Chapter 2

Lecture 1

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Objective
After going through the lecture, the student willbe able to define and
explain;
❑ Different concepts of Health
❑ Get foundational knowledge within the 5 core areas of Public Health.
❑ Define public health and its main aims.
❑ Willbe able to identify key objectives for pursuance of aims.
❑ Aware of services provided in Pakistan in terms of public health.
 CONCEPTS OF HEALTH:

 Mystical concept; by supernatural means ;ancient concept

 Humoral theory; An ancient Greek theory stating that the body is composed of four basic
humors such as black bile(spleen), yellow bile (gall bladder), phlegm
(brain/lungs), and blood (liver) that were used as a basis to determine the health of an
individual. According to this theory, the four humors have to be in balance in order to
be healthy.
 Religious beliefs; Religious beliefs cause patients to give up needed medical care,
refuse life-saving procedures, and stop necessary medication, choosing faith instead of
medicine.
 Human centered approach; Human-centered design is an approach to problem-solving that
puts people first. Their needs, their constraints, their contexts and their perspectives. It focuses on
users—not necessarily what designers, researchers, or others think users need.
Cont;
 Germ theory; The germ theory of disease is the currently accepted
scientific theory for many diseases. It states that microorganisms known as
pathogens or "germs" can lead to disease. These small organisms, too
small to see without magnification, invade humans, other animals, and other
living hosts.

 Biomedical disease model; The biomedical model of health focuses on

purely biological factors and excludes psychological, environmental, and
social influences. It is considered to be the leading modern way
for health care professionals to diagnose and treat a condition in most
Western countries.
Cont;
 Biopsychosocial model; The biopsychosocial model of health and illness
is a framework developed by George L. Engel that states that interactions
between biological, psychological, and social factors determine the cause,
manifestation, and outcome of wellness and disease.
 Era of genetic basis of disease; When most people consider the genetic
basis of disease, they might think about the rare, single gene disorders,
such as cystic fibrosis (CF), phenylketonuria or haemophilia, or perhaps
even cancers with a clear heritable component (for example, inherited
predisposition to breast cancer)
 1948 WHO definition of health
According to WHO:
“Health is a state of complete physical, mental and social well
being and not merely absence of disease or infirmity (illness).”
ASPECTS/COMPONENTS OF HEALTH

Physical Mental
health health

Social Spiritual
health health
 PHYSICAL HEALTH

Physical Health means that:

 Individuals should be physically fit.

 Body organs are anatomically(structurally) in a normal state.

 Body organs are functionally(physiologically)in a normal state.

 There is a perfect co-ordination between the organs & systems so that the

body as a whole functions in perfect harmony.

 MENTAL HEALTH

➢ Mental health can be defined as the ability of the individuals to make

personal and social adjustments.
➢ Factors including heredity, Physical health, Social factors, use of
alcohol and other narcotics etc can affect the mental health of a person.
SOCIAL HEALTH
 The health of the people depends primarily on the social and
environmental conditions under which they live and work.
 Economic tensions ,poverty, illiteracy, unemployment etc greatly
effects the health of an individual.
SPIRITUAL HEALTH
It is concerned with spirit or soul and is that health which evokes the
good spirits and right things and keeps away from bad activities.
DETERMINANTS OF HEALTH

• Heredity
Individual factors • Lifestyle

• Socioeconomic
Environmental • Availability of health
factors services

• Age
Other Factors • Rural/Urban living
 FACTORS FOR PROMOTING AND MAINTAINING
GOOD HEALTH:
✓ Supply of fresh air, light and potable water.
✓ Balanced diet.
✓ Demographic factors
✓ Environmental factor
✓ Lifestyle
✓ Proper healthful shelter and adequate clothing.
✓ Hygienic sanitation.
✓ Protection from communicable ,non communicable and venereal diseases.
✓ Adequate physical activity.
✓ Suitable occupation with job satisfaction.
✓ Good and simple habits with leisure and pleasure.
 PUBLIC HEALTH:
“The science and art of preventing disease, prolonging life and
promoting health through the organized efforts and informed
choices of society, organizations, communities and individuals.”
 Characteristics of public health:

It deals with preventive rather than curative aspects of

health.
It deals with population level, rather than individual
health issues.
WHO define:
 Public health refers to all organized measures (whether public or
private) to prevent disease, promote health, and prolong life among
the population as a whole.
 Its activities aim to provide conditions in which people can be healthy
and focus on entire populations, not on individual patients or diseases.
 Thus, public health is concerned with the total system and not only
the eradication of a particular disease.
Public health promotes and protects the health of people and the
communities where they live, learn, work and play.
From conducting scientific research to educating about health, people
in the field of public health work to assure the conditions in which
people can be healthy. That can mean vaccinating children and adults
to prevent the spread of disease. Or educating people about the risks of
alcohol and tobacco.
The three main public health functions are:
 The assessment and monitoring of the health of communities and

populations at risk to identify health problems and priorities.

 The formulation of public policies designed to solve identified local

and national health problems and priorities.

 To assure that all populations have access to appropriate and cost-

effective care, including health promotion and disease prevention

services.
 Key Points:
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Public healthincorporates the interdisciplinary approaches

of epidemiology, biostatistics and health services, Environmental
health, community health, behavioral health, health economics, public policy,
insurance medicine, mental health and occupational safety .

•Modern public health practice requires multidisciplinary teams of public

health workers and professionals
 Biostatistics – Collection, storage, recovery, analysis and interpretation of health data; design and
analysis of health-related surveys and experiments; and concepts and practice of statistical data analysis.
Epidemiology – Distributions and determinants of disease, disabilities and death in human and
animal populations; the characteristics and dynamics of populations; the natural history of disease;
and the biologic basis of health.
Environmental Health Sciences – Environmental factors, including biological, physical and
chemical factors that affect the health of a community.
Health Services Administration – Development, organization, administration, management,
evaluation and policy analysis of health programs.
Social and Behavioural Sciences – Concepts and methods of social and behavioral sciences
relevant to the identification and the solution of public health problems

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AIMS:
According to health department in UK(NHS) the overall aim is to
improve health and well being of the whole population through
the resources available. Further it include:

1. Supporting activity at national level to protect, promote and

improve the nation's health;
2. Securing the provision of comprehensive, high quality care
for all those who need it, regardless of their ability to pay
or where they live or their age; and
3. Securing responsive social care and child protection for
those who lack the support they need.
 OBJECTIVES OF PUBLIC HEALTH:
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1. To reduce the incidence of avoidable illness, disease and injury in the

population. The Department of Health will do thisby:
Working across government and with local agencies and groups on a range of
measures designed to improve the health of the public;
Providing accurate and accessible information on how to reduce the risk of illness,
disease andinjury;
Encouraging people to live healthily; and
Raising standards and setting targets to stimulate and encourage widespread
improvements in public health, and in particular a narrowing of current inequalities in
health status.
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OBJECTIVES(cont):
2. To treat people with illness, disease or injury quickly,
effectively and based on need alone. The Department of Health
will do thisby:
Providing family health services which are accessible to people
wherever theylive;
Reducing the number of people waiting, and the time they have to wait, for
treatment;
Improving clinical and cost effectiveness;and
Ensuring that the NHS prioritises treatments according to clinical need, not
people's ability to pay, nor where they live.
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OBJECTIVES(cont):
3.To enable people, who are unable to perform essential activities of daily living,
including those with chronic illness, disability or terminal illness, to live as full and
normal lives as possible. The Department of Health will do thisby:
Providing care according to individual need regardless of organisational boundaries;
Helping people to live independently, and supporting them wherever possible in their own
homes;
Giving people who need it access to effective palliative care;
 And through Local Authority Social Services, by;

Securing appropriate and effective social care for those who lack the means or other support to get
the help they need.
 4.To maximise the social development of children within
stable family settings.
The Department of Health, will do this by working with local
authorities to provide seamless support, with resources and
guidance, to:
Secure appropriate and effective social care to prevent
significant neglect or abuse and to support families; and,
Assume where necessary sufficient responsibility in
relation to individual children.
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 In addition the Department of Health has the following performance
objectives;
To assure performance and support to Ministers in accounting to Parliament
and the public for the overall performance of Department of Health.
To manage the staff and resources of the Department so as to improve
performance.

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 NIDA-Pakistan is non-profitable, non-governmental, non-Political and non-Religious
organization registered under Societies and companies Act under ordinance 1860, is
committed to help the underprivileged population anywhere in Pakistan, Include FATA, and
Azad Kashmir.
It also provides trainings to public, private, Government department and voluntary
organizations. This organization operates independently of any political and cultural
influences

As a non-governmental organization NIDA-Pakistan, intervenes both in situations of disaster

and non-disaster for sustainable development of the marginalized population restoring their
autonomy in the society

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4

To ensure organized efforts of locals for making their lives better.

To improve the livelihood conditions of poor communities through integrated interventions.
To provide clean drinking water and building up sanitation infrastructure in Pakistan, especially remote
areas.
To provide health care services in women reproductive health, childcare, HIV/AIDS, tuberculosis and other
communicable diseases.
To impart skills and knowledge to improve human and institutional development through training and
consultancies with NGOs and community groups.
To facilitate women empowerment through interventions for women rights, gender and
equal participation of women in leadership and decision-making.
To contribute in developing quality education through enhancing capacity of existing systems with continuous
efforts for increasing literacy in girls and deserving sections of society.2
To network with like-minded organizations and forums for collective efforts at local, national and
28 international levels.
 Four major components:
Outreach and community-based activities,focus on
immunization,malaria control etc.
Primary care facilities for outpatient care.
Tehsil and district headquarters hospitals for basic
inpatient and outpatient care.
Tertiary care hospitals located in major cities.

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 Some notable public health campaigns:
 Vaccination and control of infectious diseases
 Motor-vehicle safety
 Safer workplaces
 Safer and healthier foods
 Safe drinking water
 Healthier child popoulation
 Decline in deaths from coronary heart disease and stroke
 Recognition of tobacco use as a health hazard.
 References
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BOOKS:
❑ Handbook of Health education and
community pharmacy, Ashok K. Gupta
Health education and community
pharmacy A.V.Yadav
Pharmacy Student survival guide
VIDEO TUTORIAL:
www.apha.org (include in exam)
www.nhs.uk
http://www.nidapakistan.org/