Public health
Overview
Public health is "the science and art of preventing disease, prolonging life and promoting health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...

 through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" (1920, C.E.A. Winslow
Charles-Edward Amory Winslow
Charles-Edward Amory Winslow was an American bacteriologist and public health expert who was, according to the Encyclopedia of Public Health, "a seminal figure in public health, not only in his own country, the United States, but in the wider Western world."Winslow was born in Boston,...

). It is concerned with threats to health based on population health
Population health
Population health has been defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” It is an approach to health that aims to improve the health of an entire population. One major step in achieving this aim is to reduce health...

 analysis. The population in question can be as small as a handful of people or as large as all the inhabitants of several continents (for instance, in the case of a pandemic
Pandemic
A pandemic is an epidemic of infectious disease that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic...

).
Encyclopedia
Public health is "the science and art of preventing disease, prolonging life and promoting health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...

 through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" (1920, C.E.A. Winslow
Charles-Edward Amory Winslow
Charles-Edward Amory Winslow was an American bacteriologist and public health expert who was, according to the Encyclopedia of Public Health, "a seminal figure in public health, not only in his own country, the United States, but in the wider Western world."Winslow was born in Boston,...

). It is concerned with threats to health based on population health
Population health
Population health has been defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” It is an approach to health that aims to improve the health of an entire population. One major step in achieving this aim is to reduce health...

 analysis. The population in question can be as small as a handful of people or as large as all the inhabitants of several continents (for instance, in the case of a pandemic
Pandemic
A pandemic is an epidemic of infectious disease that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic...

). The dimensions of health can encompass "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity", as defined by the United Nations' World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

. Public health incorporates the interdisciplinary approaches of epidemiology
Epidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...

, biostatistics
Biostatistics
Biostatistics is the application of statistics to a wide range of topics in biology...

 and health services. Environmental health
Environmental health
Environmental health is the branch of public health that is concerned with all aspects of the natural and built environment that may affect human health...

, community health
Community health
Community health, a field of public health, is a discipline that concerns itself with the study and betterment of the health characteristics of biological communities. While the term community can be broadly defined, community health tends to focus on geographic areas rather than people with shared...

, behavioral health
Behavioral health
In psychology behavioral health, as a general concept, refers to the reciprocal relationship between human behavior, individually or socially, and the well-being of the body, mind, and spirit, whether the latter are considered individually or as an integrated whole...

, and occupational health are other important subfields.

The focus of public health intervention is to improve health and quality of life through the prevention and treatment of disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...

 and other physical and mental health conditions, through surveillance of cases and the promotion of healthy behaviors. Promotion of hand washing
Hand washing
Hand washing for hand hygiene is the act of cleaning the hands with or without the use of water or another liquid, or with the use of soap, for the purpose of removing soil, dirt, and/or microorganisms....

 and breastfeeding
Breastfeeding
Breastfeeding is the feeding of an infant or young child with breast milk directly from female human breasts rather than from a baby bottle or other container. Babies have a sucking reflex that enables them to suck and swallow milk. It is recommended that mothers breastfeed for six months or...

, delivery of vaccination
Vaccination
Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...

s, and distribution of condom
Condom
A condom is a barrier device most commonly used during sexual intercourse to reduce the probability of pregnancy and spreading sexually transmitted diseases . It is put on a man's erect penis and physically blocks ejaculated semen from entering the body of a sexual partner...

s to control the spread of sexually transmitted disease
Sexually transmitted disease
Sexually transmitted disease , also known as a sexually transmitted infection or venereal disease , is an illness that has a significant probability of transmission between humans by means of human sexual behavior, including vaginal intercourse, oral sex, and anal sex...

s are examples of common public health measures.

Modern public health practice requires multidisciplinary teams
Multidisciplinarity
Multidisciplinarity is a non-integrative mixture of disciplines in that each discipline retains its methodologies and assumptions without change or development from other disciplines within the multidisciplinary relationship....

 of professionals including physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

s specialising in public health/community medicine/infectious disease, epidemiologists
Epidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...

, biostatisticians
Biostatistics
Biostatistics is the application of statistics to a wide range of topics in biology...

, public health nurses, medical microbiologists
Microbiologist
A microbiologist is a scientist who works in the field of microbiology. Microbiologists study organisms called microbes. Microbes can take the form of bacteria, viruses, fungi, and protists...

, environmental health officer
Environmental health officer
Environmental health officers are usually employed by local government or state health authorities to advise on and enforce public health standards...

s, dental hygienist
Dental hygienist
thumb|right|300px|Dental hygienist holding a scalerA dental hygienist is a licensed dental professional who specializes in preventive oral health, typically focusing on techniques in oral hygiene. Local dental regulations determine the scope of practice of dental hygienists...

s, dietitian
Dietitian
Dietitians supervise the preparation and service of food, develop modified diets, participate in research, and educate individuals and groups on good nutritional habits. The goals of dietitians are to provide medical nutritional intervention, and to obtain, safely prepare, serve and advise on...

s and nutritionist
Nutritionist
A nutritionist is a person who advises on matters of food and nutrition impacts on health. Different professional terms are used in different countries, employment settings and contexts — some examples include: nutrition scientist, public health nutritionist, dietitian-nutritionist, clinical...

s, health inspector
Health inspector
A health inspector is a public employee who investigates health hazards in a wide variety of locations, then will take action to mitigate or eliminate the hazards...

s, veterinarian
Veterinarian
A veterinary physician, colloquially called a vet, shortened from veterinarian or veterinary surgeon , is a professional who treats disease, disorder and injury in animals....

s, public health engineers, public health lawyers, sociologists, community development workers, communications officers, and others.

Objectives

The focus of a public health intervention is to prevent and manage diseases, injuries and other health conditions through surveillance of cases and the promotion of healthy behaviors
Health promotion
Health promotion has been defined by the World Health Organization's 2005 Bangkok Charter for Health Promotion in a Globalized World as "the process of enabling people to increase control over their health and its determinants, and thereby improve their health"...

, communities
Healthy community design
Healthy community design is planning and designing communities that make it easier for people to live healthy lives. Healthy community design offers important benefits:...

 and environments
Environmental protection
Environmental protection is a practice of protecting the environment, on individual, organizational or governmental level, for the benefit of the natural environment and humans. Due to the pressures of population and our technology the biophysical environment is being degraded, sometimes permanently...

. Many diseases are preventable through simple, non-medical methods. For example, research has shown that the simple act of hand washing
Hand washing
Hand washing for hand hygiene is the act of cleaning the hands with or without the use of water or another liquid, or with the use of soap, for the purpose of removing soil, dirt, and/or microorganisms....

 with soap can prevent many contagious diseases. In other cases, treating a disease or controlling a pathogen
Pathogen
A pathogen gignomai "I give birth to") or infectious agent — colloquially, a germ — is a microbe or microorganism such as a virus, bacterium, prion, or fungus that causes disease in its animal or plant host...

 can be vital to preventing its spread to others, such as during an outbreak of infectious disease
Infectious disease
Infectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...

, or contamination of food or water supplies. Public health communications programs, vaccination
Vaccination
Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...

 programs, and distribution of condom
Condom
A condom is a barrier device most commonly used during sexual intercourse to reduce the probability of pregnancy and spreading sexually transmitted diseases . It is put on a man's erect penis and physically blocks ejaculated semen from entering the body of a sexual partner...

s are examples of common public health measures.

Public health plays an important role in disease prevention efforts in both the developing world and in developed countries, through local health systems and non-governmental organization
Non-governmental organization
A non-governmental organization is a legally constituted organization created by natural or legal persons that operates independently from any government. The term originated from the United Nations , and is normally used to refer to organizations that do not form part of the government and are...

s. The World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

 (WHO) is the international agency that coordinates and acts on global public health
Global health
Global health is the health of populations in a global context and transcends the perspectives and concerns of individual nations. Health problems that transcend national borders or have a global political and economic impact, are often emphasized...

 issues. Most countries have their own government public health agencies, sometimes known as ministries of health, to respond to domestic health issues. For example in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

, the front line of public health initiatives are state and local health department
Health department
A health department or health ministry is a part of government which focuses on issues related to the general health of the citizenry. Subnational entities, such as states, counties and cities, often also operate a health department of their own...

s. The United States Public Health Service
United States Public Health Service
The Public Health Service Act of 1944 structured the United States Public Health Service as the primary division of the Department of Health, Education and Welfare , which later became the United States Department of Health and Human Services. The PHS comprises all Agency Divisions of Health and...

 (PHS), led by the Surgeon General of the United States
Surgeon General of the United States
The Surgeon General of the United States is the operational head of the Public Health Service Commissioned Corps and thus the leading spokesperson on matters of public health in the federal government...

, and the Centers for Disease Control and Prevention
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...

, headquartered in Atlanta
Atlanta, Georgia
Atlanta is the capital and most populous city in the U.S. state of Georgia. According to the 2010 census, Atlanta's population is 420,003. Atlanta is the cultural and economic center of the Atlanta metropolitan area, which is home to 5,268,860 people and is the ninth largest metropolitan area in...

, are involved with several international health activities, in addition to their national duties. In Canada, the Public Health Agency of Canada
Public Health Agency of Canada
The Public Health Agency of Canada is an agency of the Government of Canada that is responsible for public health, emergency preparedness, and response and infectious and chronic disease control and prevention...

 is the national agency responsible for public health, emergency preparedness and response, and infectious and chronic disease control and prevention. In India, the Public Health Foundation of India
Public Health Foundation of India
The Public Health Foundation of India , is an autonomous foundation located in New Delhi, India. The foundation was created as a public-private initiative and launched by the Prime minister of India, Manmohan Singh in 2006 with the aim of enhancing the capacity of public health professionals in the...

 was launched in 2006 as a response to growing concern over the emerging public health challenges in that country.

There is a vast discrepancy in access to health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...

 and public health initiatives between developed nations and developing nations. In the developing world, public health infrastructures are still forming. There may not be enough trained health workers or monetary resources to provide even a basic level of medical care and disease prevention. As a result, a large majority of disease and mortality in the developing world results from and contributes to extreme poverty. For example, many African governments spend less than USD$
United States dollar
The United States dollar , also referred to as the American dollar, is the official currency of the United States of America. It is divided into 100 smaller units called cents or pennies....

10 per person per year on health care, while, in the United States, the federal government
Federal government of the United States
The federal government of the United States is the national government of the constitutional republic of fifty states that is the United States of America. The federal government comprises three distinct branches of government: a legislative, an executive and a judiciary. These branches and...

 spent approximately USD$4,500 per capita in 2000.

History of public health

In some ways, public health is a modern concept of human development in science , although it has roots in antiquity. From the beginnings of human civilization, it was recognized that polluted water
Water
Water is a chemical substance with the chemical formula H2O. A water molecule contains one oxygen and two hydrogen atoms connected by covalent bonds. Water is a liquid at ambient conditions, but it often co-exists on Earth with its solid state, ice, and gaseous state . Water also exists in a...

 and lack of proper waste disposal spread communicable diseases (theory of miasma
Miasma theory of disease
The miasma theory held that diseases such as cholera, chlamydia or the Black Death were caused by a miasma , a noxious form of "bad air"....

). Early religion
Religion
Religion is a collection of cultural systems, belief systems, and worldviews that establishes symbols that relate humanity to spirituality and, sometimes, to moral values. Many religions have narratives, symbols, traditions and sacred histories that are intended to give meaning to life or to...

s attempted to regulate behavior that specifically related to health, from types of food
Food
Food is any substance consumed to provide nutritional support for the body. It is usually of plant or animal origin, and contains essential nutrients, such as carbohydrates, fats, proteins, vitamins, or minerals...

 eaten, to regulating certain indulgent behaviors, such as drinking alcohol
Alcohol
In chemistry, an alcohol is an organic compound in which the hydroxy functional group is bound to a carbon atom. In particular, this carbon center should be saturated, having single bonds to three other atoms....

 or sexual relations. The establishment of government
Government
Government refers to the legislators, administrators, and arbitrators in the administrative bureaucracy who control a state at a given time, and to the system of government by which they are organized...

s placed responsibility on leader
Leadership
Leadership has been described as the “process of social influence in which one person can enlist the aid and support of others in the accomplishment of a common task". Other in-depth definitions of leadership have also emerged.-Theories:...

s to develop public health policies and programs in order to gain some understanding of the causes of disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...

 and thus ensure social stability prosperity
Wealth
Wealth is the abundance of valuable resources or material possessions. The word wealth is derived from the old English wela, which is from an Indo-European word stem...

, and maintain order.

The term "healthy city
Healthy city
Healthy city is a term used in public health and urban design to stress the impact of policy on human health. Its modern form derives from a World Health Organization initiative on Healthy Cities and Villages in 1986, but has a history dating back to the mid 19th century...

" used by today's public health advocates reflects this ongoing challenge to collective physical well-being that results from crowded conditions and urbanization.

Early public health interventions

By Roman
Ancient Rome
Ancient Rome was a thriving civilization that grew on the Italian Peninsula as early as the 8th century BC. Located along the Mediterranean Sea and centered on the city of Rome, it expanded to one of the largest empires in the ancient world....

 times, it was well understood that proper diversion of human waste
Waste management
Waste management is the collection, transport, processing or disposal,managing and monitoring of waste materials. The term usually relates to materials produced by human activity, and the process is generally undertaken to reduce their effect on health, the environment or aesthetics...

 was a necessary tenet of public health in urban areas. The Chinese
History of China
Chinese civilization originated in various regional centers along both the Yellow River and the Yangtze River valleys in the Neolithic era, but the Yellow River is said to be the Cradle of Chinese Civilization. With thousands of years of continuous history, China is one of the world's oldest...

 developed the practice of variolation following a smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...

 epidemic around 1000 BC. An individual without the disease could gain some measure of immunity against it by inhaling the dried crusts that formed around lesions of infected individuals. Also, children were protected by inoculating
Inoculation
Inoculation is the placement of something that will grow or reproduce, and is most commonly used in respect of the introduction of a serum, vaccine, or antigenic substance into the body of a human or animal, especially to produce or boost immunity to a specific disease...

 a scratch on their forearms with the pus from a lesion. This practice was not documented in the West until the early-18th century, and was used on a very limited basis. The practice of vaccination
Vaccination
Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...

 did not become prevalent until the 1820s, following the work of Edward Jenner
Edward Jenner
Edward Anthony Jenner was an English scientist who studied his natural surroundings in Berkeley, Gloucestershire...

 to treat smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...

.

During the 14th century Black Death
Black Death
The Black Death was one of the most devastating pandemics in human history, peaking in Europe between 1348 and 1350. Of several competing theories, the dominant explanation for the Black Death is the plague theory, which attributes the outbreak to the bacterium Yersinia pestis. Thought to have...

 in Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...

, it was believed that removing bodies of the dead would further prevent the spread of the bacterial infection. This did little to stem the plague, however, which was most likely spread by rodent
Rodent
Rodentia is an order of mammals also known as rodents, characterised by two continuously growing incisors in the upper and lower jaws which must be kept short by gnawing....

-borne flea
Flea
Flea is the common name for insects of the order Siphonaptera which are wingless insects with mouthparts adapted for piercing skin and sucking blood...

s. Burning parts of cities resulted in much greater benefit, since it destroyed the rodent infestations. The development of quarantine
Quarantine
Quarantine is compulsory isolation, typically to contain the spread of something considered dangerous, often but not always disease. The word comes from the Italian quarantena, meaning forty-day period....

 in the medieval period helped mitigate the effects of other infectious diseases. However, according to Michel Foucault
Michel Foucault
Michel Foucault , born Paul-Michel Foucault , was a French philosopher, social theorist and historian of ideas...

, the plague model of governmentality
Governmentality
Governmentality is a concept first developed by the French philosopher Michel Foucault in the later years of his life, roughly between 1977 and his death in 1984, particularly in his lectures at the Collège de France during this time...

 was later controverted by the cholera
Cholera
Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission occurs primarily by drinking or eating water or food that has been contaminated by the diarrhea of an infected person or the feces...

 model. A Cholera pandemic devastated Europe between 1829 and 1851, and was first fought by the use of what Foucault called "social medicine", which focused on flux, circulation of air, location of cemeteries, etc. All those concerns, born of the miasma theory of disease
Miasma theory of disease
The miasma theory held that diseases such as cholera, chlamydia or the Black Death were caused by a miasma , a noxious form of "bad air"....

, were mixed with urbanistic
Urbanism
Broadly, urbanism is a focus on cities and urban areas, their geography, economies, politics, social characteristics, as well as the effects on, and caused by, the built environment.-Philosophy:...

 concerns for the management of populations, which Foucault designated as the concept of "biopower
Biopower
Biopower was a term coined by French Social theorist and philosopher Michel Foucault it refers to the practice of modern states and their regulation of their subjects through "an explosion of numerous and diverse techniques for achieving the subjugations of bodies and the control of populations." ...

". The German conceptualized this in the Polizeiwissenschaft
Polizeiwissenschaft
Polizeiwissenschaft was a discipline born in the first third of the 18th century which lasted until the middle of the 19th century.Considered as the science of the internal order of the community, it was a comprehensive term, which included today's...

("Science of police").

The science of epidemiology
Epidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...

 was founded by John Snow
John Snow (physician)
John Snow was an English physician and a leader in the adoption of anaesthesia and medical hygiene. He is considered to be one of the fathers of epidemiology, because of his work in tracing the source of a cholera outbreak in Soho, England, in 1854.-Early life and education:Snow was born 15 March...

's identification of a polluted public water well as the source of an 1854 cholera
Cholera
Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission occurs primarily by drinking or eating water or food that has been contaminated by the diarrhea of an infected person or the feces...

 outbreak in London. Dr. Snow believed in the germ theory of disease as opposed to the prevailing miasma theory
Miasma theory of disease
The miasma theory held that diseases such as cholera, chlamydia or the Black Death were caused by a miasma , a noxious form of "bad air"....

. Although miasma theory correctly teaches that disease is a result of poor sanitation, it was based upon the prevailing theory of spontaneous generation
Spontaneous generation
Spontaneous generation or Equivocal generation is an obsolete principle regarding the origin of life from inanimate matter, which held that this process was a commonplace and everyday occurrence, as distinguished from univocal generation, or reproduction from parent...

. Germ theory developed slowly: despite Anton van Leeuwenhoek
Anton van Leeuwenhoek
Antonie Philips van Leeuwenhoek was a Dutch tradesman and scientist from Delft, Netherlands. He is commonly known as "the Father of Microbiology", and considered to be the first microbiologist...

's observations of Microorganisms, (which are now known to cause many of the most common infectious diseases) in the year 1680, the modern era of public health did not begin until the 1880s, with Louis Pasteur
Louis Pasteur
Louis Pasteur was a French chemist and microbiologist born in Dole. He is remembered for his remarkable breakthroughs in the causes and preventions of diseases. His discoveries reduced mortality from puerperal fever, and he created the first vaccine for rabies and anthrax. His experiments...

's germ theory and production of artificial vaccine
Vaccine
A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe or its toxins...

s.

Other public health interventions include latrinization, the building of sewer
Sanitary sewer
A sanitary sewer is a separate underground carriage system specifically for transporting sewage from houses and commercial buildings to treatment or disposal. Sanitary sewers serving industrial areas also carry industrial wastewater...

s, the regular collection of garbage followed by incineration or disposal in a landfill
Landfill
A landfill site , is a site for the disposal of waste materials by burial and is the oldest form of waste treatment...

, providing clean water and draining standing water to prevent the breeding of mosquitoes. This contribution was made by Edwin Chadwick in 1843 who published a report on the sanitation of the working class population in Great Britain at the time. So began the inception of the modern public health. The industrial revolution had initially caused the spread of disease through large conurbations around workhouses and factories. These settlements were cramped and primitive and there was no organised sanitation. Disease was inevitable and its incubation in these areas was encouraged by the poor lifestyle of the inhabitants.

Modern public health

With the onset of the epidemiological transition
Epidemiological transition
In demography and medical geography, epidemiological transition is a phase of development witnessed by a sudden and stark increase in population growth rates brought about by medical innovation in disease or sickness therapy and treatment, followed by a re-leveling of population growth from...

 and as the prevalence of infectious diseases decreased through the 20th century
Infectious disease in the 20th century
Many infectious diseases that killed by the millions were greatly reduced in the 20th century, with one notable achievement being the eradication of smallpox, and considerable progress being made toward the eradication of polio and Guinea Worm Disease....

, public health began to put more focus on chronic diseases such as cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

 and heart disease
Heart disease
Heart disease, cardiac disease or cardiopathy is an umbrella term for a variety of diseases affecting the heart. , it is the leading cause of death in the United States, England, Canada and Wales, accounting for 25.4% of the total deaths in the United States.-Types:-Coronary heart disease:Coronary...

. Previous efforts in many developed countries had already led to dramatic reductions in the infant mortality rate using preventative methods. For instance in the United States, public health worker Dr. Sara Josephine Baker
Sara Josephine Baker
Sara Josephine Baker was an American physician notable for contributions to public health in New York City...

 established many programs to help the poor in New York City keep their infants healthy, leading teams of nurses into the crowded neighborhoods of Hell's Kitchen
Hell's Kitchen, Manhattan
Hell's Kitchen, also known as Clinton and Midtown West, is a neighborhood of Manhattan in New York City between 34th Street and 59th Street, from 8th Avenue to the Hudson River....

 and teaching mothers how to dress, feed, and bathe their babies.

During the 20th century and early in the next, the dramatic increase in average life span is widely credited to public health achievements, such as vaccination programs and control of many infectious diseases including polio
Poliomyelitis
Poliomyelitis, often called polio or infantile paralysis, is an acute viral infectious disease spread from person to person, primarily via the fecal-oral route...

, diphtheria
Diphtheria
Diphtheria is an upper respiratory tract illness caused by Corynebacterium diphtheriae, a facultative anaerobic, Gram-positive bacterium. It is characterized by sore throat, low fever, and an adherent membrane on the tonsils, pharynx, and/or nasal cavity...

, yellow fever
Yellow fever
Yellow fever is an acute viral hemorrhagic disease. The virus is a 40 to 50 nm enveloped RNA virus with positive sense of the Flaviviridae family....

 and smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...

; effective health and safety policies such as road traffic safety and occupational safety
Occupational safety and health
Occupational safety and health is a cross-disciplinary area concerned with protecting the safety, health and welfare of people engaged in work or employment. The goal of all occupational safety and health programs is to foster a safe work environment...

; improved family planning
Family planning
Family planning is the planning of when to have children, and the use of birth control and other techniques to implement such plans. Other techniques commonly used include sexuality education, prevention and management of sexually transmitted infections, pre-conception counseling and...

; tobacco control
Tobacco Control
Tobacco control is a field of public health science, policy and practice dedicated to controlling the growth of tobacco use and thereby reducing the morbidity and mortality it causes...

 measures; and programs designed to decrease non-communicable disease
Non-communicable disease
A non-communicable disease, or NCD, is a medical condition or disease which is non-infectious. NCDs are diseases of long duration and generally slow progression. They include heart disease, stroke, cancer, asthma, diabetes, chronic kidney disease, osteoporosis, Alzheimer's disease, cataracts, and...

s by acting on known risk factors such as a person's background, lifestyle and environment. One of the major sources of the increase in average life span in the early 20th century was the decline in the "urban penalty" brought on by improvements in sanitation
Sanitation
Sanitation is the hygienic means of promoting health through prevention of human contact with the hazards of wastes. Hazards can be either physical, microbiological, biological or chemical agents of disease. Wastes that can cause health problems are human and animal feces, solid wastes, domestic...

. These improvements included chlorination
Chlorination
Chlorination is the process of adding the element chlorine to water as a method of water purification to make it fit for human consumption as drinking water...

 of drinking water, filtration and sewage treatment
Sewage treatment
Sewage treatment, or domestic wastewater treatment, is the process of removing contaminants from wastewater and household sewage, both runoff and domestic. It includes physical, chemical, and biological processes to remove physical, chemical and biological contaminants...

 which led to the decline in deaths caused by infectious waterborne diseases
Waterborne diseases
Waterborne diseases are caused by pathogenic microorganisms which are directly transmitted when contaminated fresh water is consumed. Contaminated fresh water, used in the preparation of food, can be the source of foodborne disease through consumption of the same microorganisms...

 such as cholera
Cholera
Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission occurs primarily by drinking or eating water or food that has been contaminated by the diarrhea of an infected person or the feces...

 and intestinal diseases. In Cutler and Miller's, "The Role of Public Health Improvements in Health Advances", they display evidence of the decline in typhoid fever
Typhoid fever
Typhoid fever, also known as Typhoid, is a common worldwide bacterial disease, transmitted by the ingestion of food or water contaminated with the feces of an infected person, which contain the bacterium Salmonella enterica, serovar Typhi...

 deaths in Chicago, Baltimore, Cincinnati, and Cleveland after these American cities adopted chlorination, filtration, or a sewage improvement.

Meanwhile, large parts of the developing world remained plagued by largely preventable/treatable infectious diseases and poor maternal
Maternal health
Maternal health refers to the health of women during pregnancy, childbirth, and the postpartum period. It encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to reduce maternal morbidity and mortality.Preconception care can include...

 and child health outcomes, exacerbated by malnutrition
Malnutrition
Malnutrition is the condition that results from taking an unbalanced diet in which certain nutrients are lacking, in excess , or in the wrong proportions....

 and poverty. The WHO
Who
Who may refer to:* Who , an English-language pronoun* who , a Unix command* Who?, one of the Five Ws in journalism- Art and entertainment :* Who? , a 1958 novel by Algis Budrys...

 reports that a lack of exclusive breastfeeding during the first six months of life contributes to over a million avoidable child deaths each year. Intermittent preventive therapy
Intermittent preventive therapy
Intermittent preventive therapy is a public health intervention aimed at treating and preventing malaria episodes in infants , children , schoolchildren and pregnant women...

 aimed at treating and preventing malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...

 episodes among pregnant women and young children is one public health measure in endemic
Endemic (epidemiology)
In epidemiology, an infection is said to be endemic in a population when that infection is maintained in the population without the need for external inputs. For example, chickenpox is endemic in the UK, but malaria is not...

 countries.

Front-page headlines continue to present society with public health issues on a daily basis: emerging infectious diseases such as SARS, rapidly making its way from China (see Public health in China) to Canada, the United States and other geographically distant countries; reducing inequities in health care access
Health equity
Health equity refers to the study of differences in the quality of health and health care across different populations....

 through publicly funded health insurance programs; the HIV/AIDS pandemic and its spread from certain high-risk groups to the general population in many countries, such as in South Africa
HIV/AIDS in South Africa
HIV/AIDS in South Africa is a prominent health concern because South Africa is believed to have more people with HIV/AIDS than any other country....

; the increase of childhood obesity
Childhood obesity
Childhood obesity is a condition where excess body fat negatively affects a child's health or wellbeing. As methods to determine body fat directly are difficult, the diagnosis of obesity is often based on BMI. Due to the rising prevalence of obesity in children and its many adverse health effects...

 and the concomitant increase in type II diabetes among children; the social, economic and health impacts of adolescent pregnancy; and the ongoing public health challenges related to natural disaster
Natural disaster
A natural disaster is the effect of a natural hazard . It leads to financial, environmental or human losses...

s such as the 2004 Indian Ocean tsunami, 2005's Hurricane Katrina
Hurricane Katrina
Hurricane Katrina of the 2005 Atlantic hurricane season was a powerful Atlantic hurricane. It is the costliest natural disaster, as well as one of the five deadliest hurricanes, in the history of the United States. Among recorded Atlantic hurricanes, it was the sixth strongest overall...

 in the United States and the 2010 Haiti earthquake
2010 Haiti earthquake
The 2010 Haiti earthquake was a catastrophic magnitude 7.0 Mw earthquake, with an epicentre near the town of Léogâne, approximately west of Port-au-Prince, Haiti's capital. The earthquake occurred at 16:53 local time on Tuesday, 12 January 2010.By 24 January, at least 52 aftershocks...

.

Since the 1980s, the growing field of population health
Population health
Population health has been defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” It is an approach to health that aims to improve the health of an entire population. One major step in achieving this aim is to reduce health...

 has broadened the focus of public health from individual behaviors and risk factor
Risk factor
In epidemiology, a risk factor is a variable associated with an increased risk of disease or infection. Sometimes, determinant is also used, being a variable associated with either increased or decreased risk.-Correlation vs causation:...

s to population-level issues such as inequality
Health equity
Health equity refers to the study of differences in the quality of health and health care across different populations....

, poverty, and education. Modern public health is often concerned with addressing determinants of health across a population. There is a recognition that our health is affected by many factors including where we live, genetics, our income, our educational status and our social relationships - these are known as "social determinants of health
Social determinants of health
Social determinants of health are the economic and social conditions under which people live which determine their health. They are "societal risk conditions", rather than individual risk factors that either increase or decrease the risk for a disease, for example for cardiovascular disease and...

." A social gradient in health runs through society, with those that are poorest generally suffering the worst health. However even those in the middle classes will generally have worse health outcomes than those of a higher social stratum. The new public health seeks to address these health inequalities by advocating for population-based policies that improve health in an equitable manner.

Public Health 2.0

Public Health 2.0 is the term given to a movement within public health that aims to make the field more accessible to the general public and more user-driven. There are three senses in which the term "Public Health 2.0" is used. In the first sense, "Public Health 2.0" is similar to the term "Health 2.0
Health 2.0
Health 2.0 are terms representing the possibilities between health care, eHealth and Web 2.0, and has come into use after a recent spate of articles in newspapers, and by Physicians and Medical Librarians...

" and is used to describe the ways in which traditional public health practitioners and institutions are reaching out (or could reach out) to the public through social media. In the second sense, "Public Health 2.0" is used to describe public health research that uses data gathered from social networking sites, search engine queries, cell phones, or other technologies. In the third sense, "Public Health 2.0" is used to describe public health activities that are completely user-driven. An example this type of Public Health 2.0 is the collection and sharing of information about environmental radiation levels following the March 2011 tsunami in Japan. In all cases, Public Health 2.0 draws on ideas from Web 2.0
Web 2.0
The term Web 2.0 is associated with web applications that facilitate participatory information sharing, interoperability, user-centered design, and collaboration on the World Wide Web...

, such as crowdsourcing
Crowdsourcing
Crowdsourcing is the act of sourcing tasks traditionally performed by specific individuals to a group of people or community through an open call....

, information sharing
Information sharing
The term "information sharing" gained popularity as a result of the 9/11 Commission Hearings and its report of the United States government's lack of response to information known about the planned terrorist attack on the New York City World Trade Center prior to the event...

, and user-centred design.

Education and training

Education and training of public health professionals is available throughout the world in Medical Schools, Veterinary Schools, Schools of Nursing, Schools of Public Health, and Schools of Public Affairs. The training typically requires a university degree with a focus on core disciplines of biostatistics
Biostatistics
Biostatistics is the application of statistics to a wide range of topics in biology...

, epidemiology
Epidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...

, health services administration
Health administration
Health administration or healthcare administration is the field relating to leadership, management, and administration of hospitals, hospital networks, health care systems, and public health systems...

, health policy, health education
Health education
Health education is the profession of educating people about health. Areas within this profession encompass environmental health, physical health, social health, emotional health, intellectual health, and spiritual health...

, behavioral science and environmental health
Environmental health
Environmental health is the branch of public health that is concerned with all aspects of the natural and built environment that may affect human health...

.

Schools of public health

In the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

, the Welch-Rose Report of 1915 has been viewed as the basis for the critical movement in the history of the institutional schism between public health and medicine because it led to the establishment of schools of public health supported by the Rockefeller Foundation
Rockefeller Foundation
The Rockefeller Foundation is a prominent philanthropic organization and private foundation based at 420 Fifth Avenue, New York City. The preeminent institution established by the six-generation Rockefeller family, it was founded by John D. Rockefeller , along with his son John D. Rockefeller, Jr...

. The report was authored by William Welch
William Welch
William C. Welch is an American professional wrestler, better known by his ring name The Messiah.-Professional wrestling career:...

, founding dean of the Johns Hopkins Bloomberg School of Public Health
Johns Hopkins Bloomberg School of Public Health
The Johns Hopkins Bloomberg School of Public Health is part of Johns Hopkins University in Baltimore, Maryland, United States...

, and Wycliffe Rose of the Rockefeller Foundation. The report focused more on research than practical education. Some have blamed the Rockefeller Foundation's 1916 decision to support the establishment of schools of public health for creating the schism between public health and medicine and legitimizing the rift between medicine's laboratory investigation of the mechanisms of disease and public health's nonclinical concern with environmental and social influences on health and wellness.

Even though schools of public health had already been established in Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...

, Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...

 and North Africa
North Africa
North Africa or Northern Africa is the northernmost region of the African continent, linked by the Sahara to Sub-Saharan Africa. Geopolitically, the United Nations definition of Northern Africa includes eight countries or territories; Algeria, Egypt, Libya, Morocco, South Sudan, Sudan, Tunisia, and...

, the US had still maintained the traditional system of housing faculties of public health within their medical institutions. A $25,000 donation from businessman Samuel Zemurray, instituted the country's first School of Hygiene and Tropical Medicine in 1912, laying the groundwork for today's School of Public Health and Tropical Medicine at Tulane University
Tulane University School of Public Health and Tropical Medicine
The Tulane School of Public Health and Tropical Medicine is part of Tulane University of Louisiana. It is the oldest school of public health in the United States and the only American school of Tropical Medicine.-Departments:...

 . A year following the Welch-Rose report, and four years following Samuel Zemurray's donation to Tulane, the Johns Hopkins School of Hygiene and Public Health was founded in 1916. By 1922, schools of public health were established in Columbia
Columbia University
Columbia University in the City of New York is a private, Ivy League university in Manhattan, New York City. Columbia is the oldest institution of higher learning in the state of New York, the fifth oldest in the United States, and one of the country's nine Colonial Colleges founded before the...

, Harvard and Yale
YALE
RapidMiner, formerly YALE , is an environment for machine learning, data mining, text mining, predictive analytics, and business analytics. It is used for research, education, training, rapid prototyping, application development, and industrial applications...

 universities. By 1999 there were twenty nine schools of public health in the US, enrolling around fifteen thousand students.

Over the years, the types of students and training provided have also changed. In the beginning, students who enrolled in public health schools typically had already obtained a medical degree; public health school training was largely a second degree for medical professionals
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

. However, in 1978, 69% of American students enrolled in public health schools had only a bachelor's degree
Bachelor's degree
A bachelor's degree is usually an academic degree awarded for an undergraduate course or major that generally lasts for three or four years, but can range anywhere from two to six years depending on the region of the world...

.

Degrees in public health

Schools of public health offer a variety of degrees which generally fall into two categories: professional or academic. The two major postgraduate professional degrees are the Master of Public Health
Master of Public Health
The Master of Public Health and the Doctor of Public Health are multi-disciplinary professional degrees awarded for studies in areas related to public health....

 (MPH) or the Master of Science
Master of Science
A Master of Science is a postgraduate academic master's degree awarded by universities in many countries. The degree is typically studied for in the sciences including the social sciences.-Brazil, Argentina and Uruguay:...

 in Public Health (MSPH). Doctoral studies in this field include Doctor of Public Health
Professional degrees of public health
The Master of Public Health and the Doctor of Public Health are multi-disciplinary professional degrees awarded for studies in areas related to public health....

 (DrPH) and Doctor of Philosophy
Doctor of Philosophy
Doctor of Philosophy, abbreviated as Ph.D., PhD, D.Phil., or DPhil , in English-speaking countries, is a postgraduate academic degree awarded by universities...

 (PhD) in a subspeciality of greater Public Health disciplines. DrPH is regarded as a professional leadership degree and PhD is more an academic degree.

Professional degrees are oriented towards practice in public health settings. The Master of Public Health
Master of Public Health
The Master of Public Health and the Doctor of Public Health are multi-disciplinary professional degrees awarded for studies in areas related to public health....

, Doctor of Public Health, Doctor of Health Science
Doctor of Health Science
The Doctor of Health Science is a post-professional academic degree for those who intend to pursue or advance a professional practice career in Health Arts and Sciences, and Health Care Delivery Systems, to include clinical practice, education, administration, and research. Individuals who...

 (DHSc) and the Master of Health Care Administration
Master of Health Administration
The Master of Health Administration is a master's-level professional degree granted to students who complete a course of study in the knowledge and competencies needed for careers in health administration, involving the management of hospitals and other health services organizations, as well as...

 are examples of degrees which are geared towards people who want careers as practitioners of public health in health departments, managed care and community-based organizations, hospitals and consulting firms among others. Master of Public Health
Master of Public Health
The Master of Public Health and the Doctor of Public Health are multi-disciplinary professional degrees awarded for studies in areas related to public health....

 degrees broadly fall into two categories, those that put more emphasis on an understanding of epidemiology and statistics as the scientific basis of public health practice and those that include a more eclectic range of methodologies. A Master of Science of Public Health is similar to an MPH but is considered an academic degree (as opposed to a professional degree) and places more emphasis on quantitative methods and research. The same distinction can be made between the DrPH and the DHSc. The DrPH is considered a professional degree and the DHSc is an academic degree.

Academic degrees are more oriented towards those with interests in the scientific basis of public health and preventive medicine
Preventive medicine
Preventive medicine or preventive care refers to measures taken to prevent diseases, rather than curing them or treating their symptoms...

 who wish to pursue careers in research, university teaching in graduate programs, policy analysis and development, and other high-level public health positions. Examples of academic degrees are the Master of Science
Master of Science
A Master of Science is a postgraduate academic master's degree awarded by universities in many countries. The degree is typically studied for in the sciences including the social sciences.-Brazil, Argentina and Uruguay:...

, Doctor of Philosophy
Doctor of Philosophy
Doctor of Philosophy, abbreviated as Ph.D., PhD, D.Phil., or DPhil , in English-speaking countries, is a postgraduate academic degree awarded by universities...

, Doctor of Science
Doctor of Science
Doctor of Science , usually abbreviated Sc.D., D.Sc., S.D. or Dr.Sc., is an academic research degree awarded in a number of countries throughout the world. In some countries Doctor of Science is the name used for the standard doctorate in the sciences, elsewhere the Sc.D...

 (ScD), and Doctor of Health Science
Doctor of Health Science
The Doctor of Health Science is a post-professional academic degree for those who intend to pursue or advance a professional practice career in Health Arts and Sciences, and Health Care Delivery Systems, to include clinical practice, education, administration, and research. Individuals who...

 (DHSc). The doctoral programs are distinct from the MPH and other professional programs by the addition of advanced coursework and the nature and scope of a dissertation research project.

In the United States, the Association of Schools of Public Health represents Council on Education for Public Health
Council on Education for Public Health
The Council on Education for Public Health is an independent agency recognized by the U.S. Department of Education to accredit schools of public health as well as certain programs offered in settings other than in schools of public health...

 (CEPH) accredited schools of public health. Delta Omega
Delta Omega
Delta Omega is the honorary society for graduate studies in public health. The society was founded in 1924 at the Johns Hopkins University Bloomberg School of Public Health. Currently, there are approximately 50 chapters throughout the United States and Puerto Rico.Since Delta Omega's...

 is the honorary society
Honor society
In the United States, an honor society is a rank organization that recognizes excellence among peers. Numerous societies recognize various fields and circumstances. The Order of the Arrow, for example, is the national honor society of the Boy Scouts of America...

 for graduate studies in public health. The society was founded in 1924 at the Johns Hopkins School of Hygiene and Public Health. Currently, there are approximately 68 chapters throughout the United States and Puerto Rico.

Public health programs

Today, most governments recognize the importance of public health programs in reducing the incidence disease, disability, and the effects of aging and other physical and mental health conditions, although public health generally receives significantly less government funding compared with medicine. In recent years, public health programs providing vaccination
Vaccination
Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...

s have made incredible strides in promoting health, including the eradication of smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...

, a disease that plagued humanity for thousands of years.

The World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

 (WHO) identifies core functions of public health programs including:
  • providing leadership on matters critical to health
    Health
    Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...

     and engaging in partnerships where joint action is needed;
  • shaping a research
    Research
    Research can be defined as the scientific search for knowledge, or as any systematic investigation, to establish novel facts, solve new or existing problems, prove new ideas, or develop new theories, usually using a scientific method...

     agenda and stimulating the generation, translation and dissemination of valuable knowledge;
  • setting norms and standards and promoting and monitoring their implementation;
  • articulating ethical and evidence-based policy
    Evidence-based policy
    Evidence-based policy is public policy informed by rigorously established objective evidence. It is an extension of the idea of evidence-based medicine to all areas of public policy...

     options;
  • monitoring the health situation and assessing health trends.


In particular, public health surveillance programs can:
  • serve as an early warning system for impending public health emergencies;
  • document the impact of an intervention, or track progress towards specified goals; and
  • monitor and clarify the epidemiology of health problems, allow priorities to be set, and inform health policy and strategies.
  • diagnose, investigate, and monitor health problems and health hazards of the community


Public health surveillance has led to the identification and prioritization of many public health issues facing the world today, including HIV/AIDS, diabetes, waterborne diseases
Waterborne diseases
Waterborne diseases are caused by pathogenic microorganisms which are directly transmitted when contaminated fresh water is consumed. Contaminated fresh water, used in the preparation of food, can be the source of foodborne disease through consumption of the same microorganisms...

, zoonotic diseases
Zoonosis
A zoonosis or zoonoseis any infectious disease that can be transmitted from non-human animals to humans or from humans to non-human animals . In a study of 1415 pathogens known to affect humans, 61% were zoonotic...

, and antibiotic resistance
Antibiotic resistance
Antibiotic resistance is a type of drug resistance where a microorganism is able to survive exposure to an antibiotic. While a spontaneous or induced genetic mutation in bacteria may confer resistance to antimicrobial drugs, genes that confer resistance can be transferred between bacteria in a...

 leading to the reemergence of infectious diseases such as tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

. Antibiotic resistance, also known as drug resistance, was the theme of World Health Day 2011
World Health Day
World Health Day is celebrated every year on 7 April, under the sponsorship of the World Health Organization .In 1948, the World Health Organization held the First World Health Assembly. The Assembly decided to celebrate 7 April of each year, with effect from 1950, as the World Health Day...

.

For example, the WHO reports that at least 220 million people worldwide suffer from diabetes. Its incidence is increasing rapidly, and it is projected that the number of diabetes deaths will double by the year 2030. In a June 2010 editorial in the medical journal The Lancet
The Lancet
The Lancet is a weekly peer-reviewed general medical journal. It is one of the world's best known, oldest, and most respected general medical journals...

, the authors opined that "The fact that type 2 diabetes, a largely preventable disorder, has reached epidemic proportion is a public health humiliation." The risk of type 2 diabetes is closely linked with the growing problem of obesity
Obesity
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...

. The WHO’s latest estimates highlighted that globally approximately 1.5 billion adults were overweight in 2008, and nearly 43 million children under the age of five were overweight in 2010. The United States is the leading country with 30.6% of its population being obese. Mexico follows behind with 24.2% and the United Kingdom with 23%. Once considered a problem in high-income countries, it is now on the rise in low-income countries, especially in urban settings. Many public health programs are increasingly dedicating attention and resources to the issue of obesity, with objectives to address the underlying causes including healthy diet
Healthy diet
A healthy diet is one that helps maintain or improve general health. It is important for lowering many chronic health risks, such as obesity, heart disease, diabetes, hypertension and cancer. A healthy diet involves consuming appropriate amounts of all essential nutrients and an adequate amount of...

 and physical exercise
Physical exercise
Physical exercise is any bodily activity that enhances or maintains physical fitness and overall health and wellness. It is performed for various reasons including strengthening muscles and the cardiovascular system, honing athletic skills, weight loss or maintenance, as well as for the purpose of...

.

Some programs and policies associated with public health promotion and prevention can be controversial. One such example is programs focusing on the prevention of HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

 transmission through safe sex
Safe sex
Safe sex is sexual activity engaged in by people who have taken precautions to protect themselves against sexually transmitted diseases such as AIDS. It is also referred to as safer sex or protected sex, while unsafe or unprotected sex is sexual activity engaged in without precautions...

 campaigns and needle-exchange programme
Needle-exchange programme
A Needle & syringe programme or syringe-exchange programme is a social policy based on the philosophy of harm reduction where injecting drug users can obtain hypodermic needles and associated injection equipment at little or no cost. Many programmes are called "exchanges" because some require...

s. Another is the control of tobacco smoking
Tobacco smoking
Tobacco smoking is the practice where tobacco is burned and the resulting smoke is inhaled. The practice may have begun as early as 5000–3000 BCE. Tobacco was introduced to Eurasia in the late 16th century where it followed common trade routes...

. Changing smoking behavior requires long term strategies, unlike the fight against communicable diseases which usually takes a shorter period for effects to be observed. Many nations have implemented major initiatives to cut smoking, such as increased taxation and bans on smoking in some or all public places. Proponents argue by presenting evidence that smoking is one of the major killers, and that therefore governments have a duty to reduce the death rate, both through limiting passive (second-hand) smoking
Passive smoking
Passive smoking is the inhalation of smoke, called secondhand smoke or environmental tobacco smoke , from tobacco products used by others. It occurs when tobacco smoke permeates any environment, causing its inhalation by people within that environment. Exposure to secondhand tobacco smoke causes...

 and by providing fewer opportunities for people to smoke. Opponents say that this undermines individual freedom and personal responsibility, and worry that the state may be emboldened to remove more and more choice in the name of better population health overall.

Simultaneously, while communicable diseases have historically ranged uppermost as a global health
Global health
Global health is the health of populations in a global context and transcends the perspectives and concerns of individual nations. Health problems that transcend national borders or have a global political and economic impact, are often emphasized...

 priority, non-communicable disease
Non-communicable disease
A non-communicable disease, or NCD, is a medical condition or disease which is non-infectious. NCDs are diseases of long duration and generally slow progression. They include heart disease, stroke, cancer, asthma, diabetes, chronic kidney disease, osteoporosis, Alzheimer's disease, cataracts, and...

s and the underlying behavior-related risk factors have been at the bottom. This is changing however, as illustrated by the United Nations
United Nations
The United Nations is an international organization whose stated aims are facilitating cooperation in international law, international security, economic development, social progress, human rights, and achievement of world peace...

 hosting its first General Assembly Special Summit on the issue of non-communicable diseases in September 2011.

Applications in healthcare

As well as seeking to improve population health through the implementation of specific population-level interventions, public health contributes to medical care by identifying and assessing population needs for health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...

 services, including:
  • Assessing current services and evaluating whether they are meeting the objectives of the health care system
    Health care system
    A health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations....

  • Ascertaining requirements as expressed by health professionals
    Health care provider
    A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities....

    , the public and other stakeholders
  • Identifying the most appropriate interventions
  • Considering the effect on resources for proposed interventions and assessing their cost-effectiveness
  • Supporting decision making in health care and planning health services including any necessary changes.
  • Informing, educating, and empowering people about health issues

See also

  • Behavioral medicine
    Behavioral medicine
    Behavioral medicine is an interdisciplinary field of medicine concerned with the development and integration of knowledge in the biological, behavioral, psychological, and social sciences relevant to health and illness...

  • Breastfeeding promotion
    Breastfeeding promotion
    Breastfeeding promotion refers to coordinated activities and policies to promote health among women, newborns and infants through breastfeeding....

  • Diseases of affluence
    Diseases of affluence
    Diseases of affluence is a term sometimes given to selected diseases and other health conditions which are commonly thought to be a result of increasing wealth in a society...

     / Diseases of poverty
    Diseases of poverty
    Diseases of poverty is a term sometimes used to collectively describe diseases and health conditions that are more prevalent among the poor than among wealthier people. In many cases poverty is considered the leading risk factor or determinant for such diseases, and in some cases the diseases...

  • Environmental epidemiology
    Environmental epidemiology
    Environmental epidemiology is the branch of epidemiology concerned with discovery of the environmental exposures that contribute to or protect against injuries, illnesses, developmental conditions, disabilities, and deaths; and identification of public health and health care actions to avoid,...

  • Environmental health
    Environmental health
    Environmental health is the branch of public health that is concerned with all aspects of the natural and built environment that may affect human health...

  • Epidemiology
    Epidemiology
    Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...

  • Global health
    Global health
    Global health is the health of populations in a global context and transcends the perspectives and concerns of individual nations. Health problems that transcend national borders or have a global political and economic impact, are often emphasized...

  • Global Mental Health
    Global Mental Health
    The World Health Organization defines mental health as a 'state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community'.The term Global...

  • Health care delivery
  • Health care provider
    Health care provider
    A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities....

    s
  • Health Officers
    Health Officers
    Health Officers is a common term used in the United States and elsewhere for public health officials. Public health officials may serve at the global, federal, state, county, or municipal level...

  • Health profession
    Health profession
    The health care industry, or medical industry, is the sector of the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, palliative, or, at times, unnecessary care...

  • List of preventable causes of death
  • National public health institutes
    National public health institutes
    National public health institutes are science-based governmental organizations that serve as a focal point for a country's public health efforts, as well as a critical component of global disease prevention and response systems...

  • One Health
    One Health
    One Health has been defined as "the collaborative effort of multiple disciplines-working locally, nationally, and globally – to attain optimal health for people, animals and the environment."-Background:...

  • Public health journals
  • Public health law
    Public health law
    Law is an important public health tool that plays a critical role in reducing illness and premature death. Public health law examines the authority of the government at various jurisdictional levels to improve the health of the general population within societal limits and norms.Public health law...

  • Universal health care
    Universal health care
    Universal health care is a term referring to organized health care systems built around the principle of universal coverage for all members of society, combining mechanisms for health financing and service provision.-History:...

  • World Health Report
    World Health Report
    The World Health Report is a series of reports produced regularly by the World Health Organization . First published in 1995, the World Health Report is WHO's leading publication...



International public health strategies and programs
  • Global Strategy for Women's and Children's Health
    Global Strategy for Women's and Children's Health
    The Global Strategy for Women's and Children's Health is a program of the United Nations directed at improving women's and children's health in the developing world.The program was announced by UN Secretary-General Ban Ki-moon in September 2010...

  • International Code of Marketing of Breast-milk Substitutes
    International Code of Marketing of Breast-milk Substitutes
    The International Code of Marketing of Breastmilk Substitutes is an international health policy framework for breastfeeding promotion adopted by the World Health Assembly of the World Health Organization in 1981...

  • Millennium Development Goals
    Millennium Development Goals
    The Millennium Development Goals are eight international development goals that all 193 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015...

  • The Global Fund to Fight AIDS, Tuberculosis and Malaria
    The Global Fund to Fight AIDS, Tuberculosis and Malaria
    The Global Fund to Fight AIDS, Tuberculosis and Malaria is an international financing organization that aims to "[a]ttract and disburse additional resources to prevent and treat HIV and AIDS, tuberculosis and malaria." A public–private partnership, the organization has its secretariat in Geneva,...

  • WHO Framework Convention on Tobacco Control


External links

  • Centre for History in Public Health, London School of Hygiene & Tropical Medicine
    London School of Hygiene & Tropical Medicine
    The London School of Hygiene & Tropical Medicine is a constituent college of the federal University of London, specialising in public health and tropical medicine...

  • Health-EU, the official public health portal of the European Union
    European Union
    The European Union is an economic and political union of 27 independent member states which are located primarily in Europe. The EU traces its origins from the European Coal and Steel Community and the European Economic Community , formed by six countries in 1958...

  • Healthy Stories, a collection of stories concerning public health from the Miami-Dade County
    Miami-Dade County, Florida
    Miami-Dade County is a county located in the southeastern part of the state of Florida. As of 2010 U.S. Census, the county had a population of 2,496,435, making it the most populous county in Florida and the eighth-most populous county in the United States...

    Health Department
  • What Is Public Health? by the Association of Schools of Public Health
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