Public Health in UK

10 Key excerpts on "Public Health in UK"

• 

  eBook - PDF

  Health and Health Care in Britain

  • Rob Baggott(Author)
  • 2004(Publication Date)
  • Red Globe Press

    (Publisher)

  Public Health What is Public Health? According to Smith and Jacobson (1988, p. 3), public health ‘involves the promotion of health, the prevention of disease, the treatment of illness, the care of those who are disabled, and the continuous development of the technical and social means for the pursuit of these objectives’. Public health has many differ-ent aspects (see Griffiths and Hunter, 1999; Baggott, 2000; Hunter, 2003) and there is disagreement about the relative importance of these aspects, for exam-ple about the appropriate balance between the treatment of disease and the pro-motion of health. Nonetheless, there is agreement that public health is primarily concerned with the efforts of the community to improve health, rather than the treatment of disease manifested in the individual. Action to promote the health of the whole community dates back to the ear-liest civilisations (Rosen, 1993). The Ancient Greeks recognised the links between location, environment, lifestyles, nutrition and the health of the community. The Romans, too, were aware of these factors, and sought to improve public health through large-scale engineering works such as water supply systems and sewers. Centuries later, the Victorians established a legislative and administra-tive framework that led to improvements in health through better housing, san-itation and a cleaner environment, while laying the foundations of the modern welfare state. For most of the twentieth century, however, health policy was mainly concerned with the provision of health care, rather than with the pro-motion of good health. This reflected to some extent the dominance of the orthodox biomedical approach (see Chapter 2), the low status of public health doctors compared with other medical practitioners, the power and resources of the hospital sector, and the fragmentation of Government responsibilities affecting health, which made it difficult to co-ordinate action.

  Sign up to read

  Learn more about book
• 

  eBook - PDF

  Public Health

  Local and Global Perspectives

  • Pranee Liamputtong(Author)
  • 2016(Publication Date)
  • Cambridge University Press

    (Publisher)

  To what extent is your health a reflection of government policies and practices? Perhaps you recently required treatment in a hospital and, despite your student income, you were able to access treatment because of a universal health insurance system. A common thread tying public health’s history together is this tension between individual and collective responsibility for health. As you read about health in different times and places in this chapter, ask yourself: why does this tension persist? Introduction All knowledge is a product of its time, culture and context. Often, histories are pre- sented as the result of progress, a linear path of discovery. The social philosopher Michel Foucault (1926–84), however, argued that histories typically overlook the acci- dents and struggles that take place over time (Foucault, [ 1969] 2002). Examining these frictions can offer insight, challenging us to question what we take for granted. This chapter explores the assumptions and struggles of public health’s long history. It is an opportunity to question what public health is and where it is going based on where it has come from. A comprehensive history is outside the scope of a single chapter. Instead, this chapter takes a critical approach to examining public health’s history, depicting current public health principles and practices as the result of the actions of heroes and innovators as much as chance and folly. Through a critical examination of its history, this chapter shows that public health is more than a health discipline. It is a scientific profession, a social science and a political endeavour committed to empowering individuals and health through organ- ised collective intervention (see also Chapter 1 ). This chapter introduces readers to the different lenses through which public health has been defined and practised, from individualistic, behaviourist and biomedical through to socio-environmental; from ancient Greece to 19th century Prussia.

  Sign up to read

  Learn more about book
• 

  eBook - PDF

  Public Health

  Local and Global Perspectives

  • Pranee Liamputtong(Author)
  • 2019(Publication Date)
  • Cambridge University Press

    (Publisher)

  A common thread in the history of public health is this tension between individual and collective responsibility for health. As you read about health in different times and places in this chapter, ask yourself: why does this tension persist? 26 Introduction All knowledge is a product of its time, culture and context. Often, histories are presented as the result of progress, a linear path of discovery. The social philosopher Michel Foucault (1926–84), however, argued that histories typically overlook the accidents and struggles that take place over time (Foucault, [1969] 2002). Examining these frictions can offer insight, challenging us to question what we take for granted. This chapter explores the assumptions and struggles of public health’s long history. It is an opportunity to question what public health is and where it is going, based on where it has come from. A comprehensive history is outside the scope of a single chapter. Instead, this chapter takes a critical approach to examining public health’s history, depicting current public health principles and practices resulting from the actions of heroes and innovators as much as chance and folly. Through a critical examination of its history, this chapter shows that public health is more than a health discipline. It is a scientific profession, a social science and a political endeavour committed to empowering individuals and health through organised collective intervention (see also chapters 1, 5, 9 and 13). This chapter introduces readers to the different lenses through which public health has been viewed and practised, from indi- vidualist, behaviourist and biomedical perspectives through to socio-environmental; from ancient Greece to 19th-century Prussia. Australia’s and New Zealand’s histories are also explored, showing how different approaches to public health throughout history have (de) emphasised the importance of collective action.

  Sign up to read

  Learn more about book
• 

  eBook - PDF

  Promoting Health

  Politics and Practice

  • Lee Adams, Mary Amos, James Munro, Lee Adams, Mary Amos, James Munro(Authors)
  • 2002(Publication Date)
  • SAGE Publications Ltd

    (Publisher)

  The phrase ‘public health’ as currently used embodies many of the confu-sions, vested interests and singular interpretations that have resulted from a simplistic interpretation of its historical development. It could even be argued that the term public health is often used in a spirit of what might be described as conspiratorial confusion – a point made by Alan Milburn as UK Secretary of State for Health: ‘Public health’ understood as the epidemiological analysis of the patterns and causes of population health and ill health gets confused with ‘public health’ understood as population-level health promotion, which in turn gets confused with ‘public health’ understood as public health professionals trained in medicine. So by series of definitional sleights of hand, the argu-ment runs that the health of the population should be mainly improved by population-level health promotion and prevention, which in turn is best delivered, or at least overseen and managed, by medical consultants in public health. The time has come to abandon this lazy thinking and occupa-tional protectionism. (Milburn, 2000) The minister’s evident frustration testifies to the current confusion over defini-tions of purpose and territorial responsibility among health professionals. Implicit in the above quotation, and most other current discussions of public health, are elements of a definition that have, in fact, been in widespread use over the past 75 years. The goals of public health are usually stated to be pre-venting disease and promoting health, and the mechanism for realizing these objectives to be organized interventions directed at particular groups or the community as a whole. Clearly, therefore, public health has always been associ-ated in some way with health promotion. While this dual identity has been a source of strength, as noted below, it has also proved to be an effective source of friction.

  Sign up to read

  Learn more about book
• 

  eBook - PDF

  Healthy or Sick?

  Coevolution of Health Care and Public Health in a Comparative Perspective

  • Philipp Trein(Author)
  • 2018(Publication Date)
  • Cambridge University Press

    (Publisher)

  Yet, many of the interventionist public health policies in the United Kingdom went unopposed, because the government intro- duced most of these policies at the end of the nineteenth century based on the findings of bacteriological research. Therefore, the discretion of the national government to regulate individual lives augmented during this period. For example, the Local Government Act of 1875 allowed public health officers to remove sick individuals from the community and place them in homes (Porter, 1999, 134–135). Around the end of the nineteenth century, the United Kingdom’s public health sector was a very important part of health policymaking. MOsH (medical officers of health) were appointed throughout the country. They were part of the public health system and essentially responsible for a population-oriented health system. MOsH were United Kingdom: Health Care and Public Health 87 hired by the local and municipal public health services, which the national government coordinated. In that period, the power of the medical profession declined with respect to preventive health and administrators’ roles became more important (Porter, 1999, 137). According to Dorothy Porter, “[the public health movement] was a movement much broader than state medicine, outside the central corridors of power and beyond the elite province of the medical and scientific communities. It was not, however, a ‘lay’ organization, but was associated with the growth of prevention as a professional practice distinct from cure” (Porter, 1999, 138). Prevention efforts involved a group of doctors focusing on community health issues supported by a “community” of interests surrounding preventive medicine, communicated through journal literature and high-profile conferences, and embodied in a variety of institutions set up for edu- cational and research purposes (Watkins, 1984; Porter, 1999, 138).

  Sign up to read

  Learn more about book
• 

  eBook - PDF

  The public health system in England

  • Hunter, David J., Marks, Linda(Authors)
  • 2010(Publication Date)
  • Policy Press

    (Publisher)

  Emergence of the new public health From the late 1970s, tensions and reorganisations surrounding the public health function in England were concurrent with a broader, international movement that came to be known as the ‘new public health’. This movement threw into relief the aridity and reductionist nature of narrow, professional debates. The period was also marked by a sense of growing exasperation among many involved in public health with the neglect of public health and preventive initiatives.These perceptions and developments were instrumental in fostering a broad, and some would say political, movement concerned to put in place what came to be known as ‘the new public health’. This movement drew on the spirit of the early pioneers in public health but within the context of the new health challenges (Unit for the Study of Health Policy, 1979; Ashton and Seymour, 1988). Webster (1992: 10) argues that,“as in the 1930s, much of the impetus for the New Public Health has emerged from outside the ranks of public health organisations, initiatives in other western nations, or lay and scientific pressure groups”. The movement also reflected critiques of the scope of clinical medicine 51 The evolution of the public health function in England (1): 1974–97 in improving population health when compared with the impact of better nutrition and healthier environments (McKeown, 1976) and an emerging body of literature that underlined the interplay between health and social and environmental factors, and emphasised the role of public policy, intersectoral collaboration and community action. As such, it prefigures later attempts to interpret and define a broad public health system.A key influence was the publication of a Canadian policy document called A new perspective on the health of Canadians (Lalonde, 1974), which became known as ‘the Lalonde report’, after the Minister of Health and Welfare at the time, Marc Lalonde.

  Sign up to read

  Learn more about book
• 

  eBook - PDF

  Public Health

  Local and Global Perspectives

  • Pranee Liamputtong(Author)
  • 2022(Publication Date)
  • Cambridge University Press

    (Publisher)

  This tension between individual and collective responsibility for health is a common thread in the history of public health. As you read this chapter, ask yourself: how has this tension developed over time, and why does it persist? Introduction This chapter explores the assumptions and struggles that have occurred over the long history of public health. It provides an opportunity to question what public health is and where it is going, based on where it has been. A comprehensive history is outside the scope of a single chapter; instead, the chapter takes a critical overview. Following the social philosopher Michel Foucault (1926–84), the public health knowledge presented is considered a product of its time, culture and context, rather than the result of ‘progress’: a linear path of discovery (Foucault, [1969] 2002). Accordingly, the chapter examines contemporary public health principles and practices that have resulted from the actions of historic heroes and innovators as much as from chance or folly. With a critical examination of its history, this chapter shows that public health is more than a health discipline. It is a scientific profession, a social science and a political endeavour to empower individuals and improve health through organised collective intervention (see also chapters 1, 5, 10 and 14). This chapter introduces readers to the different lenses through which public health has been viewed and practised, from individualist, behaviourist and biomedical perspectives through to cultural and socio-environmental; from ancient Greece to 19th-century Prussia. Australia’s and Aotearoa New Zealand’s histories are also explored, to show how different approaches to public health have (de)emphasised the importance of collective action. The chapter concludes with an examination of this tension in contemporary public health through the example of tobacco control.

  Sign up to read

  Learn more about book
• 

  eBook - ePub

  Public Health

  Policy and Politics

  • Rob Baggott(Author)
  • 2010(Publication Date)
  • Bloomsbury Academic

    (Publisher)

  Although Parliament was a key battleground between public health reformers and their opponents in the Victorian era, local government was also an important arena. The 1848 Act was permissive in all but the most exceptional circumstances. This meant that decisions about public health were delegated to local communities, stimulating political divisions at this level. Efforts to impose a central framework for regulation were vigorously resisted. Indeed, according to some (Szreter, 1995, cited in Baum, 2002, p. 19) the 1840s were ‘a false dawn’ for the public heath movement, which failed to win over the governing classes. In the longer term, however, the impetus proved too powerful. The crucial change was the 1866 Sanitary Act, which imposed obligations on localities to cleanse their communities, although local communities continued to have considerable autonomy within this framework.

  The Public Health Act of 1875 represented the culmination of the sanitary reformers’ campaign. Although a consolidating measure, it set a clear framework for public health for the next fifty years. It also signalled the end of an era, for although legislation would still be used to improve the physical environment, attention was shifting towards other means of intervention aimed at improving social welfare generally and personal hygiene in particular.

  Victorian Public Health: Preventive Medicine

  In the latter part of the Victorian period, ‘preventive medicine’ replaced the ‘sanitary idea’ as the dominant philosophy of public health (see Armstrong, 1993; Kickbusch, 1986; Fee and Porter, 1992; Lewis, 1992). This was manifested in the ‘medicalization’ of public health; in a shift in the focus of attention from the general population towards specific subgroups and individuals, and in an increasing emphasis on access to health services. At the same time, the activities of the sanitary movement, while still contributing to public health debates, became more closely integrated with broader issues of social welfare.

  It should be noted that Chadwick had a ‘deep-seated distrust of curative medicine’ (Finer, 1952, p. 157). Indeed, the early Victorian public health programme was ‘fundamentally environmentalist’ (Sheard and Donaldson, 2006, p. 1). Medicine played a secondary role to other professions, such as engineering for example. As already mentioned, medical professional bodies were less than enthusiastic about central government intervention. Nonetheless, individual members of the medical profession were an important driving force behind the sanitary revolution. Much of the early evidence about the extent of the problem was documented by individuals with a medical background, such as Farr, Southwood Smith and Simon.

  Sign up to read

  Learn more about book
• 

  eBook - PDF

  The Development of Modern Medicine

  An Interpretation of the Social and Scientific Factors Involved

  • Richard Harrison Shryock(Author)
  • 2017(Publication Date)
  • University of Pennsylvania Press Anniversary Collection

    (Publisher)

  59 5 7 Stephen Smith, The History of Public Health, 1871-1921, in M. P. Ravenel (Ed.), A Half Century of Public Health (N. Y „ 1921), p. 7. 58 Simon gives an interesting account in his English Sanitary Institutions, pp. 250 f. 5» Simon, op. cit., describes the reorganization in London. The detailed his-tory of the city is given in Henry L. Jephson, The Sanitary Evolution of London (Lon., 1907). For the New York story, see Stephen Smith, op. cit., and C. F. Bolduan, Over a Century of Health Administration in New York City, N.Y.C. Dep't. of Health Mon. Ser., No. 13 (1916), pp. 3 ff. The out-standing history of municipal health in the U.S.A. is W. T . Howard, Public Health Administration and the Natural History of Disease in Baltimore, Maryland, 1898-1920 (Washington, 1924). Further references to New York 228 DEVELOPMENT OF MODERN MEDICINE It is fair to say, then, that at least a beginning was achieved by 1870 in practical sanitary reform, and in the development of permanent urban health administration. This was also true of the development of health organization on a provin-cial and national scale. If Great Britain, Germany, and the United States are again taken as examples of the more progressive nations, certain common trends are discernible in the evolution of their general health institutions. Following the investigations of the forties, various medical and health societies attempted to organize on a national scale, and ad-vocated national health offices. Most rapid progress in this direction was at first made in Great Britain, where excellent opportunities were afforded by the existence of a relatively small area and a centralized governmental authority. South-wood Smith was able to organize an effective Health of Towns Association for the whole country in 1844; and four years later Chadwick and others persuaded Parliament to establish a national board of health in London. At the very start, the board was given some administrative as well as advisory functions.

  Sign up to read

  Learn more about book
• 

  eBook - PDF

  The Origins of the British Welfare State

  Society, State and Social Welfare in England and Wales, 1800-1945

  • Bernard Harris(Author)
  • 2018(Publication Date)
  • Red Globe Press

    (Publisher)

  This Act was followed by the Public Health Act of 1872, which sought to simplify the pattern of sanitary administration in England and Wales by creating a single sanitary authority for each area, and obliged every sanitary authority to appoint its own Medical Officer of Health. The process of reform was continued by the Public Health Act of 1875. This enormous Act – it ran to 343 separate sections and five schedules – consolidated the public health legislation of the previous 27 years, and established the basic legal framework for the development of public health policy for the next 60 years. 39 The changing relationship between central and local government was also reflected in the increase in the value of the loans made by central government to local authorities to enable them to finance public health works. The PUBLIC HEALTH IN THE 19TH CENTURY 111 Government first acquired the power to issue such loans under section 108 of the 1848 Public Health Act, and a special Act to provide loans to manufactur-ing districts was passed in 1863, but the value of these loans increased sharply following the establishment of the Local Government Board in 1871. During the 1850s and 1860s, the average value of the loans contracted by local author-ities for public works varied between £300,000 per year and £700,000 per year, but the average value of the loans contracted during the 1870s and 1880s was over £2,000,000. During the 1890s, the value of the loans contracted by local authorities ranged from £2.8 million (in 1890) to £7.3 million (in 1893). 40 The period after 1848 also witnessed some important developments in the relationship between the state and the individual. In 1840, Parliament estab-lished a voluntary vaccination service for infants against smallpox. The scheme was administered by the Poor Law medical service, and parents could choose whether or not to take advantage of it.

  Sign up to read

  Learn more about book