
• Interventions has a complex
contemporary discussion of
attribution of effect.
• Interventions are considered to
be futile and short term.
(McQueen and De Salazar,
2011).
The two terms originate from the analogy of busily dragging
drowning people from a flooded river (downstream) without
going (upstream) to discover the reason as to why they were
falling or being pushed into the river (McKinlay, 1979).

18. SOCIAL DETERMINANTS OF HEALTH

19. THE PUBLIC HEALTH SYSTEM
Public health system is defined as “all public, private,
and voluntary entities that contribute to the delivery of
essential public health services within a jurisdiction.”
It includes:
•Public health agencies at state and local levels
•Healthcare providers
•Public safety agencies
•Human service and charity organizations
•Education and youth development organizations
•Recreation and arts-related organizations
•Economic and philanthropic organizations
•Environmental agencies and organizations

20. A PUBLIC HEALTH APPROACH
What is the
problem?
What is the
cause?
How do you do
it ?
What works?
Problem Response
Surveillance Risk Factor
Identification
Intervention
Evaluation Implementation
https://www.cdc.gov/publichealth101/public-health.html
Source:

21. A PUBLIC HEALTH APPROACH-- CHOLERA
Cholera, a fatal intestinal disease, was rampant during the early 1800s
in London, causing death to tens of thousands of people in the area.
Cholera was commonly thought to be caused by bad air from rotting
organic matter.

22. JOHN SNOW, PHYSICIAN
John Snow is best known for his work tracing the source of the cholera outbreak and he
is considered the Father of Modern Epidemiology.
He believed that the illness was spreading by way of a contaminated water supply
because sewage was routinely dumped into the Thames River and cesspools near town
wells.

23. Epidemiology — What is the Problem?
Cluster of Cholera Cases, London — 1854
Image: The Geographical Journal
Reverend Henry Whitehead
Snow was assisted by a local
clergyman, Reverend Henry
Whitehead, in tracking down and
interviewing cholera victims and
their families and geographically
mapping the outbreak

24. Cluster of Cholera Cases and Pump Site Locations
Risk Factor Identification — What Is the Cause?
Image: The Geographical Journal
 Snow believed that water was
a potential cholera source,
based on his previous works
 This observation prompted Snow to
further research the distribution of
water pumps in London.
 Through his research, Snow
identified and concluded that
drawing water from the Broad
Street pump was a primary risk
factor for becoming ill with cholera.
 The map reveals that the
largest number of cholera
cases occurred in areas near
water pumps.

25. Intervention Evaluation — What Works?
Through continuous research, Snow understood
what interventions were required to
• stop exposure to the contaminated water
supply on a larger scale, and
• stop exposure to the entire supply of
contaminated water in the area

26. Implementation — How Do You Do It?
John Snow’s research convinced the
British government that the source of
cholera was water contaminated with
sewage, which resulted in the
implementation of policies and laws for
water sanitation.
Snow implemented the Intervention by
taking out the handle off the broad
street pump, and the cholera outbreak
subsided.

27. THREE CORE FUNCTIONS OF PUBLIC HEALTH
ASSESSMENT
POLICY DEVELOPMENT
ASSURANCE
Ensure provision of services to those in need
Promote the use of a scientific knowledge
base in policy and decision making
Systematically collect, analyze, and make available
information on healthy communities.
https://www.cdc.gov/publichealth101/public-health.html
Source:

28. 10 ESSENTIAL SERVICES OF PUBLIC HEALTH
MONITOR HEALTH
DIAGNOSE AND INVESTIGATE
INFORM, EDUCATE, EMPOWER
MOBILIZE COMMUNITY PARTNERSHIP
DEVELOP POLICIES
ENFORCE LAWS
LINK TO/PROVIDE CARE
ASSURE A COMPETENT WORKFORCE
EVALUATE
RESEARCH

29. ASSESSMENT
1
Monitor health status to identify
community health problems:
Examples: Death Certificates, Birth
Certificates, Immunizations Registries,
Surveillance
2
Diagnose and investigate health problems
and health hazards in the community:
Examples: Outbreak Investigations, Child
Death Review Boards

30. POLICY DEVELOPMENT
4
Mobilize community partnerships to
identify and solve health problems:
Example: ACHD Tobacco Stakeholders
Group, Advisory Boards, Collaborative
Activities
5
Develop policies and plans that support
individual and community health efforts:
Example: Smoking Bans, Helmet Laws,
Restaurant Inspection Laws
3
Inform, educate, and empower people
about health issues:
Example: Lead Paint displays in hardware
stores, New Releases on Rabies and West
Nile Virus

31. ASSURANCE
8
Assure a competent public health and personal
health care workforce.
Example: Conferences, Training programs,
journals, School of Public Health, Satellite
Programs, Certifications
9
Evaluate effectiveness, accessibility, and quality
of personal and population-based health services
Example: Outcome evaluation and Economic
Analyses
6
Enforce laws and regulations that protect health
and ensure safety:
Example: Food Inspection Certificates,
Enforcement of Smoking Regulations
7
Link people to needed personal health services
and assure the provision of health care when
otherwise unavailable:
Example: Children’s Health Insurance Programs,
Federally Qualified Centers.
10
Research for new insights and innovative
solutions to health problems
Example: Needle Exchange Programs

32. PRINCIPLES OF PUBLIC HEALTH
Five key principles:
1. A broad and positive health
concept;
2. Participation and involvement;
3. Action and action competence;
4. A settings perspective and
5. Equity in health
KEY ELEMANTS OF PUBLIC HEALTH
HEALTH PROTECTION
HEALTH PROMOTION
1. planning and preparedness;
2. prevention and early detection;
3. investigation and control; and
4. wider public health
management and leadership
(including communication to
professionals and the public).
Source : https://studylib.net/doc/9380766/principles-and-concepts-of-public-health

33.  Activating and mobilizing emergency plans
 Serving as communicable disease experts. During disease
outbreaks, epidemiological experts conduct investigations,
contact tracing, monitor suspected cases, enforce isolation and
quarantine protocols and set up mass clinics;
 Assisting and connecting vulnerable individuals to resources like
housing, nutritious meals, utilities and health or mental health
services;
 Supporting community partners and working with the State
Department of Health and the Centers for Disease Control and
Prevention.
 Upholding state and local laws. Public Health law grants authority
to local health officials to respond to disease threats and they are
legally responsible for the control of communicable diseases;
 Keeping community members informed by answering questions,
providing up-to date information and the local community
impact, and recommendations for how to protect your family
from exposure.
IMPORTANCE OF PUBLIC HEALTH IN COVID-19 PANDEMIC

34. 10 FACTS ON THE STATE OF GLOBAL HEALTH
Global average life expectancy increased by 5 years between 2000 and 2015, the fastest increase since the 1960s
Globally, healthy life expectancy (HLE) at birth in 2015 was estimated at 63.1 years
In 2015, more than 16000 children under age five died every day
45% deaths among children under age five occur during the first four weeks of life
In 2015, an estimated 2.6 million babies were stillborn
1.3 million deaths in 2015 were attributable to hepatitis
Noncommunicable diseases (NCDs) caused 37% of deaths in low- income countries in 2015, up from 23% in 2000
Ischemic heart disease and stroke killed 15 million people in 2015
Diabetes are among the 10 leading causes of deaths and disability worldwide
Injuries claimed nearly 5 million lives in 2015
-World Health Organization (WHO)-2017

35. Elevating health in the climate debate
Delivering health in conflict and crisis
Making health care fairer
Expanding access to medicines
Stopping infectious diseases
Preparing for epidemics
Protecting people from dangerous products
Investing in the people who defend our health
Keeping adolescents safe
Earning public trust
Harnessing new technologies
Keeping health care clean
Protecting the medicines that protect us
URGENT CHALLENGES IN PUBLIC HEALTH
Source: World Health Organization (WHO)- Jan 2020
With the deadline for the 2030 Sustainable Development Goals.

36. REFERENCES
• History of public health-
https://sphweb.bumc.bu.edu/otlt/MPHModules/PH/PublicHealthHistory/PublicHealthHistory_print.html
• Public Health Approach- https://www.cdc.gov/publichealth101/public-health.html
• https://www.cdc.gov/publichealthgateway/publichealthservices/essentialhealthservices.html
• Soben Peter. Essentials of Public Health Dentistry. 5th ed. New Delhi: Arya Publishing House; 2013.