Public health functions

1. Public Health
Functions
By.
Souma Shankar
Mukherjee

2. CONTENTS
• Definition of public health
• What is Public Health?
• Core Disciplines of Public Health
• Public Health Functions
• Problems and Barriers
• Conclusion

3. Definition of Public Health
• ‘Public health is the science and art of preventing disease, prolonging life and
promoting physical health and efficiency through organized community efforts for the
sanitation of the environment, the control of community infections, the education of
the individual in principles of personal hygiene, the organization of medical and
nursing service for the early diagnosis and preventive treatment of disease, and the
development of social machinery which will ensure to every individual in the
community a standard of living adequate for the maintenance of health’. (Winslow,
1920)

4. Definition of Public Health
• Sir Donald Acheson in 1988 defined it as: ‘the science and art of preventing disease,
prolonging life and promoting, protecting and improving health through the organized
efforts of society’
• The field pays special attention to the social context of disease and health, and focuses
on improving health through society-wide measures like vaccinations, the fluoridation
of drinking water, or through policies such as seatbelt and non-smoking laws.
• Donald Acheson Report, 1988, UK

5. What is public health?
Public health is considered to be about the health of people or communities, as opposed to
individual health - it is everyone's responsibility
The concept of public health is not unique and has changed over the years due to changes in the
health status of the population and the determining situations of health.
This definition of public health is directly linked to the wider definition of health, found in the
preamble of the constitution of the World Health Organisation (1948), where health is referred to
as "a state of complete physical, mental and social well-being and not merely the absence of
disease."

6. Core Disciplines of Public Health
• Environmental Health
• Epidemiology
• Biostatistics
• Health Policy
• Social and Behavioral Sciences

7. Core Disciplines of Public Health
Environmental Health
The term environment implies all the external factors - living and
non-living, material and non-material which surround man.

8. Core Disciplines of Public Health
Environmental Health
For descriptive purpose, environment has been divided into three
components

9. Core Disciplines of Public Health
Environmental Health
Environmental Sanitation" has been defined by WHO as "the control of
all those factors in man's physical environment which exercise or may
exercise a deleterious effect on his physical development, health and
survival"

10. Core Disciplines of Public Health
EPIDEMIOLOGY
The word epidemiology comes from the
Greek words epi, meaning on or upon,
demos, meaning people, and logos,
meaning the study of.

11. Core Disciplines of Public Health
EPIDEMIOLOGY
Epidemiology is the study of the distribution and
determinants of health-related states or events in specified
populations, and the application of this study to the control
of health problems.

12. Core Disciplines of Public Health
EPIDEMIOLOGY
Epidemiology is the study (scientific, systematic, data-driven) of the
distribution (frequency, pattern) and determinants (causes, risk
factors) of health-related states and events (not just diseases) in
specified populations (patient is community, individuals viewed
collectively), and the application of (since epidemiology is a discipline
within public health) this study to the control of health problems.

13. Core Disciplines of Public Health
EPIDEMIOLOGY
Uses
• Assessing the community’s health
• Making individual decisions
• Completing the clinical picture
• Searching for causes

14. Core Disciplines of Public Health
BIOSTATISTICS
Data management, analysis, and
presentation of public health data.

15. Core Disciplines of Public Health
BIOSTATISTICS
In the line of definition of Croxton and Cowden, a
comprehensive definition of statistics could be
The Science of
• Collection
• Organization
• Presentation
• Analysis
• And interpretation of numerical data

16. Core Disciplines of Public Health
HEALTH POLICY
Public policy is defined as a course of method of
action selected usually by Government from among
alternatives to guide and determine present and
future decisions.

17. Core Disciplines of Public Health
HEALTH POLICY
The stages of the cycle consists of
• Issue Identification
• Micro and Macro Policy Formulation
• Policy Selection
• Policy Advocacy
• Policy Adoption
• Policy Implementation
• Policy Evaluation
• Policy Reformulation

18. Core Disciplines of Public Health
SOCIAL AND BEHAVIOURAL SCIENCES
The term 'social sciences' is applied to those disciplines which are
committed to the scientific examination of human behavior

19. Core Disciplines of Public Health
SOCIAL AND BEHAVIOURAL SCIENCES
• Economics
• Political Science
• Sociology
• Social Psychology
• Social Anthropology.

20. Public Health Functions
THE 10 ESSENTIAL PUBLIC
HEALTH SERVICES
To protect and promote the health of all people in
all communities

21. Public Health Functions
• To achieve equity, the Essential Public Health Services actively promote
policies, systems, and overall community conditions that enable optimal
health for all and seek to remove systemic and structural barriers that
have resulted in health inequities.
• Such barriers include poverty, racism, gender discrimination, ableism,
and other forms of oppression.

23. Assess and monitor population health
status, factors that influence health, and
community needs and assets

24. Assess and monitor population health status,
factors that influence health, and community
needs and assets

25. Investigate, diagnose, and address
health problems and hazards affecting
the population

26. Investigate, diagnose, and address health
problems and hazards affecting the population

27. Communicate effectively to inform and
educate people about health, factors that
influence it, and how to improve it

28. Communicate effectively to inform and educat
people about health, factors that influence it, an
how to improve it

29. Strengthen, support, and mobilize communities and
partnerships to improve health

30. Strengthen, support, and mobilize communities an
partnerships to improve health

31. Create, champion, and implement policies, plans,
and laws that impact health

32. Create, champion, and implement policies, plans,
and laws that impact health

33. Utilize legal and regulatory actions designed to
improve and protect the public’s health

34. Utilize legal and regulatory actions designed to
improve and protect the public’s health

35. Assure an effective system that enables
equitable access to the individual services
and care needed to be healthy

36. Assure an effective system that enables equitable
access to the individual services and care needed
to be healthy

37. Assure an effective system that enables equitable
access to the individual services and care needed
to be healthy

38. Build and support a diverse and skilled
public health workforce

39. Build and support a diverse and skilled
public health workforce

40. Improve and innovate public health
functions through ongoing evaluation,
research, and continuous quality
improvement

41. Improve and innovate public health
functions through ongoing evaluation,
research, and continuous quality
improvement

42. Build and maintain a strong organizational
infrastructure for public health

43. Problem
Diagnostic surveillance
system
Requires Solution
Problem Exists

44. Problem
Undertake corrective or
preventive activities
Mobilization of Resources
Influence those responsible
for executive action

45. Problem
Environmental
Societal

46. Implementation of Proposals and Monitoring the
effectiveness
Curative Medicine is
the most important
component for the
maintenance of the
health of the public

47. Implementation of Proposals and Monitoring the
effectiveness
Since the middle of the last century
Curative medicine ( which is
considered to have dramatic
and immediate effects on
health status)
Objectives of the discipline of
Public Health

48. Implementation of Proposals and Monitoring the
effectiveness
Major advances in medicine and thus in health are
provided through hospital services

49. Implementation of Proposals and Monitoring the
effectiveness
Implementing
health policy
Public
Health
interventions
Change
from
Curative
Preventive
services
Public
Heath

50. Implementation of Proposals and Monitoring the
effectiveness
• Investigation of the virus
• Molecular basis of generation of the
disease
• Its treatment
• Development of a vaccine to
prevent the disease

51. Implementation of Proposals and Monitoring the
effectiveness
• Problems of understanding human
behavior
• Modification of human behavior
• Which influence the rate and mode
of transmission in Western, African,
Asian and other populations

52. Implementation of Proposals and Monitoring the
effectiveness
Cannot be held accountable for the
failure of public health policy if their
advice is ignored
Thus they cannot be held responsible
for the health of the public without
political power
They do not have the power to
implement the policies they have
identified
Public Health as a discipline is failing
to fulfill its role

53. Implementation of Proposals and Monitoring the
effectiveness
The major issues
facing public
health are
Responsibility
and
accountability
Internal issues
specific to the
discipline of
public health
Changing health
environment

54. Issue of responsibility and accountability
• Policy-making
• Determination of priorities.
• Health Service Organization

55. Policy Making
• Public health practitioners cannot act on isolations.
• Dependent on government at central or local level for the
freedom to practice their discipline effectively.
There is failure to recognize the
nature of professional responsibilities
for the public’s health
There is a failure to allow the public
health professions a sufficient place or
the power to determine and execute
appropriate health policies

56. Policy Making
• Florence nightingale advocated the miasmatic theory of contagion whereas the
public health practitioners of the day believed in the transmissibility of infection.
• Nightingale and her followers were influenced in their views on hospital design

57. Policy Making
• Many politicians believed that cervical cancer
screening should be introduced for all women
aged 16 to 64 years.
• Major ‘at-risk’ group were those aged over 35
years.
• Over dilution of effort would reduce the overall
benefits of the service.

58. Policy Making
Financial or bureaucratic responsibilities are given too high
a priority and the public health suffers.
Public Health
Professionals are
not given the
responsibility for
the public’s health
Their priorities
would not
necessarily
reflect the
priorities of
the
government
Health services would
no longer reflect
government policy

59. Determination of Priorities
Identify the problem
freely and devise and
implement appropriate
solutions.

60. Determination of Priorities
Measures to
reduce lead
pollution from
motor vehicle
emissions in the
United Kingdom

61. Determination of Priorities
More serious impact of
lead contamination of the
water supply from lead
pipes

62. Health Service Organization
• Public Health Medicine plays a vital role in the management and
organization of health services.
• Decisions about reorganization are beyond the realms of the practitioners.
• Are given responsibilities for implementing operational decisions without
being party to strategic planning.
• This lack of clearly allocated responsibilities and accountabilities is the
paramount problem facing the public health services.

63. Health Service Organization
Policies having an
impact on Health
Adequately
performed
Retain its
integrity
Operational
Decision
making
Strategic
Decision
Making

64. Health Service Organization
Some of these conditions are now met in the
United Kingdom by the division into purchaser-
provider organizations, with the public health
discipline represented in the purchaser domain.

65. Health Service Organization
THE DIRECTOR OF
PUBLIC HEALTH
Responsible for the health
of a defined population
Authority to purchase
services that promote
health, including health
services
Publishing an annual report
on the health problems of
the populations
Identifying both
problems and
solutions
Recording over time
what progress have
been made

66. Health Service Organization
Such changes in structure enable an authority to take a much
broader view and enables expenditure to be directed in a more
structured manner.
Expenditure on road and housing
improvements rather than only accidents
and emergency facilities to reduce the
problem of accidents

67. CONCLUSION
• Public health is a vital function that requires broad public concern and support in
order to fulfill society's interest in assuring the conditions in which people can be
healthy. History teaches us that organized community effort to prevent disease
and promote health is both valuable and effective.
• Restoring an effective public health system cannot be achieved by public health
professionals alone.

68. Thank You

69. REFERENCES
• Centers for Disease Control and Prevention. Essential public health services.
National Public Health Performance Standards Program. 10.
• World Health Organization. Essential public health functions, health systems and
health security: developing conceptual clarity and a WHO roadmap for action.
• Park K. Preventive and social medicine.
• Detels R, Beaglehole R, Lansang MA, Gulliford M. Oxford textbook of public health.
Oxford University Press; 2011.
• Pellmar TC, Brandt Jr EN, Baird MA. Health and behavior: the interplay of
biological, behavioral, and social influences: summary of an Institute of Medicine
report. American Journal of Health Promotion. 2002 Mar;16(4):206-19.