A Short History of Public Health

Although medicine and public health share a lot of the same concerns relating to human health, the two disciplines approach the problem differently. Public health primarily focuses on treating the population, but these concerns about the population are tempered by concerns about the individual, the emphasis is on prevention and health promotion for the entire community and the intervention is in the areas of the environment, human behavior and medical care. Medicine focuses on the treatment of the individual, the emphasis is on diagnosis and treatment of the patient and the predominant emphasis is on medical care.

The principle public health story is that of John Snow, a London physician. In 1854, he was concerned about outbreaks of cholera in London. He plotted the deaths resulting from an outbreak on a map of London and found that they were clustered in a specific area. He concluded that the disease was probably a result of drinking contaminated water from a pump on Broad Street. His approach was a classic “public health” approach. 

• Sanitation/ prevention of water-borne diseases: The first big step in improving public health was an improvement in sanitation resulting in the availability of unpolluted water for the general population.
• Diseases from the Biological Environment: Smallpox was being controlled through vaccination - the first disease controlled in this fashion.
• Diseases from exposure to the Physical Environment/Occupational Health: occupational diseases were treated in many ways by limiting exposure through engineering controls, masks and by limiting the exposure through job rotation.
• Diseases from exposure to the Physical Environment/Environmental Pollution: immediate, dramatic decrease in bronchitis, asthma and other respiratory diseases went back up to their previous levels.
• Risk analysis and Individual Behavior: As infectious disease was controlled, human mortality was greatly improved. However, it was realized that we don’t live in a risk-free world.
• As we head into the twenty-first century, public health systems are facing a range of new and continuing challenges including the re-emergence of once rare communicable diseases, new types of illness, injury, and disease, new social problems that affect health, and changing definitions of health. 

However, many pandemic diseases like AIDS, avian flu, etc. have emerged and there are new factors at play. So the battle is far from over.