The best job in the world: A past, and a future in public health
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A description of my career in public health today including lessons from local, national and international public health and the current COVID-19 pandemic. Presentation for the Coventry University BSc in public health employability course, October 25th 2021. 211025 middleton coventry final
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The best job in the world: A past, and a future in public health
- 1. The best job in the world A past, and a future in public health A presentation for Coventry University, October 25th 2021 Employability session Professor John Middleton Hon FFPH, FRCP, President, Association of Schools of Public Health in the European Region
- 2. What is ASPHER ? The Association of Schools of Public Health in the European Region (ASPHER) is the key independent European organisation dedicated to strengthening the role of public health by improving education and training of public health professionals for both practice and research. We have 120 member schools of public health in Europe and associates globally. We are developing our partnerships with sister public health organisations in America, Africa, Asia, Australasia and the Arab world
- 3. Salus populi suprema lex esto Cicero ‘The health of the people is the highest law’
- 4. Public health is : The science and art of promoting health, preventing disease and prolonging life through the organised efforts of society Acheson 1988, after Winslow 1927, WHO 1948
- 5. What is public health? The public’s health And The public system, services and profession
- 6. What is public health? The public health system, services and profession
- 7. What is public health? Public health practice is population-based It emphasises collective responsibility for health, health protection and disease prevention It recognises the key role of the state, linked to a concern for the underlying socio-economic and wider determinants of health, as well as disease Public health practice also emphasises partnership working with all those who contribute to the health of the population. Good Public Health Practice UK Faculty of Public Health 2016
- 8. What is public health? Three domains of public health : Health protection Health improvement Health care related public health UK Faculty of Public Health, 2016
- 9. Good public health practice • A: Knowledge, Skills and Performance • B: Safety and quality • C: Communication, partnership & teamwork • D: Maintaining public trust
- 11. A medical specialty… but a multidisciplinary profession, service and system UK Faculty of public Health Careers in public health
- 12. Multidisciplinary public health • 19th Century: early Ukpublic health practitioners were multi-disciplinary: John Snow (Surgeon/Anaesthetist), Florence Nightingale (Nurse); Edwin Chadwick (Lawyer); Joseph Bazalgette (Engineer); Mary Seacole (nurse)
- 14. “ Medicine is a social science and politics is nothing else but medicine on a large scale. “Medicine as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution; the politician, the practical anthropologist, must find the means for their actual solution” Rudolf Virchow
- 15. it's not who your doctor is, it's who you vote for, that most affects your health
- 16. 06/11/2021 16 • ‘The interests of health, and the interests of common physical convenience and comfort are in various cases, identical’ • Sir John Simon, First Medical Officer of Health for the City of London 1848, and First Chief Medical Officer for the British government , 1856 • WHO ‘Prerequisites for health/ health determinants’ perhaps?
- 18. A life in local public health The best job in the world: practicing public health, past, present, future
- 19. Coventry public health 1983-1987 Coventry Health Promotion Committee Accident prevention Heart disease Measles Maternal and child health Cancer prevention The Health of Coventry Annual public health report 1985 Health for Coventry by the Year 2000
- 21. Random static roadside breath testing to prevent drinking- driving, Finland
- 31. Sandwell Valley, King George Playing fields 2014
- 35. A life course – 24th annual report for Sandwell
- 36. Teenage Conception 1998-2012 Sandwell's reduction since baseline (44%) is higher than England & Wales's reduction of 40.8%. The West Midlands reduction has also been lower than Sandwell at 42%. Figure 1, above, show that the gap between Sandwell and England is reducing further.
- 40. Domestic burglary Sandwell 2001-2005 Full implementation drug intervention project doubling numbers of drug users in treatment 1300 fewer domestic burglaries 33% fall
- 44. 06/11/2021 44 •Asset based public health •Community assets
- 48. • Reducing social inequalities: UK Marmot review • Create fair employment and good quality work for all and improve quality of work across social gradients
- 50. By 2003 the mixed use site was in production…
- 52. 52
- 53. 06/11/2021 53 • Asset based public health • ‘The health dividend’
- 55. 55 i- House, demonstration house West Bromwich 2008
- 58. Middleton J. The hospital of the future comes to the West Midlands. BMJ blogs October 1st 2014. http://blogs.bmj.com/bmj/2014/10/01/john-middleton-the-hospital-of-the-future-comes-to-the-west- midlands/
- 61. The public’s health There’s never been a better, or more necessary, time to be in public health
- 62. 62 06/11/2021 The public’s health: global burden of disease, corporate anti-health interest,
- 63. Globally, mortality rates have decreased across all age groups over the past five decades, with the largest improvements occurring among children younger than 5 years. However, at the national level, considerable heterogeneity remains in terms of both level and rate of changes in age-specific mortality; increases in mortality for certain age groups occurred in some locations. Countries have saved more lives over the past decade, especially among children under age 5, but persistent health problems, such as obesity, conflict, and mental illness, comprise a “triad of troubles,” and prevent people from living long, healthy lives. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5–24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. Global burden of disease study, 2019
- 64. Global burden of disease 2019
- 65. These 10 Corporations Control Almost Everything We Eat
- 67. 67 06/11/2021 Violence, conflict and public health at home and abroad
- 68. The epidemiology of violence Evidence-based violence prevention: a life course approach Asset based community development Primary, secondary &tertiary prevention role of the public health community as primary preventers of violent conflict, through healthy public policies and tackling major social inequalities in health; and as early reactors, mitigaters and responders to violence. New public mental health approaches A role for public health in conflict resolution with aid agencies, political scientists, theologians and international lawyers A role for public health educational bodies A leadership and partnership role for public health www.fph.org.uk/uploads/Violence%20report.pdf Areas of action for the public health community in preventing violence
- 69. Interconnectedness: conflict over natural resources: oil, water
- 70. Interconnectness: Loss of agricultural land through global warming, crop failure, food riots, Arab Spring, Syrian war
- 71. 71 06/11/2021 Planetary health: environment, loss of biodiversity, food and ecosystems balance, climate change.
- 72. A role for our climate change special interest group
- 74. • 74 06/11/2021
- 75. 75 06/11/2021
- 79. Coccolithophore (diatom): Produces 50% of the world’s oxygen Algal blooms photosynthesising off south west coast of Wales
- 80. Climate breakdown is here now!- 1 fire
- 81. • Climate breakdown is here now!- 2 floods Indonesia floods Climate breakdown is here now!- 2 floods
- 82. Climate breakdown is here now!- 3 marine life extinction
- 83. John Middleton:Planning for an outbreak of health
- 85. 06/11/2021 85
- 87. Infodemics: misappropriating personal information to sway opinion and behaviour – in this example in elections
- 88. Infodemics: misappropriating social media - to sway opinion and behaviour – in this example in vaccine hesitancy
- 95. 06/11/2021 95
- 96. 06/11/2021 96
- 98. John Middleton [lecture title] [date] Global governance for health
- 100. 06/11/2021 100
- 101. 06/11/2021 101
- 102. 06/11/2021 102 ASPHER COVID-19 task force Members in 30 countries Actions: • Reports on testing • Masks • Inequalities • Second wave and winter planning • How to count illness • Basic terms of inequalities in health • Herd immunity • Five vaccination statements including the latest Vaccine internationalism, vaccine passports and vaccine diplomacy https://www.aspher.org /covid-19-task- force.html
- 103. 06/11/2021 103 ASPHER COVID-19 task force Actions : Public health service functions : • Contracts with European Health surveillance centre ECDC for reviewing competencies in infectious diseases, and vaccinology. • Young professionals training and project work • A survey of the work of our member schools in the pandemic • Surveys of actions by our schools in delivering teaching, in person or remotely • Papers on the erosion of public health • Support statements for the role of WHO https://www.aspher.org /covid-19-task- force.html
- 108. Planning for an outbreak of health
- 109. Planning for an outbreak of health: The public health system, services and profession
- 110. https://epha.org/public- health-must-be- strengthened-for-a- healthy-post-covid-world/ Global governance for health
- 113. John Middleton:Planning for an outbreak of health
- 115. John Middleton:Planning for an outbreak of health Renew the mandate of the UN and WHO in global health governance The new Treaty for pandemic preparedness Governance Transparency and information sharing Resources and capacity New continental/WHO regional structures with response capacity Ceded authority to supranational structures
- 118. Revised mandate of ECDC and EMA Crisis preparedness and response New regulation for pharmaceutical industry Europe’s Beating Cancer plan
- 120. John Middleton: Planning for an outbreak of health Planning for an outbreak of health: The public’s health
- 121. John Middleton [lecture title] [date] Upsides of lockdown 1 : Decline in air pollution
- 122. Upsides in lockdown 2: interest in more active travel
- 123. ‘Build back’ ? Working practices and relationships ? Reducing inequalities? Minorities? Vulnerable groups? Women? Older people?
- 124. John Middleton:Planning for an outbreak of health https://www.health.org.uk/sites/default/files/upl oad/publications/2020/Build-back-fairer-the- COVID-19-Marmot-review.pdf Build back Fairer?
- 125. John Middleton:Planning for an outbreak of health Build back Fairer? The richest billionaires could give $139,300,000,000 away and still be as rich as they were in 2020. These billionaires could end global hunger for about $300 billion. A fraction of their overall wealth.
- 126. ‘Build back’?
- 127. ‘Build back’ ?
- 128. ‘Build back’ ?
- 129. ‘Build back’ ?
- 130. ‘Protecting resources from one generation to the next’ The Welsh Wellbeing of Future Generations Act, 2015
- 131. ‘Build back’ ? To what austerity, poverty and unfairness? Environmental squalor and health and wealth for some? Plan for an outbreak of health….
- 132. William Beveridge designed a welfare state for the UK in the deepest point of the Second World War. ‘We should regard want, idleness , ignorance, squalor and disease as enemies of us all. That is the meaning of a social conscience; that we refuse to make our separate peace with evil.’
- 133. Science knows no country, because knowledge belongs to humanity, and is the torch which illuminates the world. Louis Pasteur
- 134. Thank you John Middleton, President Association of Schools of Public Health In the European Region John.middleton@aspher.org