Public Health History
Public Health History of Public Health
Introduction to Public Health History
People in ancient societies were concerned about personal hygiene and sanitation for religious reasons. The Bible contains many rules for cleanliness, and describes public health measures still important today. These include quarantining the sick to prevent the spread of disease and avoiding contact with objects used by sick people.
The Greek physician Hippocrates first made the connection between disease and natural environmental factors in the 4th century bc. His treatise Airs, Waters, and Places described how diseases can result from way of life, climate, impure water, and other environmental factors. For the next 2000 years, it was the most widely used text on public health and epidemiology.
Ancient Romans adopted Greek ideas about public health after colonizing Greece in the 1st century bc. Rome’s greatest contributions to public health involved sanitary engineering. They built aqueducts to supply Rome with pure water and a public sewer system to carry away wastes, as well as public baths and hospitals. The Roman government also hired physicians and assigned them to villages to care for the poor.
After the Roman Empire collapsed in ad 476 public health efforts were forgotten and unsanitary conditions returned. Millions of people died when great epidemics of smallpox, leprosy, bubonic plague, tuberculosis, and other diseases swept across Europe in the Middle Ages (5th to 15th centuries ad). The first modern advances in public health occurred as officials tried to cope with disease epidemics. They used tactics including quarantining sick people to prevent the spread of disease; disinfecting objects that came into contact with the sick; and establishing observation stations to monitor outbreaks of disease. City officials also realized the importance of disposing of human wastes and garbage, which previously were thrown into the street where they attracted flies and rats; and providing clean drinking water.
In the 19th and 20th centuries, efforts to improve sanitation, especially in big cities, have had a major impact in improving human health and increasing life expectancy. Many medical advances, including the introduction of antibiotics and vaccines, became important tools of public health. The first health departments were established in cities and rural areas. In the United States, public health measures to prevent the spread of infectious disease were so effective that by the late 1970s, U.S. health experts expected to eradicate infectious disease by the end of the 20th century.
In the 1980s, however, public health officials realized that infectious diseases remained a major international threat. Tuberculosis and other infections, once regarded as under control, appeared in forms resistant to conventional antibiotics. New infectious diseases, such as AIDS and new forms of hepatitis, took the world by storm. A global epidemic of AIDS began in 1981, and intensive, multibillion dollar global efforts to curb the spread of AIDS continue to dominate the public health front. International education campaigns have significantly reduced the spread of AIDS in many regions of the world. Although medical research has produced promising drugs (though often prohibitively expensive), no cure has been found and intensive multinational efforts to find a cure or a vaccine for AIDS continue.
Experts predict that viruses yet undiscovered may pose the greatest challenges to public health yet. Global population levels are increasing at exponential levels, and the pressing need for food and housing results in the clearing of previously uninhabited tropical forests at equally alarming rates. In this process, humans are exposed to disease-causing viruses previously confined deep within tropical rain forests. Because humans have never before been exposed to these viruses, experts predict that we will have no natural immunity to them, and they may have devastating health effects.
New viruses will spread faster and more efficiently than ever before. In the past, geographic barriers confined outbreaks to particular regions because those infected were not able to make the often arduous trips across mountain ranges, deserts, or oceans. But efficient and affordable airplane travel has virtually eliminated these barriers to transmission-it is now possible for someone to be exposed to a deadly virus and travel across the globe before showing signs of infection. Future public health efforts will have to address ways to manage global outbreaks of new diseases in a world more densely populated than ever before.” (1)
Resources
Notes and References
- Information about Public Health History in the Encarta Online Encyclopedia
Leave a Reply