The rise and falls of public health

Question 1

what is the definition of public health (3P’s)

Answer 1

preventing disease
prolonging life
promoting health
through the organised efforts and informed choices of society, organisations, communities and individuals.

Question 2

what is clinical medicine

Answer 2

example- giving one child a vaccine through explaining the risks and benefits to the parents

Question 3

what is public health

Answer 3

example- how giving the vaccine to lots of children, overall affects the general health of the population.

Question 4

what can be actively done to help with public health.

Answer 4

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

Question 5

what was believed in the first dark ages about public health.

Answer 5

practice cleanliness for religious reasons

epidemics were wicked of mankind

Question 6

what was believed in the first golden age about public health

Answer 6

Hippocrates
link disease and the environment
disease epidemics are dependent on seasons of the year

Question 7

what was used in the second golden age

Answer 7

sewers and public baths

Question 8

what was used in the second dark age

Answer 8

plaque and perstilence

Question 9

what occurred in the third dark age

Answer 9

pollution, overcrowding, poor housing, contaminated water and disease.

Question 10

when were the public health acts established.

Answer 10

3rd golden age

Question 11

what years was the 1st public health act and what did it state

Answer 11

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

Question 12

what year was the 2nd public health act and what did it state

Answer 12

1872- local medical officer of health was established

Question 13

what year was the 3rd public health act and what did it state

Answer 13

1875- enforced laws about slum clearance, provision of sewers and clean water, and the removal of nuisances.

Question 14

in what year were free school meals introduced

Answer 14

1906

Question 15

in what year were school medical examinations introduced

Answer 15

1907

Question 16

in what year were old age pensions introduced

Answer 16

1908

Question 17

in what year was the national insurance introduced

Answer 17

1911

Question 18

In what year was the NHS established

Answer 18

1948

Question 19

What discovery did Ignaz Philip Semmelweis make

Answer 19

Doctors wards had 3 times mortality of midwifes wards- just because lack of hand handwashing.

Question 20

when were Koch postulates established

Answer 20

1884

Microorganism is found in people with the disease but not in healthy people.

Question 21

what measures were undertaken to help reduce the public health effects of Gin

Answer 21

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.

Question 22

what measures are undertaken to help reduce the public health effects of tobacco and alcohol.

Answer 22

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.

Question 23

what are the options on a intervention ladder.

Answer 23

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

Question 24

Are stop smoking programmes, cycle lanes, free fruit in schools enabling choices, or guiding through incentives

Answer 24

enabling choice.

Question 25

what makes public health interventions good.

Answer 25

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