PATHFINDERS on the ROAD to HEALTH

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					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
Lady Mary Wortley Montague
John Snow
1813-1858
 Cholera in South London, 1854
  in Relation to Water Supply
Southwark         40,046 houses    71 per 10,000
& Vauxhall        286 deaths       houses
Water Company
Lambeth           26,107 houses    5 per 10,000
Water Company     14 deaths        houses

All other Water   287,345 houses   9 per 10,000
Companies         277 deaths       houses
     Contributions of
Bacteriology to Public Health


IDENTIFYING,CLASSIFYING
         BACTERIA
     VACCINES, 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
    REVOLUTION
Late 19th-Early 20th Century

Clean, pure, safe water
       Sanitation
   (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

				
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posted:4/10/2008
language:English
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