Lecture 3: Public Health Principles and Practice in Nutrition

Question 1

John Snow

Answer 1

Proved that cholera was coming from the water.

scientists consider Snow to be the pioneer of public health research in a field known as epidemiology. Much of the current epidemiological research done at the U.S. Centers for Disease Control, which still uses theories such as Snows’ to track the sources and causes of many diseases.

Question 2

What is paradigm shift?

Answer 2

A paradigm shift (also radical theory change), a concept identified by the American physicist and philosopher Thomas Kuhn (1922–1996), is a fundamental change in the basic concepts and experimental practices of a scientific discipline.

Question 3

What are the 6 eras of public health?

Answer 3

1. Health protection
2. Miasma control
3. Contagion control
4. Preventive medicine
5. Primary healthcare
6. Health promotion

Question 4

Explain the health protection era (antiquity-1830)

Answer 4

• Diseases may be prevented by enforced regulation of human behavior, mediated through societies’ social structures
• Interpretation/promulgation of religious and cultural rules that are thought by the ruling elites to protect the health of the individual and the community
• Enforcement of spiritual practices, community taboos, customs, and quarantine

Question 5

What are the legacies of health protection era incorporated into contemporary public health?

Answer 5

Quarantine of illegal migrants; enforcement of some environmental protection laws; aspects of spirituality in prevention and coping with disease some occupational and transport safety laws

Question 6

Explain the miasma control era (1840-1870)

Answer 6

• Addressing unsanitary environmental conditions may prevent diseases
• Demonstration that poor health and epidemics resulted directly from unsanitary physical and social environments
• Centralized action to improve environmental sanitation; public health legislation relating to minimum standards for drainage, sewage, and refuse disposal

Question 7

What are the legacies of miasma control era incorporated into contemporary public health?

Answer 7

Aspects of Heathy Cities Initiatives; potable water and sanitation programs; legal framework for implementing public health activities; foundations of modern epidemiology and surveillance

Question 8

Explain the contagion control era (1880-1930)

Answer 8

• Germ Theory: positivist approach to demonstration of infectious origins of diseases
• Demonstration of the presence of disease-causing microorganisms in infected media, their isolation, and experimental transmission
• Interruption of disease transmission through water filtration processes; vaccination; standardized disease outbreak control measures

Question 9

What are the legacies of contagion control era incorporated into contemporary public health?

Answer 9

Evidence based public health practice; ethical vaccination practices; foundations for international cooperation in health; foundations for modern chemotherapy

Question 10

Explain the preventive medicine era (1940-1960)

Answer 10

• Improvements in public health through fouls on the prevention and cure of diseases in “high-risk groups”
• Definition of, and interventions aimed at, main avenues for disease transmission. Medical dominance, with focus on treatment of communicable diseases and primary care of “special populations” (e.g., pregnant women and factory workers)
• Environmental interventions directed at disease vectors such as mosquitos; identification and use of “useful” microbes; enhanced medical care for “high-risk groups”; foundations of modern clinical pathology

Question 11

What are the legacies of preventive medicine era incorporated into contemporary public health?

Answer 11

Focus on “high-risk groups” in the planning and implementation of public health programs; improved understanding of the pathogenesis of communicable and noncommunicable diseases

Question 12

Explain the primary healthcare era (1970-1980)

Answer 12

• Health for All: effective health care geared toward the community, for the community, and by the community
• Largely preventive health care approach, underpinned by emphasis on equity, community participation, accessibility of services, and social determinants of health
• Emphasis on global cooperation and peace; adapting health services to countries and communities; links between health care and socioeconomic development; intersectoral cooperation in health promotion and disease prevention; equity in health care.

Question 13

What are the legacies of primary healthcare era incorporated into contemporary public health?

Answer 13

Concepts underpinning multicultural health and Health Cities Initiatives, health inequalities, and community participation in health promotion activities.

Question 14

Explain the health promotion era (1990-present)

Answer 14

• Advocacy for health; enabling individuals and communities to attain optimal health
• Individuals and communities may be assisted by educational, economic, and political actions to increase control over, and improve, their health through attitudinal, behavioral, social, and environmental changes.
• Encapsulated by the key action areas of the Ottawa Charter; build health public policy; create supportive environments; strengthen community action; develop personal skills; and reorient health services.

Question 15

Who used the world “health promotion” first?

Answer 15

‘Health Promotion’ as a term was used for the first time by Marc Lalonde Minister of national Health and Welfare in 1974.

Question 16

What does the Lalonde report say?

Answer 16

Based on evidence, the Lalonde Report suggested that health care services were not the most important determinant of health.

The four “health fields” are – lifestyle, environment, health care organization, human biology

Major improvements in health would result primarily from improvements in lifestyle, environment and our knowledge of human biology.

Question 17

What are the four health fields that are mentioned in the Lalonde report?

Answer 17

• lifestyle
• environment
• health care organization
• human biology

Question 18

Lalonde Report says that major improvements in health would result primarily from improvements in _____

Answer 18

lifestyle, environment and our knowledge of human biology.

Question 19

What was Ottawa Charter for Health Promotion about?

Answer 19

This conference was primarily a response to growing expectations for a new public health movement around the world.

Question 20

Define “Health Promotion”

Answer 20

Health promotion is the process of enabling people to increase control over, and to improve, their health.

Question 21

To reach a state of complete physical, mental and social well-being, an individual or group must be able to __________

Answer 21

identify and to realize aspirations, to satisfy needs, and to change or cope with the environment.

Question 22

How is health defined in health promotion idea?

Answer 22

Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being

Question 23

What are the health promotion actions?

Answer 23

 Build healthy Public Policy
 Create Supportive Environments 
 Strengthen Community Action 
 Develop Personal Skills
 Reorient Health Services

Question 24

What are blue zones?

Answer 24

Blue Zones are regions of the world where Dan Buettner claims people live much longer than average.

Question 25

What are the 9 power principles of blue zones?

Answer 25

• Move naturally
• Wine five
• Know your purpose
• Right tribe
• Down shift
• Community
• 80% rule (stomach)
• Loved ones first
• Plant slant

Question 26

What are the social structures of health underlying patterns of inequities?

Answer 26

 Social class
 Gender
 Racism
 Poverty
 Educational status
 Underlying power, status and access to resources.