'This Is Public Health' - a Comparison Between Old and New Public Health Systems in Australia

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As the term ‘health’ progresses to even more dynamic and ambiguous territories in the world today, health promotion and public health organisations have become increasingly important and prevalent in our society. As the World Health Organisation has tried to define health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’, it is obvious that health is viewed from many perspectives today and this can help explain the trends and shifts in public health as it tries to address a more modern and relevant set of determinates of health.

The determinates of health are the circumstances under which people live that can contribute to their health or ill health and can cause drastic inequity between communities and people. As public health strives to shift towards this more holistic view of health among the public, we see focus on prevention, education, accessibility, promotion and policy, thus contributing to the health of the community through large-scale community efforts, rather than focusing on the individual.

This can be referred to as the population strategy, which forms the framework of the ‘new’ public health paradigm. According to findings in the The Lalonde Report, the new public health systems started to develop in the 1970s. The population strategy deals with the complexity of health by addressing social, behavioural and environmental determinants of health such as education, employment, socioeconomic status, environment and accessibility in the hope that these inequalities and inequities in health can be balanced. This is in contrast to the ‘old’ public health paradigm, which focuses on the biological determinants of health. This includes clinical treatment and more direct, clear-cut methods in treatment of communicable disease. Although the new public health understanding is a more modern concept, advantages and disadvantages exist in each model of public health.

In considering the key determinates of public health, examples of old and new public health beliefs and practices and their strengths and weaknesses can be taken from society today. This paper will discuss relevant organisations and campaigns and how they relate and respond to the different determinants of health. These include: the role of the local council in society, schools and government, specifically primary school education and the national ‘Sun Smart’ campaigns. Firstly, it will look at the role the local council plays in society as a representation of ‘old’ public health model.

Local councils are a clear representation of old public health ideals, specifically in areas such as sanitation and waste management programs that have historical roots yet are just as important in health management today. Sanitation is the process of preventing human, animal, and insect contact with human waste, which is imperative in avoiding the spread of diseases (Global Education, 2010). The importance of sanitation dates back to the discoveries of John Snow amongst the London cholera epidemic of 1854 (Johnson, 2006). Where Snow, a doctor, was able to establish geographical distributions of cholera deaths and chemically assess the water and patterns of the disease, he simply did not have the authority to interfere with the public water supply. Yet, the local government body, or local council could act on powers given to them by the 1848 health act (Judith Raferty, 2009), and so the importance of the local council in public health and epidemiology became a bigger focus. The Australian Government through local council has long recognised the importance of clean water and sanitation. Although programs through local council target our large areas and populations and the implementation of infrastructures, sanitation deals with biological causes of disease as a method of prevention rather than considering a more environmental and social approach to health and therefore represents the ‘old’...
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