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    DR Shabir

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    jk045413
    This document outlines the history and evolution of community medicine and public health. It discusses [1] the various stages in the history of medicine from ancient times to modern times, [2] key concepts in public health like definitions of health, determinants of health, and responsibilities for health, and [3] important public health indicators, theories of disease causation, and levels of disease prevention. The document provides helpful context on the foundations and development of community medicine as a field.

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    DR Shabir

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    jk045413
    33 views30 pages
    This document outlines the history and evolution of community medicine and public health. It discusses [1] the various stages in the history of medicine from ancient times to modern times, [2] key concepts in public health like definitions of health, determinants of health, and responsibilities for health, and [3] important public health indicators, theories of disease causation, and levels of disease prevention. The document provides helpful context on the foundations and development of community medicine as a field.

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    This document outlines the history and evolution of community medicine and public health. It discusses [1] the various stages in the history of medicine from ancient times to modern times, [2] key concepts in public health like definitions of health, determinants of health, and responsibilities for health, and [3] important public health indicators, theories of disease causation, and levels of disease prevention. The document provides helpful context on the foundations and development of community medicine as a field.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    33 views30 pages

    DR Shabir

    Uploaded by

    jk045413
    This document outlines the history and evolution of community medicine and public health. It discusses [1] the various stages in the history of medicine from ancient times to modern times, [2] key concepts in public health like definitions of health, determinants of health, and responsibilities for health, and [3] important public health indicators, theories of disease causation, and levels of disease prevention. The document provides helpful context on the foundations and development of community medicine as a field.

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    Attribution Non-Commercial (BY-NC)
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    Download as ppt, pdf, or txt
    of 30

    History of Medicine

    (Evolution of Community Medicine)

    Dr. shabir Ahmad


    pg student
    Community Medicine Department
    Medical College
    srinager
    Evolution of Community Medicine
    (History of Medicine)
    Stages seen in the history of medicine:
    • Stone age
    • 5000 BC: Indian medicine
    • 2700 BC: Chinese medicine (system of
    barefoot doctor, System of acupuncture)
    • 2000 BC: Egyptian medicine (manuscript
    of papyrus)
    Continued…..
    Evolution of Community Medicine
    (History of Medicine)
    Stages seen in the history of medicine:
    • 2000 BC: Mesopotamian medicine
    (Babylonian code of hammurabi)
    • 460 BC: Greek medicine (Hygiea daughter
    of Aescuapius, Hippocrates oath)
    • 130 AD: Roman medicine (Galen)
    • Up to 800 AD: Dark ages of medicine
    Continued…..
    Evolution of Community Medicine
    (History of Medicine)
    Stages seen in the history of medicine:
    • 900 AD: Arabic medicine (Rhazes, Avicenna)
    • 1500 AD: Revival period (theory of contagion
    blood circulation by Harvey, vaccination by
    Jenner)
    • 1800: Sanitary awakening
    • 1850: Rise of public health (epidemic of
    cholera by John Snow, typhoid by William,
    Chadwick’s sanitary reforms)

    Continued…..
    Evolution of Community Medicine
    (History of Medicine)
    Stages seen in the history of medicine:
    • 1860: Germ theory (anthrax by Robert
    Koch)
    • 1880: Typhoid & pneumonia 1882 TB
    • 1883: Birth of preventive medicine (ARV)
    • 1883: Cholera vaccine, 1892 dipth
    antitoxin
    • 1898: Malaria transmission by Ross

    Continued…..
    Evolution of Community Medicine
    (History of Medicine)
    Stages seen in the history of medicine:
    • 1900: Multifactorial causation of disease
    • 1911: Social medicine
    • 1920: Disease control
    • 1960: Health promotion
    • 1981: HFA
    Concept of Health
    Concept of Health

    • Biomedical concept
    • Ecological concept
    • Psychological concept
    • Holistic concept
    WHO Definition of Health

    Health is a state of complete physical, mental


    and social well-being and not merely an
    absence of disease or infirmity
    and ability to lead socially and economically productive life

    Operational definition:
    A condition or quality of human organism expressing the adequate functioning
    of the organism in giving condition, genetic or environmental
    Dimensions of health

    1. Physical 6. Vocational
    2. Mental 7. Others:
    1. Cultural
    3. Social 2. Socioeconomic
    4. Spiritual 3. Environmental
    4. Educational
    5. Emotional 5. Nutritional
    6. Curative
    7. Preventive
    Concept of Wellbeing
    • Objective component
    1. Standard of living
    2. Level of living

    • Subjective component
    • Quality of Life (PQLI)
    (IM, Life expt. @ 1, Literacy.)
    • Human development Index
    (Life expt. @ 0, Knowledge, Income)
    Concept of Wellbeing

    • Subjective component
    • Quality of Life (PQLI)
    (IM, Life expt. @ 1, Literacy.)
    The condition of life resulting from combination of the factors such as
    those determining health happiness education social and intellectual
    attainments freedom of action, justice and freedom of expression

    • Human development Index


    (Life expt. @ 0, Knowledge, Income)
    Determinants of health
    1. Biological / Hereditary
    2. Behavioral & Socio-cultural Lifestyle
    3. Environmental
    4. Socioeconomic conditions
    5. Health and family welfare services
    6. Aging of the population
    7. Gender
    8. Others…..
    Determinants of health
    1. Biological 8. Science and
    2. Behavioral technology
    3. Environmental 9. Information and
    communication
    4. Socioeconomic
    10. Gender
    5. Health system
    11. Equality and social
    6. Socio-cultural justice
    7. Aging of the 12. Human rights
    population
    Responsibility of Health

    1. Individual responsibility
    2. Community responsibility
    3. State responsibility
    4. International responsibility
    Indicators of health
    (Valid Reliable Sensitive Specific)

    1. Mortality indicators
    2. Morbidity indicators
    3. Disability indicators
    4. Nutritional Status indicators
    5. Health care delivery indicators
    6. Utilization rate
    7. Indicators of social and mental health
    8. Environmental indicators
    9. Socioeconomic indicators
    10. Health policy indicators
    11. Indicators of quality of life
    12. Others……….
    Health Indicators
    Valid, reliable, sensitive and relevant indicators which
    determine health development are called health
    indicators:
    • Mortality Indicators: Death rate, Life span, IMR, Child mortality rate,
    MMR, Case fatality rate, proportion mortality rate.
    • Morbidity Indicators: Disease rate (incidence, prevalence)
    • Disability Indicators: Hospitalization, loss of work, sullivan index DALYs
    • Nutritional Indicators: Anthropometric values, LBW
    • Utilization Indicators: Fully immunized, bed turn out…
    • Socioeconomic Indicators: Per capita income. Family size.
    Mortality indicators
    1. Crude death rate
    2. Expectancy of life
    3. Infant mortality rate
    4. Child Mortality rate
    5. Under 5 proportionate mortality rate
    6. Maternal mortality
    7. Disease specific mortality
    8. Proportionate mortality rate
    Concept of disease
    It is departure from state of health interrupting in
    normal function of the body
    Concept of disease
    • Theories of causation of disease
    • (Germ theory, Epidemiological Triad, Multifactorial causation, web of causation)

    • Natural History of disease


    (Prepathogenesis – pathogenesis) (Agent Host Environment)

    • Risk Factors
    • Iceberg Phenomena
    • Monitoring he performance & analysis of routine measurements aimed at
    t detecting
    changes in the environment or health status of population

    • Surveillance The continuous scrutiny of the factors that determines the occurrence
    and distribution of disease and other conditions of ill health

    • Sentinel Surveillance
    • Prevention and Control
    Difference between
    Control & Eradication
    Control Eradication
    Definition To reduce incidence to Total extirpation of
    acceptable level disease agent
    Objective To reduce morbidity & To uproot the disease
    mortality (no more PH problem)
    Area of operation In high incidence area Total coverage

    Duration of operation Indefinite Time limited

    Economic aspect Recurring Cheap

    Case finding, Not important Very Important


    Confirmation,
    Epidemiological investi.
    Examples of Risk Factors
    Fatty diet, obesity Diabetes
    Alcohol Cirrhosis of liver
    Smoking, radiation Cancer
    High cholesterol, obesity, type Heart diseases
    of personality
    Smoking, high BP, high Stroke
    cholesterol
    Alcohol, Ignorance about Accident
    traffic signals
    LEVEL OF PREVENTION

    1. Primordial Prevention
    2. Primary Prevention
    3. Secondary Prevention
    4. Tertiary Prevention
    Natural history of disease
    Interrelation of Agent , Host and Reaction of the host to the stimulus
    Environmental Factor

    Production of stimulus Early Discernible Advance Convalescence


    pathogenesis early lesions disease

    Pre-pathogenesis period Period of Pathogenesis


    Health Promotion Specific protection Early diagnosis & Disability Rehabilitation
    prompt treatment limitation
    •Health Education •Use of specific •Case finding measures •Adequate •Provision of
    •Good standard of immunization individual & mass treatment to hospital &
    nutrition adjusted to •Attention to personal •Screening surveys arrest the community facilities
    developmental phases hygiene disease for retaining &
    •Selective examinations
    of life process and to education for
    •Use of environmental objectives
    prevent further maximum use of
    •Attention of sanitation To cure & prevent
    personality complications remaining capacities
    •Protection against disease process
    development occupational hazards •Education of public
    To prevent the spread of & industry the
    •Provision of adequate •Protection from a communicable diseases •Provision of
    housing recreation & facilities to rehabilitated
    accidents To prevent complications
    agreeable working limit disability •As full employment
    •Use of specific & sequel as possible
    cond. nutrients and to prevent
    To shorten period of
    •Marriage counseling death •Selective
    •Protection of disability placement
    ang sex education carcinogens
    •Genetics •Work therapy in
    •Avoidance of allergens hospitals
    •Periodic selective
    examination •Use of shelter
    colony
    Primary prevention Secondary Prevention Tertiary prevention
    Modes of Intervention
    Intervention is an attempt to intervene or interrupt the usual
    sequence in the development of disease in a man.

    1. Health Promotion:
    It is a process of enabling people to increase control
    over & to improve health
    – Health education
    – Environmental health
    – Nutritional intervention
    – Lifestyle changes
    – Behavior changes
    Modes of Intervention

    2. Specific Protection:
    It is a process to totally avoid disease or illness
    – Immunization
    – Nutritional supplement
    – Chemoprophylaxis
    – Immunoprophylaxis
    – Protective device in industry
    – Protective device against carcinogen
    – Protective device against allergens
    Modes of Intervention

    3. Early diagnosis and prompt


    treatment
    It is a process of early detection of transformation from physiological to
    pathological state
    Early diagnosis and prompt treatment of:
    • Ca breast
    • Ca cervix
    • TB
    • Leprosy
    Modes of Intervention

    4. Disability Limitation
    It is a process involving interaction to
    prevent disability e.g.
    – Disability limitation in nerve damage in
    leprosy
    – Physiotherapy in polio lameness.

    Impairment Disability Handicap


    Modes of Intervention
    5. Rehabilitation
    It is a combine & co-ordinate use of medical, social,
    economical, vocational and psychological measure to
    make an individual or community function normally
    – Medical rehabilitation
    – Social rehabilitation
    – Economic rehabilitation
    – Vocational rehabilitation
    – Psychological rehabilitation
    Thanks

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