The rise and falls of public health Flashcards
what is the definition of public health (3P’s)
preventing disease
prolonging life
promoting health
through the organised efforts and informed choices of society, organisations, communities and individuals.
what is clinical medicine
example- giving one child a vaccine through explaining the risks and benefits to the parents
what is public health
example- how giving the vaccine to lots of children, overall affects the general health of the population.
what can be actively done to help with public health.
surveillance and assessment of the population’s health.
assess effectiveness of interventions and services
developing policy and statergy
leadership and collaborative working for health
health improvement
health protection
health and social service quality
public health intelligence
what was believed in the first dark ages about public health.
practice cleanliness for religious reasons
epidemics were wicked of mankind
what was believed in the first golden age about public health
Hippocrates
link disease and the environment
disease epidemics are dependent on seasons of the year
what was used in the second golden age
sewers and public baths
what was used in the second dark age
plaque and perstilence
what occurred in the third dark age
pollution, overcrowding, poor housing, contaminated water and disease.
when were the public health acts established.
3rd golden age
what years was the 1st public health act and what did it state
1848-Public health act
central board imposed local health boards in areas where the death rate was above average.
Local boards- managed street cleaning, refuse collection, water supplies and sewers
what year was the 2nd public health act and what did it state
1872- local medical officer of health was established
what year was the 3rd public health act and what did it state
1875- enforced laws about slum clearance, provision of sewers and clean water, and the removal of nuisances.
in what year were free school meals introduced
1906
in what year were school medical examinations introduced
1907
in what year were old age pensions introduced
1908
in what year was the national insurance introduced
1911
In what year was the NHS established
1948
What discovery did Ignaz Philip Semmelweis make
Doctors wards had 3 times mortality of midwifes wards- just because lack of hand handwashing.
when were Koch postulates established
1884
Microorganism is found in people with the disease but not in healthy people.
what measures were undertaken to help reduce the public health effects of Gin
1736- Gin act imposed a prohibitively high duty on Gin
1742-gin act abolished
1751- restricted gin sales to licensed premises.
19th century restricted opening hours
1914- defence of the realm act
2005- 24 hour opening possible.
what measures are undertaken to help reduce the public health effects of tobacco and alcohol.
Increase public awareness- campaigns and health warnings on products.
Pricing and taxation
Advertising and merchandising by industry.
Restrictions and regulation at point of sale.
Addressing antisocial behaviour
Clinical treatment for patients with problems.
what are the options on a intervention ladder.
Do nothing or simply monitor the situation
Provide information e.g. Campaign for 5 a day
Enable choice e.g. ‘stop smoking programmes, cycle lanes, free fruit in schools
Guide choices through changing the default policy e.g. Restaurants make health option the norm with chips as option
Guide choices through incentives
Guide choice through disincentives
Restrict choice e.g. Removing unhealthy ingredients from food in shops or restaurants
Eliminate choice
Are stop smoking programmes, cycle lanes, free fruit in schools enabling choices, or guiding through incentives
enabling choice.
what makes public health interventions good.
Public generally supportive or at least not antagonistic
Good evidence that initiative will produce the desired effect
The restriction is proportionate to the risk to the public health
The benefits to the public health out-weigh the downsides of the policy
The people who are impacted by the policy are the ones most likely to benefit
No less intrusive alternatives
Initiative focuses on the specific behaviour and has limited impact on other aspects of public life
