NUR 408 Epidemiology: Global and Public Health
March 25, 2012
Bonnie Copland, RN, PHN, MSN
The purpose of this paper is to describe the history of public health, including pertinent dates and significant events and the different aspects of public and community-based health. Public health is the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals (Winslow, 1920). It is concerned with threats to health based on population health analysis. The population in question can be as small as a handful of people or as large as all the inhabitants of several continents (for instance, in the case of a pandemic). The dimensions of health can encompass "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity", as defined by the United Nations World Health Organization. Public health incorporates the interdisciplinary approaches of epidemiology, biostatistics and health service. Environmental health, community health, behavioral health and occupational health are other important subfields.
The focus of public health intervention is to improve health and quality of life through the prevention and treatment of disease and other physical and mental health conditions, through surveillance of cases and the promotion of healthy behaviors. Promotion of hand washing and breastfeeding, delivery of vaccinations, and the distribution of condoms to control the spread of sexually transmitted diseases are examples of common public health measures. The origins of the Public Health Service can be traced to the passage of an act in 1798 that provided for the care and relief of sick and injured merchant seamen. Reorganization in 1870 converted the loose network of locally controlled hospitals into a centrally controlled Marine Hospital Service, with its headquarters in Washington, D.C. The position of Supervising Surgeon (later Surgeon General) was created to administer the Service, and John Maynard Woodworth was appointed as the first incumbent in 1871. The commissioned officer corps (now known as the Commissioned Corps of the U.S. Public Health Service or the Public Health Service Commissioned Corps) was established by legislation in 1889. At first open only to physicians, over the course of the twentieth century, the Corps expanded to include veterinarians, dentists, Physician Assistants, sanitary engineers, pharmacists, nurses, sanitarians, scientists, and other health professionals. Quarantine was originally a state function rather than federal, but the National Quarantine Act of 1878 vested quarantine authority to the Marine Hospital Service and the National Board of Health. The National Board was not reauthorized by Congress in 1883 and its powers reverted to the Marine Hospital Service. Over the next half a century, the Marine Hospital Service increasingly took over quarantine functions from state authorities. As immigration increased dramatically in the late nineteenth century, the Federal Government also took over the processing of immigrants from the states, beginning in 1891. Because of the broadening responsibilities of the Service, its name was changed in 1902 to the Public Health and Marine Hospital Service, and again in 1912 to just the Public Health Service. As the century progressed, PHS commissioned officers served their country by controlling the spread of contagious diseases such as smallpox and yellow fever, conducting important biomedical research, regulating the food and drug supply, providing health care to underserved groups, supplying medical assistance in the aftermath of disasters, and in numerous other ways. Today the mission of the Commissioned Corps of the PHS is "Protecting, promoting, and advancing the health and safety of the Nation." The Public Health Service Act of 1944...
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