The document discusses the changing concepts in public health over different time periods from 1900 to 2000. It describes four phases: 1) the disease control phase from 1880-1920 which focused on sanitation reforms, 2) the health promotion phase from 1920-1960 which added services like maternal/child health, 3) the social engineering phase from 1960-1980 which addressed chronic diseases and risk factors, and 4) the health for all phase from 1981-2000 in which WHO pledged to bridge health gaps between developed and developing nations. The focus of public health has evolved from disease control to health promotion to addressing social determinants of health and achieving health for all people worldwide.

1. CHANGING CONCEPTS in PUBLIC HEALTH
Dr. SASI KUMAR PJ M.D.

2. PUBLIC HEALTH
• Improving in health of populations
• Making people healthy
• Saving lives
Unites States
1900 ———> 1990
Life expectancy —— 30 years
25 years —— PUBLIC HEALTH

3. Health is a state of
complete Physical,
Mental and Social well-
being and not merely
the absence of disease
or infirmity.

5. The science and art of
Preventing disease,
Prolonging life and
Promoting health
through the organised
efforts of society.

7. Who is responsible for public health ?
• All sectors of society
• Health departments
• Other areas of government
• Private sector
• NGOs
• International organisations
Improve
Health
of
Public

9. 1. Disease control phase (1880 - 1920)
2. Health promotional phase (1920 - 1960)
3. Social engineering phase (1960 - 1980)
4. Health for All phase (1981 - 2000)
CHANGING CONCEPTS in PUBLIC HEALTH

10. 1. Disease control phase (1880 - 1920)
• Public health during the 19th century was largely a
matter of Sanitary legislation and Sanitary reforms
aimed at the control of man’s Physical environment,
e.g., water supply, sewage disposal, etc.
• Clearly these measures were not aimed at the control
of any specific disease
• However, these measures vastly improved the health
of the people due to disease and death control.

11. At the beginning of the 20th century, a new
concept, the concept of "Health Promotion"
began to take shape.
2. Health promotional phase (1920 - 1960)

12. • Mother and child health services,
• School health services,
• Industrial health services,
• Mental health and
• Rehabilitation services.

13. C.E.A. Winslow
“The science and art of
Preventing disease,
Prolonging life and
Promoting health
through the organised
efforts of society”.

14. •PHC’s and Sub centres
for rural and urban areas
•Important development
a) Provision of Basic Health Services

15. • Is an attempt to bring about a
social and economic
transformation of village life
through the efforts of the people
themselves
• Promote village development
• Active participation of whole
community
b) Community development programme, 1952

16. • With the advances in preventive medicine
and practice of public health, the pattern
of disease began to change in the
developed world.
• Many of the acute illness problems have
been brought under control.
3. Social engineering phase (1960 - 1980)

17. Chronic diseases
eg: cancer, diabetes,
CVD, alcoholism and
drug addiction.

21. • A new concept, the concept of "risk factors" as
determinants of these diseases came into
existence.
• The consequences of these diseases, unlike the
swift death brought by the acute infectious
diseases, was to place a chronic burden on the
society that created them. These problems brought
new challenges to public health which needed
reorientation more towards social objectives.

22. Public health entered a new phase in
the 1960s, described as the "social
engineering" phase

23. • Social and behavioural aspects of
disease and health .
• Public health moved into the
preventive and rehabilitative aspects of
chronic diseases and behavioural
problems.
NEW PRIORITY WERE GIVEN TO

26. 4. Health for All (1981 - 2000)
• Most people in the developed countries, and the elite of
the developing countries, enjoy all the determinants of
good health - adequate income, nutrition, education,
sanitation, safe drinking water and comprehensive
health care.
• In contrast, only 10 to 20% of the population in
developing countries enjoy ready access to health
services of any kind.

27. • Death claims 60-250 of every 1000 live
births within the first year of life
• Life expectancy is 30% lower than in the
developed countries .

28. “Large no. of the worlds
peoples, perhaps more than
half, have no access to
health care at all, and for
many of the rest, the care
they receive does not
answer the problems they
have”.

29. In 1981 WHO pledged
“Health For All” by 2000 to
bridge the gap between
developing and developed
countries.

31. “To lead a Socially & Economically
productive life”

33. Disease
Disease control phase (1880 - 1920)
Poor sanitation
Health promotion phase (1920 - 1960)
Sanitary legislation &
sanitary reforms
Health promotion
Social objectives
Social engineering phase (1960 - 1980)
Gap between rich
& poor within
countries
WHO
Health For All phase (1981 - 2000)

34. THANK YOU