Pubh 102 1nd EditionExam # 1 Study Guide Lectures: 1 - 10INTRO/ WHAT IS PUBLIC HEALTH/ HISTORY- Determinants of health – o Risk Factors of health – set of common causes of death, disability, illness and injury (behavioral – smoking, poor diet, lack of physical activity, alcohol consumption, etc.) more likely to be under the control of individuals at risk. o Risk conditions of health – More distal risk factors: biological (age, sex, genetics); environmental (safe community/ worksite; adequate housing); enforcement of policies and regulations; less likely to be under the control of individualso Lifestyle – pattern of behavior; more complex, lifetime habits and social circumstances- 3 Levels of Prevention – o Primary- action taken to avert occurrence of diseaseo Secondary- action taken to identify diseases at their earliest stages and to apply appropriate treatments to limit their consequences and severityo Tertiary- specific interventions to assist diseased or disabled persons in limiting the effects of their diseases or disabilities; also may include activities to prevent recurrence of a disease.- Major Historical eras o Ancient Greeks (500-323 BC) – understood the importance personal hygiene including washing hands and taking a bath. Also physical fitness and exercising (they started the Olympics), and eating good food. Believed in the naturalistic concept – disease was caused by imbalance between man and the environmento Hippocrates (b. 460 BC) – father of Western medicine. Looked for and described casual relationship between disease and factors such as soil, climate, water, lifestyle,and nutrition. Illness had a physical and rational explanation. Also coined the term ‘epidemic’: Epis (on or akin to) and Demos (people)o Roman Empire (23 BC – 476 AD) – Adopted Greek health values. Great engineers – built sewage systems (advanced plumbing technology), they replaced leaky clay pipes with lead pipes (unfortunately, Romans suffered from lead poisoning) and aqueducts (Pont du Gard) to bring water to their city. Collected taxes to support public services such as public baths, water and sewage systems and restaurant inspection.o Middle Ages (476-1450 AD) – also called the ‘dark ages’. Decline of hygiene and sanitation – general abandonment of the Greek and Roman values of hygiene and sanitation. Physicial body was less important than spiritual self. Faith and prayer were the accepted treatment for illness. Understandings that isolating ships and diseased individuals could help prevent the spread of disease (quarantine of ships and travelers for 40 days, persons denied entry to infect ships).o ‘The Plague’ (Black Death) (1348-1530+ AD) – End of Middle ages through the renaissance. 25-50% of population in Western Europe died. 2 types: bubonic & pneumonic. The plague was the worst from 1348-1352 and killed at lease 25 million people in Europe (1/3 of population) and more than 60 million worldwide. o Renaissance (1400-1600 AD) – Arts and literature exploration flourished. Explorers and traders unknowingly spread diseases like smallpox, measles, and typhoid. This method of the spread of diseases still exists today (spread of SARS/Flu across countries albeit in a very accelerated form). Disease killed 90% of indigenous people in the New World.o Age of Reason and Enlightenment (1650-1800 AD) – birth of Modern Medicine by William Harvey: 1628 theories of circulation, first to suggest that humans and other mammals reproduced via the fertilization of an egg by sperm. Also, Edward Jenner did the 1796 cowpox experiment and coined the term ‘vaccine’ (vacca, Latin for ‘cow’)o ‘Industrial Urbanization (1800s) – ‘new’ PH problems: slums, poverty, disease (worse than 1000 years before). At this time, English working class had a life expectancy of 7years.o Great Sanitary Awakening (1800s-1900s) – Great strides in scientific knowledge to help understand the origin and treatment of disease. Interest in humanitarian ideals.Acknowledgement of the connection between poverty and disease. Even today, poverty is the single best predictor of poor health. Returning to what the Romanshad figured out, new infrastructures for clean water and sewage removal. Birth of a system to monitor the health status of communities- Key Historical people – o Dr. John Snow (1813-1858) – the “George Washington” of public health. Well-educated despite being raised in a working class family. Man of many interests, a physical to Queen Victoria, and a mathematician. Became very concerned about the cholera outbreaks in London that were devastating the population. He made careful observations of the disease, who caught it, and where the deaths occurred.o William Harvey (1578-1657) – an English physician who demonstrated the function of the heart and circulatory system. First to suggest that humans and other mammals reproduced via the fertilization of an egg by sperm. Used dissection (no microscope) to create theories)o Edwin Chadwick (1800-1890) – created the Chadwick Report ‘survey into the Sanitary Condition of the Laboring Classes in Great Britain’ o Lemuel Shattuck (1793-1859)– teacher, historian, statistician, publisher, and visionary. Developed the original plan that led to the establishment in 1869 of the nations first Board of Health in Massachusetts. He was the first to identify major MA public health issues that could be applied to the entire nation. His ‘US Sanitary Reform’ shows health records, vital public health statistics as tools to fight disease. Developed a system of sanitary inspection. And provided vaccination programs.o Louis Pasteur (1822-1895) – 1862 germs caused many diseases, 1888 first public health lab. He was a French Chemist who’s earliest research consisted of chemical studies of the tartrates, in which he discovered molecular dissymmetry. His experiments with bacteria conclusively disproved the theory of spontaneous generation and led to the germ theory of infection. His work on wine, vinegar and beer resulted in the development of the process of pasteurization. Of great economic value also was his solution of the control of silkworm disease, his study of chicken cholera, and his technique of vaccination against anthrax, which was successfully administered against rabies in 1885. Pasteur institute was founded in paris with Pasteur as its director to continue work on rabies and to provide a teaching and