Abstract
Public health has been defined as ‘the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" (Winslow, 1920). Precisely, credit ought to be given to Sir Dr. John Snow (1848), who has impacted the science through investigations leading to the development of assumptions pertaining to Contagion theory. Clarifications, regarding communicable diseases and their occurrences became institutionalized doctrines of the science
Nursing: Public Health Movement- Nineteenth Century to Present
Essentially, the challenges facing environmental safety, disease control and sustainable health for individuals and societies created urgency for investigations within the practice. It included training to manage communicable diseases based on a scientific understanding derived from research studies; towards more meaningful ways in addressing pandemics drastically reducing world populations, especially in Europe and among developing nations.
As such, health innovators decided that in allowing public access to medical presence within communities would be beneficial in reducing death rates and improving the quality of life on this planet. Therefore, the history of public health could be related in terms of changing philosophies within the science over centuries.
Importantly, when Romans began to practice public health they invented the philosophy of linking disease with preventable measures to improve health within communities (Kumar, 2007). This same theme has transcended time through nineteen century interventions way into the twenty first century. Precisely, in discussing public health movement through the designated era, philosophies regarding linking disease occurrence with prevention strategies, would be the common trend of perspectives advanced in highlighting significant movements within the discipline.
Nineteen century public health practices in Europe owe its development to Romans who interpreted public health to mean isolating people with infectious diseases as a means of preventing others from catching the virus, bacteria or germ. The term used to describe this practice was known as leprosania (Kumar 2007).
Subsequently, in response to reports emerging from research conducted by British Attorney, Sir Edwin Chadwick in 1842, extemporaneously describing ‘the sanitary conditions of laboring population of Great Britain’ legislations were passed for sanitary upgrade in communities with, problems of environmental degradation, human disease and misery (Kumar, 2007).
In linking the environment with disease and poverty Sir Chadwick (1842) highlighted in his report that improvement of house drainage to remove noxious smells from homes would alleviate disease and death. However, the underlying premise was that house drainage and noxious smells were closely related to poverty (Kumar, 2007)
Further, reports on Sir Chadwick’s impact in public health as a major force of international change can be related to his parliamentary address in 1846 when he is quoted to have said, “All smell is, if it be intense, immediate acute disease; and eventually we may say that, by depressing the system and rendering it susceptible to the action of other causes, all smell is disease.’ (Metropolitan Sewage Committee, 1846)
Conclusively, after immense theoretical deliberations he resigned to the assumption that it was easier and more important to remove smells from dwellings than to address water purification, placing urgency regarding dwelling sanitation above river and water purification (Kumar, 2007).
Further support was obtained in advancing public health as a movement through British physician Neil Arnott (1844) who emphasized that, ‘Florence Nightingale attributed scarlet fever, measles, and smallpox to the practice of building houses with drains beneath them from which odors could escape and infect the inhabitants’(Florence Nigtehgale,1859). This was subsequently validated by engineer, Goldsworthy Gurney (The London Sewage question, 1890).
Importantly, an account of 19th century public health movement would be inconclusive if the name Sir John Snow (1848) is omitted. Being an anesthetist, he presented an alternative hypothesis regarding the environment, disease and poverty as they are related to pure water supply.
His theoretical assumptions were targeted towards impure water supply being the cause of cholera instead of impure air derived from odors. Precisely, it explained the epidemiology of air and water borne diseases leading towards establishment of the public health act in 1848.
Even with improved environmental safety measures and quarantining of infectious people; still new public health issues surfaced requiring more research and the application of appropriate scientific techniques. Especially during 1920-1930 poverty became a real issue regarding maintenance of structures established to deal with basic public health issues.
Clearly, objectives of dealing with this dysfunction were to improve accessibility to quality health through prophylaxis and lifting communities from the disease of poverty. As such, the pension act was introduced offering financial assistance to senior citizens. This was followed by the National Insurance Act of 911 passed during the leadership (Prime Minster) of Lloyd George (1909)
This Act under British legislation is considered the first attempts at social welfare in the United Kingdom. It was inevitable as a consequence of impeding extermination of the population from diseases liked to poor environmental sanitation and poverty. There were two parts of this Act.
The first part provided medical insurance which enforced accessible health care and free communicable disease coverage. Part 11 allows for unemployment benefits. Many sub legislations were passed to address specific poverty and environmental deficits. Lord William Beverdige’s (1942) input into strategies related to unemployment welfare benefits are still honored as an overwhelming public health contribution
Twenty first century approaches towards the public health movement in Great Britain has been focused on sustainable development. With increasing demands for disease prevention and control in areas of AIDS/ HIV, public health has inevitably become a huge undertaking. Thanks to the achievements of government in developing a full welfare state. Modern or new public health has given communities the options of primary; secondary and tertiary levels of public intervention.
Primary public health promotion strategies focus on vaccinations and environmental safety regulations regarding relationships with ones’ physical environment (Kumar, 2007) .Secondary engages one with frequent doctors’ visits for screening in anticipation of early detection and treatment of medical conditions. Tertiary caters for early rehabilitation after surgery or severe illnesses and education towards full recovery. These are the strides being made in twenty-first century as new public health intervention strategies towards sustainable development.
References
Florence Nightingale (1859) Notes on nursing. London: Harrison; p. 16.
Head F. (1842) Report on the sanitary condition of the laboring population of Great Britain.
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Kumar Shalia (2007) History of Public Health. Bristol: University of West England.
Metropolitan Sewage Committee proceedings (1846). Parliamentary Papers. p. 10. : 651.
The London sewage question.( 1890) Builder:78-9.
Winslow, Charles-Edward Amory (1920 Jan 9). "The Untilled Fields of Public Health". Science
51 (1306): 23–33.
