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Usher Institute. 1902 - 100 years of academic public health - 2002. PATHFINDERS on the ROAD to HEALTH. John Last University of Ottawa, Canada. THREE GIANT STEPS . Fire to cook meat (?750-500k BCE) Planting & harvesting crops Animal husbandry (10-12k BCE).
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Usher Institute 1902 - 100 years of academic public health - 2002 PATHFINDERS on the ROAD to HEALTH John Last University of Ottawa, Canada
THREE GIANT STEPS • Fire to cook meat (?750-500k BCE) • Planting & harvesting crops • Animal husbandry (10-12k BCE)
HUMAN SETTLEMENTS • Origins of culture – history, tradition, myths, legends, religious beliefs, science • Ecosystem changes – human influences on natural environment due to agriculture, waste disposal, etc • Ecological origin of diseases – fecal/oral, vector-borne, parasitic, trans-species, etc • Population surge
AIRS, WATERS, PLACES Seasons, Winds (hot, cold) Water Place – Aspect to winds, sun (sheltered or exposed) Life of the people – Hard working, eat & drink wisely, Indolent, eat and drink a lot
James Lind 1716-1794
Edward Jenner 1749-1823
John Snow 1813-1858
Contributions of Bacteriology to Public Health IDENTIFYING,CLASSIFYING BACTERIAVACCINES, SERA(Late 19th century onward)
Louis Pasteur 1822-1895
19th Cent. Public Health Heroes Snow, Farr, Nightingale Henle, Koch, Virchow, Pasteur Semmelweiss, O.W. Holmes Chadwick, Shattuck Mayhew, Kingsley Newspaper editors, cartoonists Politicians
THE SANITARY REVOLUTIONLate 19th-Early 20th CenturyClean, pure, safe waterSanitation (sanitary disposal of human waste)Improved household and personal hygiene
Essential Ingredients 1. AWARE THAT THE PROBLEM EXISTS Health Information System Public perception (Role of media)
Essential Ingredients • Aware problem exists 2. KNOW WHAT CAUSES IT (Don’t necessarily need complete understanding, just enough to be able to take action)
Essential Ingredients • Aware problem exists • Know what causes it 3. ABILITY TO CONTROL THE CAUSE (Don’t always need to understand a cause in order to be able to control it)
Essential Ingredients • Aware problem exists • Know what causes it • Able to control cause 4. BELIEF THAT IT IS IMPORTANT This requires a sense of values – a moral imperative, the public health ethic, the concept of ‘Redefining the Unacceptable’ (Geoffrey Vickers)
Essential Ingredients • Aware problem exists • Know what causes it • Able to control cause • Believe it is important 5. POLITICAL WILL Advocacy, lobby (pressure) groups
ESSENTIAL INGREDIENTS • Aware that the problem exists • Know what causes the problem • Ability to control the cause • Believe it is important (Values) • Political will
21st CENTURY CHALLENGES(Huge public health impacts) • Human disruption of global ecosystems – Atmosphere: global warming, ozone attenuation, smog; resource depletion (fresh water, ocean fisheries); loss of biodiversity, species extinctions • Violent armed conflicts • HIV/AIDS pandemic • Tobacco addiction pandemic • Petroleum fuel addiction pandemic
PROMOTING HEALTH • SAFE ENVIRONMENT • ENHANCED IMMUNITY • SENSIBLE BEHAVIOUR • GOOD NUTRITION • WELL-BORN CHILDREN • PRUDENT TREATMENT
ESSENTIAL CONCEPTS • Food and nutrition science • Environmental management • Contagion and its control • Behavioural and social determinants • Counting, measuring, surveillance • Multi-sectoral, trans-disciplinary commitment to control health problems