Talk:Public health/Archive 1

Archive 1

Winslow quote

The public health definition of Winslow has a wrong source. That sentence does not appear on p. 23 as cited. A similar sentence can be found on p. 30, but it is significantly different. —Preceding unsigned comment added by 96.22.225.208 (talk) 04:20, 3 December 2009 (UTC)

Comment

I saw the quote below and wanted to know more.

"Early on in human civilization, it was recognized that polluted water and lack of proper waste disposal may spread vector-borne diseases."

How early on? What is your source with page number included.

ken 16:18, 2 August 2005 (UTC)kdbuffalo

A good websource for the quote could be: www.jblearning.com/samples/0763738425/38425_CH01_001_034.pdf. This is a bookchapter (Chapter 1: Defining Public Health: Historical and Contemporary Developments by Novick, LF and Morrow CB.) They cite Winslow as follows: In 1920, CEA Winslow provided the following definition of public health practice: Public health is the science and art of preventing disease, prolonging life and promoting physical health and efficiency through organised community efforts, the education of the individual in principals of personal hygiene, the organization of medical and nursing services for the early diagnosis and preventive treatment of disease, and the development of social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health. {P 34 In: Winslow CEA. The Untilled Fields of Public Health. New York, NY: Health Service, New York County Chapter of the American Red Cross; 1920.}

So if you look at that defintion: the social (equality/equity) aspect of public health is already there, there is attention for public health care (focusing on hygiene and prevention, i.e. focusing on infectious diseases) but little (no?)attention for mental health. — Preceding unsigned comment added by PAWIKIrivm (talk • contribs) 12:38, 28 January 2012 (UTC)

Why

I have been avoiding this article for long because I assumed there would be a lot of controversy here. Then I came here ready to deal with the squabbles, but nada. Why? Where are the health promotion vs. health education arguments? Where are the risk factors and the health behaviours? Or is it that this is the ultimate article? The wikipedia article where everyone is NPOV? I doubt it. Well, I'll go quarrel about what Homer Simpson said or did not say. --Ezeu 14:15, 29 September 2005 (UTC)

I agree

I cleaned it up a lot but have yet to add more thorough discussion. will do in a bit,. ThatPaige 03:45, 29 November 2005 (UTC)ThatPaige

Categories

Should Category:Sewerage & Category:Water treatment be subcategories of Category:Public health?

What about other technologies, such as refrigeration, which have an impact on public health? Should we create a category called Public health technologies? --Singkong2005 04:48, 27 February 2006 (UTC)

Schools

Why is only Johns Hopkins (correctly, Bloomberg School) listed on this page? What about Harvard, Michigan, Washington, North Carolina, Emory....

I'd rather delete the link and replace it with a link to the Association of Schools of Public Health -- unless someone wants to make a list of schools and programs of public health. --D Wilbanks 03:55, 23 April 2006 (UTC)

Good point. I deleted the link to JHBSPH, replaced it with a link to ASPH, and reordered the links a little with agencies at the top. Of course, you should feel free to do this sort of editing in the future! bikeable (talk) 20:16, 23 April 2006 (UTC)

Pointing to Johns Hopkins as the first school of public health may not be entirely accurate. Public health in practice has its origins in tropical climate- specifically in New Orleans. Tulane University's School of Hygiene and Tropical Medicine, founded in 1912, layed the groundwork for today's School of Public Health and Tropical Medicine and is commonly regarded as the first school of public health in the country. (--Ajterril (talk) 17:18, 10 July 2009 (UTC))

Not true. All credible sources point to the Johns Hopkins as the first school of public health in the U.S. If you can find a source alluding to Tulane being the first "school of public health" please do share. TennisGrandSlam (talk) 17:31, 10 July 2009 (UTC)

Here's one: Delaport, Francois The History of Yellow Fever: An Essay on the Birth of Tropical Medicine, The MIT Press, 1991, p. 110. (ISBN 026204112X) And you can cite the historical record of the creation of Tulane's school in 1912. The School of Hygiene and Tropical Medicine was the first name for the School of Public Health and Tropical Medicine. see http://www.sph.tulane.edu/main/overview/history.htm. (TennisGrandSlam (talk) 17:53, 10 July 2009 (UTC))

For "programs" in tropical medicine perhaps. But as an actual formalized "school of public health" no. The name might have been there but the school wasn't actually formally established as a seperate "school of public health" until 1967. Every encyclopedia and history of public health book and article cites the Johns Hopkins School of Public Health as the first.TennisGrandSlam (talk) 17:53, 10 July 2009 (UTC)

For "programs" in tropical medicine perhaps. But as an actual formalized "school of public health" no. The name might have been there but the school wasn't actually formally established as a seperate "school of public health" until 1967. Every encyclopedia and history of public health book and article cites the Johns Hopkins School of Public Health as the first.TennisGrandSlam (talk) 17:53, 10 July 2009 (UTC)

Not true. I recommend you go to the ASPH website: http://www.asph.org/document.cfm?page=203&school_Id=25. Tulane's School of Public Health and Tropical Medicine is listed as being founded in 1912. --TennisGrandSlam (talk) 17:53, 10 July 2009 (UTC) —Preceding unsigned comment added by Ajterril (talk • contribs) 17:47, 10 July 2009 (UTC)

Again, it was founded initially as a school "for tropical medicine" only! It wasn't formally recognized as a "seperate school of public health". It was merged back into the school of medicine in 1919 and wasn't "formally" established as a seperate school until 1967. No book or encyclopedia cites Tulane as officially being the first school of public health.TennisGrandSlam (talk) 17:53, 10 July 2009 (UTC)

The Association of Schools of Public Health (to which Bloomberg belongs) clearly disagrees. At the very least, the discrepancy between the ASPH official record and this article should be noted.--Ajterril (talk) 17:55, 10 July 2009 (UTC)

Please try to understand that there is no discrepany. The Tulane school although established in 1912 was simply an independent extension of the Tulane School of Medicine. It was no doubt the first school of tropical medicine which was its modus operandi. The Bloomberg school was the first actual school of public health which typified the schism between medicine and public health which Tulane did not do until 1967. Simply having the name school of public health does not make it the first. Please refer to a book on the history of public health for more elucidation on this issue. Oh and the profiles on the ASPH website are not NPOV sources since they simply state information provided by the schools themeselves.TennisGrandSlam (talk) 18:02, 10 July 2009 (UTC)

I have referred to several and there is a discrepancy. I'm a public health historian. Your argument has several holes: first, you're saying public health as a concept was standardized by Johns Hopkins in 1915. The reality is that what public health points to (prevention and population treatment) existed under several paradigms in the early 20th century. To say that because Johns Hopkins had the first nominal school that they WERE the first ignores the preexisting concept. Second, you're working from a misinformed understanding of what Tropical Medicine is. Third, the historians you cite would AGREE with me that Tulane was the vanguard in public health programs and education in the 1910's. Tulane was founded for this very reason in 1834. Fourth, to say that public health practice was a department of the school of medicine is dubious at best and begs the question. Fifth, schism btween public health and medicine? The APHA and the AMA would have a problem with that wording. Most of the best public health people I know are M.D.s. And last, you're overplaying your hand as a student/ alumnus of Johns Hopkins. Like I said, at the very LEAST, the article needs to point out what the record of the ASPH says. --Ajterril (talk) 18:14, 10 July 2009 (UTC)

No, as I mentioned ASPH publishes profiles provided by the schools themselves. As far as the rest of your argument goes, there are too many inconsistencies for me to delve into. I would ask you to research the "Welch-Rose" Report for the formal foundation of public health schools in the U.S. This article itself cites several notable public health historians as well as the JHSPH one. Like I said, until credible NPOV sources are found (books, academic articles, encyclopedias) which "clearly" refer to Tulane as the "first school of public health" this discussion is moot.TennisGrandSlam (talk) 18:21, 10 July 2009 (UTC)

Gotta get the last word in: to continuously cite the "Welch-Rose" report to argue for preeminence of Johns Hopkins is sort of silly isn't it? It was a Johns Hopkins document after all. And last, I cited one text. Happy to get more. But you have to let me know: how many citations will be necessary for me to have made my point?--Ajterril (talk) 18:35, 10 July 2009 (UTC)

You do not possesss factual knowledge of the official established of the Tulane school of public health in 1967 nor are you cognizant of the ramifications of the Welch-Rose report which was not a "hopkins document" and which was accepted by the U.S dept. of education leading to institutionalized public health education in the U.S. Furthermore you have not cited any credible sources either which support your contention. There are a myriad of sources (as you should well know) which support JHSPH as the first school of public health, none which contend the same for Tulane. Here I am referring to to sources authored by public health historians, academic journals and even encyclopedias. That is all I have to state on this issue.TennisGrandSlam (talk) 18:49, 10 July 2009 (UTC)

I'm sure that's not true. My interest is not in proving that Tulane's school began in 1967 because it did not. We'll see what others have to say. The debate of "who started public health" has raged between Harvard, JH, Yale, and the like for years. And Welsh-Rose report is a part of that. Now, we can use that report to justify Tulane's pre-existence- it DOES cite Hygiene as a manifestation of public health- but we need only to look at the mandate of Tulane's school at the time: toward the betterment of the public's health. I guess now we'll wait for others to chime in.--Ajterril (talk) 19:20, 10 July 2009 (UTC)

A follow-up to the discussion: The Tulane University School of Public Health and Tropical Medicine will celebrate its 100th anniversary in 2012. --Ajterril (talk) 20:40, 10 September 2009 (UTC)

Note that the London School of Hygiene and Tropical Medicine was founded in 1899, and the Liverpool School in the UK predates that. This article makes it sound as if JHU invented the study of PH, which it clearly did not. 130.160.45.28 (talk) 15:08, 9 November 2009 (UTC)

Splitting?

Moved from Wikipedia_talk:WikiProject Clinical medicine:

I think this article should be split into several other articles - it would be a good thing, I feel. Does anyone else agree with this proposal?? SunStar Net 13:44, 28 October 2006 (UTC)

Why do you think that? And in what would you split? A quick look doesn't convince me that's the way to go...--Steven Fruitsmaak (Reply) 14:58, 29 October 2006 (UTC)

If you define how you would split the article and provide a good reason I may support in the future. Currently, I'm not convinced the article needs to be split. It isn't very long and the material fits together reasonably well. Nephron  T|C 05:59, 1 November 2006 (UTC)

i don't agree

The New Public Health is uncritically presented here. It is actually nothing 'new'. By focusing on community-based approach, it remains top-down. Similarly, with 'empowerment', it has not gone any far from victim blaming because the individuals are asked to take more care of themselves. Phong. —The preceding unsigned comment was added by 81.23.56.51 (talk) 22:33, 18 December 2006 (UTC).

PH Education in Medical School

I had added this article to Category:Subjects taught in medical school, which was then removed with the statement that PH was taught in Public Health school, and MDs don't receive training in it. I can say from personal experience that in my first year of medical school I had to take a 4 month course on introductory principles of public health. My collegues in other medical schools also had similar courses. I feel that it is suitably emphasised along with the other traditional courses of anatomy, physiology, biochemistry, and so on. Nanded 22:25, 8 April 2007 (UTC)

hi Nanded -- I removed the category because, while fundamentals of PH can of course be taught in medical school, public health is primarily taught in schools of public health. The category seems to include medical topics, and in fact, most of the entries in it are medical specializations, so public health seems out of place. I guess I was thinking of it as a statement like, "Public health is taught in medical school", which is somewhat true -- some elements of PH are taught in medical school -- but doesn't give the whole picture, which is that there are schools specifically for public health. (It doesn't help that we don't have a category for "Subjects taught in schools of public health", so the only school-related category is medical school.) thanks. bikeable (talk) 23:36, 8 April 2007 (UTC)

That's a fair assessment. However, if you take that stance, then you have to consider that none of the topics would appropriately belong in that catagory. One wouldn't go to Medical School to study biochemistry, as the standard medical school biochemistry course is basically an overview of the well defined biochemical pathways relevant to medicine. If you wanted to study biochemistry legitamately, you would go to grad school and do a PhD in biochemistry. Same for the other typical medical school courses like microbiology, pharmacology, anatomy, etc. I agree that that medical school doesn't teach public health in depth, but for the most part that statement would hold true for most subjects if you compare it to what the penultimate study in each of those fields are. As such, I would say that excluding it from the list of medical school course work isn't the way to go, bur rather maybe adding a clarification to the public health article about what medical school education of public health entails. Nanded 03:03, 9 April 2007 (UTC)

Thanks for the response. Yes, with my assessment the Category would be somewhat smaller; however, many of the articles in that category are medical specialities (e.g. Emergency medicine, Obstetrics, Cardiology). For others like Biochemistry it is often possible to get a degree in a medical school; for example, an MD/PhD program in biochemistry might be taught in a medical school. For public health, by constrast, virtually all coursework (except a brief introduction) would be taught in a school of public health. I think restricting the category to subjects in which you can get a degree (or specialization) in a medical school makes good sense; however, this amounts to a discussion about the category and not about the public health article. (Academic detailing and Medical humanities are somewhat odd exceptions.) Given all this, I continue to think that PH should not be in that category. thanks for your comments. bikeable (talk) 21:20, 10 April 2007 (UTC)

Quick follow-up -- I note that the category now includes this Talk page but not the public health article -- and I can't figure out why. How weird! any ideas? bikeable (talk) 21:21, 10 April 2007 (UTC)

As I see it, you're arguing that public health isn't taught in complete depth in medical school, which is completely accurate. However, I don't think that's the point of catagorizing it as a topic which is taught as part of medical school carriculum. When I updated that catagory (which had all of 6 topics in it when I began), I just went down the list of subjects I and my collegues had in medical school and added them. I basically asked "Was (blank) taught in medical school?". Biochemistry, yes. Anatomy, yes. Art history, no. Public health, yes. Taking your argument further, would you say that mathematics isn't on the list of subjects taught in High School, because its true study is done in college?Nanded 23:15, 12 April 2007 (UTC)

I have several issues with this. First is one of balance; there is no category for "subjects taught in schools of public health" (nor do I think it important that there be one, else I would create it), so including public health in the category "subjects taught in medical school" misleadingly gives the impression that public health is only or primarily taught in medical school. I think the bigger issue is with the latter category, which is poorly defined (not your fault!). As I said before, most of the article in it are medical specialties or things you can get an advanced degree in at a medical school. Neither of those encompasses public health. I think the correct solution is to define the category better; personally, I would rename it Category:Medical specializations and edit it appropriately. "Subjects taught" is simply too broad. For example, my SPH teaches classes in writing and in anatomy, but to place a category called "subjects taught in schools of public health" on the Writing page, or on the Anatomy page, would be highly misleading -- particularly if there were no other "Subjects taught in..." categories on those pages. Again, I think a clearer definition of the category is the best solution. bikeable (talk) 20:11, 13 April 2007 (UTC)

I know this argument is long, long over but I needed to add my two cents. Public health IS a specialty within medicine, you can do a "public health" rotation during your 3rd and 4th year of medical school and PH subjects are taught in medical school (Biostatistics and Epidemiology). Definitely think it should be added here. WiiAlbanyGirl (talk) 03:22, 13 January 2009 (UTC)

Yes, but Public Health is also a profession persued by non-physicians in schools of Public Health that are not part of a Medical School. Pzavon (talk) 02:56, 14 January 2009 (UTC)

I'd like to put this paragraph in, but need guidance

I'd like to follow this paragraph, with the second one, but I don't know how, and would like people's comments before I do.--Raymm 01:56, 22 April 2007 (UTC)

This is in article During the 20th century, the dramatic increase in average life span is widely credited to public health achievements, such as vaccination programs and control of infectious diseases, better safety policy such as motor-vehicle and worker safety, improved family planning, floridation of drinking water, and progams designed to decrease chronic disease such as heart disease and stroke.

I propose adding this: (but need guidance) An alternative hypothisis is proposed by Leonard A. Sagan in The Health of Nations: True Causes of Sickness and Well Being (http://www.rainbowbody.net/Finalempire/FEchap13.htm) "Finally, there is another explanation for the decline in deaths from infectious diseases, namely, an improvement in human resistance." "So what has caused the increase in health according to Sagan? His studies point to the increased strength of the nuclear family...The relatively small group of people in industrial societies, who have statistically better health and longevity also have social advantages well above the norm, Sagan finds. This is the group who has a firm social foundation as infants, who have avenues of advancement and who have, because of social privilege or unusual families, been enabled to gain optimism and self esteem. (from http://www.rainbowbody.net/Finalempire/FEchap13.htm) (Sorry, I don't know how to do footnotes, perhaps someone could give me a clue)

I removed this paragraph; sorry. I have never heard this theory before, and I do not think the website you cite is a very solid source, and so I'm not even sure I would trust their summary of the research. It's not clear to me whether the research is speaking about a genetic or a social support improvement; certainly the latter effect is well known, and there is clear improvement in morbidity and mortality with social networks, but the cultural comparison seems wildly off and I have never heard this suggested as a reason for improved health. I glanced through The Impact of the Family on Health: The Decade in Review, Ross, CE (1990) in Journal of Marriage and the Family and found references to Sagan and a lot of discussion of health consequences of family but no suggestion that this is responsible for improved 20th century health in place of vaccination. Without more detailed citations, I do not think this is useful. Incidentally, a quick way to do footnotes is just to use <ref>footnote detail</ref>. bikeable (talk) 18:16, 24 April 2007 (UTC)

I think he is saying deaths declined because the nuclear family`s lot improved.--Raymm 00:49, 25 April 2007 (UTC)

Does Leonard A. Sagan get no respect, then?

How do you do question marks?--Raymm 00:49, 25 April 2007 (UTC)

I guess that, until I see references to this theory in other work, I don't think it belongs in this paragraph. I haven't looked at his book yet, so we have only a secondhand report from rainbowbody.net of what he actually said. If you can find further references to it, preferably in the PH literature, we can add it back. Incidentally, I have no idea why question marks don't work -- are you perhaps cutting and pasting text from another program? bikeable (talk) 03:06, 25 April 2007 (UTC)

Ok, that would be beyond me, I'll leave it for someone else that knows more about PH. Question mark problem was from my computer.--Raymm 03:19, 5 May 2007 (UTC)

European Public Health

I removed the couple of sentences added on this topic, although I left it in the "see also" list. Except for the MPH program at Maastricht, I don't see a reason to think that European Public Health is a field different than public health more generally. If more citations can be added, this could be put back. (I made the same comment over at European Public Health.) bikeable (talk) 18:19, 24 April 2007 (UTC)

Too American

Yet another Americanised article. Ianguy 04:51, 12 June 2007 (UTC)

→Because the contributors can only draw upon their own experiences and research? Assuming that the editors who "Americanised" it are themselves from the United States, doesn't it logically follow that the bulk of their knowledge would be about the American public health system? If you want this to be a more global article, then by all means share your worldly experiences with those who haven't had that benefit and improve the article, don't complain about those who contribute.

See Also - too long?

Isn't the "See Also" list in this article getting too long to be useful? Since there is a "Public Health" Category wouldn't it be more effective to reference most of those articles there? I can't see a reason to duplicate everything in both locations. Pzavon 21:22, 2 December 2007 (UTC)

Should this article contain a description of publicly financed and publicly managed heath care delivery systems?

In the United Kingdom we have the concept of private medicine where one can seek treatment and pay for it out of pocket or in whole or in part from some form of medical insurance. The alternative to using that system is to use the public health care system, the National Health Service. I now live in Finland where a similar alternative applies, although the public health care system (clinics and hospitals) is run by the local municipalities. Both systems are largley publicly funded. There are many such systems around the world.

I therefore created an article called Public medicine to describe such systems. I called the article public medicine as shorter way of saying public health care systems. However, another editor has suggested that this information should reside in the Public health article and has redirected the article here, implying that I was creating a fork. I am reluctant to add this type of content here because I doubt that editors here would regard publicly delivered health care as being the same as public health. In the UK we also use the term public health, but it tends to be used to discuss very general matters of public health rather than as a generic name for the public delivered health care system that is the NHS. In everyday speech we Brits we will say "are you going public or private?" to mean "are you going to get that care from the public NHS system or will you use the private medical system?". Hence, to my ear, Public medicine is a good place holder.

I would welcome the views of other editors here. Please let me know where you think a general description of publicly funded and publicly managed health care delivery systems should reside in Wikipedia. If you think the content should be in this article please say so. If you think elsewhere please say so, and under what title you think this information should be collated. --Tom (talk) 17:38, 12 January 2008 (UTC)

I agree with you. A separate article about publiclly funded health care delivery systems is appropriate. "Public Health" is about the health of the community, or large groups, about such things as sewage collection and treatment, epidemic detection and control, food service sanitation, etc., not about systems for delivery of individual health care - although the adequacy of such systems could effect "the public health." For what it may be worth in this discussion, I am based in the US. Pzavon (talk) 03:22, 13 January 2008 (UTC)

Are there no other opinions out there? I am grateful to Pzavon for the contribution above but I was rather hoping for more views than this. I was offended by the accusation that Public medicine would be a WP:fork, so I really would like the opinion of some other editors. There is already some information at socialized medicine but the very title of that article is (a) POV because of the way the term is used in the US (b) not used outside of the USA and (c) not in any case exclusively covering public delivered health care (as the term socialized medicine is used to describe Canada's single payer health care system which is publicly financed but privately run. Hence the need to find a better location for such material. Hence my suggestion of collating at public medicine. I see that some US Medical departments at universitites in the US include the title "Public Medicine". Can anyone enlighten me as to what this refers to. Is that basicially the same as "Public Health" in the US? (i.e. the action of government in the field of health?). If that is so I can see how the argument could be made that the actions of government in meeting the health needs of the polulation should be collated under Public Health. I would say that in Britain for example as in Finland there is a seamless divide between Public Health and the delivery system that produces it.--Tom (talk) 21:12, 15 January 2008 (UTC)

I believe the Publicly-funded health care article covers much of what you are discussing, the merge tag for Socialized medicine seems correct. I would change the Public medicine redirect to point to Publicly-funded health care. There are also several other articles listed at the bottom of the existing articles in their respective see also sections. If you are looking for a description of what Public Health refers to in the us I would take a look at the Master of Public Health article for description of the topic in how it relates to an educational setting. I would tend to say the same applies to the US as it does to England and possibly other English speaking countries. Public Health is a fairly broad general term that refers to more than just the delivery of health care services. -Optigan13 (talk) 05:25, 16 January 2008 (UTC)

Thanks for the comment. I am aware of the merge suggestion to Publicly-funded health care. I will think again about this suggestion (which I previously have opposed). There were mixed views on the matter and I was myself hostile precisely because certain WP editors (mostly US based) seem to think that there is a big difference between public funded (but privately delivered) health care and publicly funded (but publicly delivered) health care. I think the differences are worth examining because the claims made are often (as I have discovered) based on the use of highly selective data, sensational tabloid newspaper reports, out-of-date, and in some cases premised on false logic or at worst pure fantasy. They are examined to a limited extent at Socialized medicine but I am unhappy about the title. It is just a derogatory term used mainly in the USA for something else, athough that "something else" is somewhat amoebic. --Tom (talk) 17:04, 16 January 2008 (UTC)

Assessment

This article needs some serious clean up work. Here are a few specific issues:

• External links should not be visible/clickable in the article, as they are, for example, under ==Education and training==.
• The linkfarm under "External links" needs to be weeded. There are links to directory services; practically everything here should be moved to the Yahoo! or DMOZ directories and removed from Wikipedia.
• The "Seealso farm" needs serious pruning. Try eliminating anything that's already linked in the text, and finding a navigation template that covers most of the rest. If none exist, please either make one or leave a note at WT:MED with a list of suggested articles, and I'm sure someone will help you make one.
• This article needs more references. Like most medicine-related articles, it's best to use inline citations instead of general references. This article can't be promoted to B class until this is improved.
• You might find some useful suggestions at WP:MEDMOS#Medical_specialties.

This is an important article, and it will be included in a few weeks in the WP:0.7 copy of Wikipedia (I think: Most top-rated articles are). I hope that these suggestions will be useful to you in improving it before then. WhatamIdoing (talk) 06:09, 18 September 2008 (UTC)

My Own Assessment

• I agree that the article needs major cleanup, and I'm going to offer my 2 cents.

1.) The absolute lack of what the modern day "Department of Health" at the local, county and state level in the United States is beyond preposterous. Someone complained about this article being americanized, and they couldn't be more wrong. The function of the modern-day health department and how it participates in disaster medicine, health education, disease surveillance (I really could go on and on...) and the lack of the mentioning of the CDC (and how it funds NUMEROUS public health programs) is ridiculous. Whoever thinks this article is a good article needs to look again. I really feel bad for the individual who looks at this article and think there's any appropriate representation of American public health here 2.) Seriously? NO mention of the obesity epidemic and what public health efforts have been set forth to control it in the USA and beyond? That would be a great example of a current public health crisis. How about MRSA? Pandemic Flu? These buzz words could help people connect what they've heard on the news to the greater concept of what public health really is. 3.) This line is very misleading and incorrect - "Public health is typically divided into epidemiology, biostatistics and health services. Environmental, social, behavioral, and occupational health are also important subfields." It makes it seem that the main fields of public health are epidemiology, biostatistics and health services (honestly, I don't even know what that is). By saying that environmental, social, behavioral and occupational health are subfields in this sentence, it makes it seem that they are subfields of the previously three mentioned categories. To be honest with you, it's incredibly incorrect. Health policy isn't even mentioned, and environmental health, health psychology and occupational health are important fields within public health.

I have been educated and I work in the field of public health, but I lack the time at the moment to devote to finding links to help build this article more constructively. Might anyone take a stab at some of my recommendations? Thanks kindly! Please get back to me if you have any feedback. WiiAlbanyGirl (talk) 03:22, 13 January 2009 (UTC)

Fluoridation

I am well aware that there are extensive arguments around the net health benefits of water fluoridation in the US (particularly since other countries have countered dental caries with the fluoridation of toothpaste), and without wishing to continue thoses discussions on this page I wonder if fluoridation of drinking water should be included in this article as one of the public health achievements contributing to the "dramatic increase in average life span" seen in the 20th century. The only reference I can find for this claim is an isolated CDC report, and the quality of studies supporting the high efficacy of fluoridation are only judged as of "moderate" quality. While I do not personally subscribe to the idea that water fluoridation is necessarily bad for health, I think that the efficacy (and benefits) of this particular public health measure may still be somewhat debatable, particularly outside of the US context.Jimjamjak (talk) 16:30, 2 June 2009 (UTC)

The major public health concern is diabetes.In 2006,according to the World Health Organisation,at least 171 million people worldwide suffered from diabetes.Its incidence is increasing rapidly and it is estimated that by the year 2030,this number will double. —Preceding unsigned comment added by 117.200.54.16 (talk) 10:49, 6 July 2009 (UTC)

strocke hemoregic

what happen want pepole get this disease?  —Preceding unsigned comment added by 124.82.222.177 (talk) 02:45, 28 April 2011 (UTC) 

Why aren't VETERINARIANS listed in any of the History of Public Health accomplishments?

Veterinarians are KEY to public health accomplishments and yet we all seem to give credit only to physicians. — Preceding unsigned comment added by 174.253.234.104 (talk) 17:17, 4 June 2011 (UTC)

Terminology

May I suggest that the terminology used in this article could be clarified by references to:

• Rychetnik L, Hawe P, Waters E, Barratt A, Frommer M (2004 Jul). "A glossary for evidence based public health". J Epidemiol Community Health. 58 (7): 538–45. doi:10.1136/jech.2003.011585. PMC 1732833. PMID 15194712. {{cite journal}}: Check date values in: |date= (help)CS1 maint: multiple names: authors list (link)

Cheers, LeadSongDog come howl! 18:53, 8 July 2011 (UTC)

This is a good start to discuss public health more broadly...but. A short overview is lacking still of the 'essential public health functions'. There are a few approaches (partly overlapping). Further major issues can then be derived these essential public health functions: 'surveillance' (of: infectious diseases, unsafe farmaca or consumer products) and 'health monitoring' ie public health or population health monitoring. One or tow conceptual models for public health should be discussed as well (Lalonde, Whitehead, maybe others). Next we would need to link to or include texts on methods, tools and approaches used....vaccination programs, screening programs, health education, health impact assessment, burden of disease determination, population attributable risks, evidence based medicine,.... — Preceding unsigned comment added by PAWIKIrivm (talk • contribs) 11:00, 28 January 2012 (UTC)

Schools of public health

The section on 'Schools of public health' is entirely US-centric. I'm not sure whether the primary aim of this section is to explain the history of public health education, or to highlight the current role of free-standing PH schools, but either way it does not acknowledge the contributions of some significant non-US institutions. Is there scope to rectify this? Normallydistributed (talk) 15:07, 19 July 2012 (UTC)

career in this field .

I want to what kind of career is there in Health Science in terms of Nepal ? --— Preceding unsigned comment added by 203.91.130.2 (talk • contribs) 6 July 2007

I have no way to back this up, but I imagine that your best bet would be to get training as a public health specialist elsewhere and then bring that expertise to Nepal, unless of course Nepal has its own program/school of public health... --— Preceding unsigned comment added by Th17kit (talk • contribs) 16 September 2007

Doesn't look like a particularly active Talk page, but if anyone is listening out there, I think the entry almost entirely ignores an important part of public health: preparedness. It mentions it as an aim of the Public Health Agency of Canada, but public health preparedness is as big a part of public health as disease detection. Rather than introduce a new section, which would not seem to fit with how the subject is approached in the article, I propose to sprinkle references and examples of public health preparedness throughout the article. If I don't hear from anyone in a few days, I'll proceed with this plan. Sebriscoe (talk) 15:15, 22 March 2013 (UTC)

Crowdsourcing

• Crowdsourcing is the process of outsourcing a task to an online community. The users are two types; namely, requesters and workers, with a middle agent as a crowdsourcing platform-like forum.

Why is this comment here? I realize (and acknowledge) that 'crowdsourcing' is an important study in public health and that it has good potential in public health work, but why is it 'sitting by itself' on the talk page of the IMPORTANT Wikipedia ARTICLE on public health, with NO OTHER 'talk' comments on public health: only the STATEMENT about CROWDSOURCING? MaynardClark (talk) 03:28, 6 January 2015 (UTC)

Relevant category

Due to the estimated 340 million new cases of curable sexually-transmitted diseases recorded worldwide yearly I found this category to be especially relevant regarding public health.

  Bfpage |leave a message  00:52, 28 March 2015 (UTC)

Reduce the long "see also" list

There are far too many items under "see also". I propose to cut them down quite drastically. Important terms should appear in the article itself (as sub-headings if needed), but such a long see also list is simply not helpful.EvM-Susana (talk) 11:06, 22 July 2015 (UTC)

The examples and perspective in this article may not represent a worldwide view of the subject

The article is biased to UK and US Public health policies. I strongly suggest the article expansion to cover other countries where Public health is far more developed (https://en.wikipedia.org/wiki/Universal_health_coverage_by_country). — Preceding unsigned comment added by Nestor-Toledo (talk • contribs) 16:15, 13 October 2015 (UTC) Nestor-Toledo (talk) 16:18, 13 October 2015 (UTC)

I suggest reducing the See Also list and the Further reading list

In my opinion, the See Also list and the Further reading list are far too long to still be useful. I think we should cut them down quite a bit. Do others agree? Someone wants to make a start? EvMsmile (talk) 03:26, 18 December 2015 (UTC)

Definition citation correction

Hello -- I just made my first Wikipedia edit ever, so I'm posting a little more explanation since I'm new.

The page originally cited Winslow's 1920 Science article for the quoted definition of public health. But this definition was actually from Winslow's separate article published in the same year in Modern Medicine. Modern Medicine does not actually seem to be available online, but the National Academies of Sciences published a Workshop Summary which outlines where and how Winslow published two related but different definitions of public health. See pages 116-117 in the pdf titled "Implications of Health Literacy for Public Health" available for free from NAS at http://iom.nationalacademies.org/Reports/2014/Implications-of-Health-Literacy-for-Public-Health.aspx — Preceding unsigned comment added by Effie Greathouse (talk • contribs) 13:55, 12 March 2016 (UTC)

We should select a different image for the lead

I think this image of newspaper articles on vaccination is not a good image for the lead. How about rather a logo or headquarter of the main organization that pushes for it (WHO?), and maybe more of an activity for public health like a handwashing campaign perhaps? Or, if it's too difficult to choose, than rather no image at all? EvMsmile (talk) 03:28, 18 December 2015 (UTC)

I agree with your opinion on the lead image. A logo would work well. I would also like to add that the whole article could use a more systematic diagram of all the subfields/how all the factors we deal with relate to each other such as images we find on Google when we search "public health paradigm." As I rarely edit Wikipedia articles, I have no idea how to do this. 2601:646:4200:C7AE:95D:C651:5178:2A0F (talk) 18:33, 13 April 2016 (UTC)A

Effie Greathouse (talk) 13:56, 12 March 2016 (UTC)

Hi User:Effie Greathouse, could you give some example images from Google image search that could be suitable? If they are open access we can use them. I just searched in Wikimedia Commons but found nothing suitable for "public health paradigm" or for "public health". EvMsmile (talk) 12:43, 22 April 2016 (UTC)

What about this one? Carl Fredrik 💌 📧 16:41, 26 December 2016 (UTC)

One of the most iconic images of public health. Mabe the magazine is even more iconic, but I'm not sure it's free.

Keeping the banner about the offline version

Hi User:KATMAKROFAN, I think you prematurely deleted the banner. Let's see first what comes out of the discussion currently taking place here: https://en.wikipedia.org/wiki/Wikipedia:Miscellany_for_deletion/Wikipedia:WikiProject_Medicine/App/Banner EvMsmile (talk) 12:12, 3 January 2017 (UTC)

Making this article more "readable"

I'm interested in making information more accessible to the average reader. I ran the "lead" through the Hemmingway App, which assesses readability and can see several obvious ways of improving the article. For example, 8 of the 13 sentences were labeled "difficult to read." I've done some minor editing in the least two days to see if anyone objected: so far no one has. Any concerns if I work on this article more to see if we can improve it? My goal is to preserve accuracy while improving clarity. No trade-offs on that whatsoever allowed.PlanetCare (talk) 19:46, 20 November 2017 (UTC)

I suggest reducing the See Also list and the Further reading list

In my opinion, the See Also list and the Further reading list are far too long to still be useful. I think we should cut them down quite a bit. Do others agree? Someone wants to make a start? EvMsmile (talk) 03:26, 18 December 2015 (UTC)

I have copied the above from the archive. I have now reduced the see also list. I think it needs to be culled further. Suggestions? EMsmile (talk) 12:57, 26 June 2018 (UTC)

Citations needed

There are many facts and statements which are really informative and useful in the topic of Public Health. But the citations are missing in many of them. If anyone can exactly find the sources, I request them to cite these statements. User:Kayastha.p (talk) 09:49, 21 September 2020 (UTC)

Work done in May 2021 and plans for improvement

I've just made quite a few changes to the article and just wanted to explain a little bit:

• I started off with streamlining the "country examples" section. This kind of section is often populated by the work of student assignments and can over time blow out a bit. So I have moved content into relevant sub-articles and replaced the content with excerpts instead. It's always a dilemma to decide how much of the country examples is useful for this kind of overview article when there are already dedicated sub-articles for this.
• Secondly, I shifted, removed or condensed some content that was giving too much emphasis to the situation in the United States. The article was overly US-centric and Europe-centric.

What still needs doing:

• I'd like to add a bit of content to explain how public health differs or overlaps with global health and with international health (but haven't found a good reference for this yet).
• More content on public health all over the world, not just United States and Europe.
• Find a better image for the lead (not sure if the current vaccination focused image is ideal).
• I'd like to find content experts (probably outside of Wikipedia) who could give this article a high-level review. I am thinking that some textbook authors (or people around retirement age with a little bit more time?) might be interested to contribute. To this end, does anyone have any textbooks or people that they would recommend to be contacted for such a high-level review? EMsmile (talk) 06:43, 28 May 2021 (UTC)

Took out "further reading" list

I have taken out the "further reading" list. If any of these publications are very important, they should be used for inline citations:

• Berridge, Virginia. Public Health: A Very Short Introduction (Oxford University Press, 2016).
• Berridge, Virginia, et al. Public Health in History (2011).
• Breslow, Lester, ed. (2002). Encyclopedia of Public Health. New York: Macmillan Reference USA. ISBN 978-0-02-865354-9.
• Heggenhougen, Kris; Stella R Quah, eds. (2008). International Encyclopedia of Public Health. Amsterdam Boston: Elsevier/Academic Press. ISBN 978-0-12-227225-7.
• La Berge, Ann F. Mission and Method: The Early Nineteenth-Century French Public Health Movement. New York: Cambridge University Press 1992.
• Novick, Lloyd F; Cynthia B Morrow; Glen P Mays (2008). Public Health Administration: Principles for Population-Based Management (2nd ed.). Sudbury, MA: Jones and Bartlett Pub. ISBN 978-0-7637-3842-6.
• Schneider, Dona; David E Lilienfeld (2008). Public Health: the Development of a Discipline. New Brunswick, NJ: Rutgers University Press. ISBN 978-0-8135-4231-7.
• Rosen, George. A History of Public Health. New York: MD Publications 1958.
• Tausch, Arno (2012). Globalization, the Human Condition, and Sustainable Development in the Twenty-first Century: Cross-national Perspectives and European Implications. With Almas Heshmati and a Foreword by Ulrich Brand (1st ed.). Anthem Press, London. ISBN 9780857284105.
• Turnock, Bernard (2009). Public Health: What It Is and How It Works (4th ed.). Sudbury, MA: Jones and Bartlett Publishers. ISBN 978-0-7637-5444-0.
• Detels, Roger; Gulliford, Martin; Karim, Quarraisha Abdool; Tan, Chorh Chuan, eds. (2013). Oxford Textbook of Public Health. Vol. 1 (6th ed.). Oxford and New York: Oxford University Press. doi:10.1093/med/9780199661756.001.0001. ISBN 9780199661756.
• White, Franklin; Stallones, Lorann; Last, John M. (2013). Global Public Health: Ecological Foundations. Oxford University Press. ISBN 978-0-19-975190-7.

EMsmile (talk) 06:52, 28 May 2021 (UTC)

Early history

The "Early history of public health" seems to be in need of an overhaul. I propose to incorporate recent work on premodern public health from across the globe (e.g. Carole Rawcliffe, Nukhet Varlik, G. Geltner, Janna Coomans) and add references and links to other relevant entries. Do people agree? Wild Bodgie (talk) 12:54, 3 January 2020 (UTC)

It would also be critical to include public health history from the Global South. Sanitation and water initiatives, the early basis of public health, existed all over the world. Jungliji (talk) 21:07, 12 February 2020 (UTC)

I have moved this back from the archive because I think it hasn't been resolved yet. EMsmile (talk) 03:28, 28 May 2021 (UTC)

Hi Wild Bodgie, I've just had a look at the work you did last year in Jan and Feb 2020. It seems to me that you've made huge improvements to the "early history" section. Thank you! How come, is this something you've worked on in "real life" before coming to Wikipedia? Also, I noticed that you deleted these four paragraphs. They actually had no citations so probably deserved to be deleted but I was just wondering if any of this is still salvageable or if it's all superceded with better content by now?

++++++++ Public health has early roots in antiquity. From the beginnings of human civilization, it was recognized that polluted water and lack of proper waste disposal spread communicable diseases (theory of miasma). Early religions attempted to regulate behavior that specifically related to health, from types of food eaten, to regulating certain indulgent behaviors, such as drinking alcohol or sexual relations. Leaders were responsible for the health of their subjects to ensure social stability, prosperity, and maintain order.

By Roman times, it was well understood that proper diversion of human waste was a necessary tenet of public health in urban areas. The ancient Chinese medical doctors developed the practice of variolation following a smallpox epidemic around 1000 BC. An individual without the disease could gain some measure of immunity against it by inhaling the dried crusts that formed around lesions of infected individuals. Also, children were protected by inoculating a scratch on their forearms with the pus from a lesion.

In 1485 the Republic of Venice established a permanent Venetian Magistrate for Health comprising supervisors of health with special attention to the prevention of the spread of epidemics in the territory from abroad. The three supervisors were initially appointed by the Venetian Senate. In 1537 it was assumed by the Grand Council, and in 1556 added two judges, with the task of control, on behalf of the Republic, the efforts of the supervisors.

However, according to Michel Foucault, the plague model of governmentality was later controverted by the cholera model. A Cholera pandemic devastated Europe between 1829 and 1851, and was first fought by the use of what Foucault called "social medicine", which focused on flux, circulation of air, location of cemeteries, etc. All those concerns, born of the miasma theory of disease, were mixed with urbanistic concerns for the management of populations, which Foucault designated as the concept of "biopower". The German conceptualized this in the Polizeiwissenschaft ("Police science"). +++++++++ EMsmile (talk) 06:34, 28 May 2021 (UTC)

Hi EMsmile, thanks for the feedback and yes, this is something I research. Along with my research team on ealry public health history we put together a full text that superceded the previous one and added sufficient and updated sources. We intervened in several other languages as well (German, Dutch, French and Farsi). One issue remaining is that the subsequent section on modern public health is now a little bit at odds (and frankly of more modest quality) that the early public health one. I also fully agree with Jungliji that other regions could be better represnted, and while I am working on expanding my own knowledge, it is still not something I have sufficient expertise in just yet. Wild Bodgie (talk) 01:52, 30 May 2021 (UTC)Wild Bodgie

Thanks a lot for that work, Wild Bodgie. I am wondering if you also have time and energy to give the rest of the article a review? It's an important topic and I think there is room for improvement (see also the next section of the talk page). If you don't have time, do you know other public health experts whom I could approach to ask for help in such a review process? Particularly those working on developing countries public health aspects in order to make the article less US-centric? EMsmile (talk) 01:19, 31 May 2021 (UTC)

Dear EMsmile, the current early history section is as good as expert peer-reviewed (I am happy to provide my credentials), and includes quite a few examples from around the world. The next section can be much improved and brought into closer dialog with this one, but it is outside my wheelhouse. You could contact someone like Tom Crook at Oxford Brookes University, who is knowledgeable and open-minded. Two other big names in the field are Virgina Berridge (LSHTM) and Sanjoiy Bhattacharya (York). Hope this helps and I will continue to monitor this entry in the futureWild Bodgie (talk) 01:12, 1 June 2021 (UTC)Wild Bodgie

Thanks a lot for that. I'll reach out to them. From their websites it seems to me that they are also into the historical aspects more than the present time (?). But perhaps they in turn can point me to experts who can help with the rest of the public health article review, i.e. not just about the history but how it looks at present time, what are the current developments, pressing needs and so forth. EMsmile (talk) 13:19, 1 June 2021 (UTC)

Removed a text block that was off-topic

I've removed this text block because it seems to me off-topic. It is more likely to fit with health care. Also it is overly detailed with examples from the US which doesn't suit this overview type article:

Implementing effective improvement strategies

To improve public health, one important strategy is to promote modern medicine and scientific neutrality to drive the public health policy and campaign. Political concerns can lead government officials to hide the real numbers of people affected by disease in their regions, such as upcoming elections. Therefore, scientific neutrality in making public health policy is critical; it can ensure treatment needs are met regardless of political and economic conditions.

The history of public health care shows the global effort to improve health care for all. However, in modern-day medicine, real, measurable change has not been clearly seen, and critics argue that this lack of improvement is due to ineffective methods that are being implemented. As argued by Paul E. Farmer, structural interventions could possibly have a large impact, and yet there are numerous problems as to why this strategy has yet to be incorporated into the health system. One of the main reasons that he suggests could be the fact that physicians are not properly trained to carry out structural interventions, meaning that the ground level health care professionals cannot implement these improvements. While structural interventions can not be the only area for improvement, the lack of coordination between socioeconomic factors and health care for the poor could be counterproductive, and end up causing greater inequity between the health care services received by the rich and by the poor. Unless health care is no longer treated as a commodity, global public health will ultimately not be achieved. This being the case, without changing the way in which health care is delivered to those who have less access to it, the universal goal of public health care cannot be achieved.

Another reason why measurable changes may not be noticed in public health is because agencies themselves may not be measuring their programs' efficacy. Perrault et al. analyzed over 4,000 published objectives from Community Health Improvement Plans (CHIPs) of 280 local accredited and non-accredited public health agencies in the U.S., and found that the majority of objectives – around two-thirds – were focused on achieving agency outputs (e.g., developing communication plans, installing sidewalks, disseminating data to the community). Approximately one-third focused on seeking measurable changes in the populations they serve (i.e., changing people's knowledge, attitudes, behaviors). What this research showcases is that if agencies are only focused on accomplishing tasks (i.e., outputs) and do not have a focus on measuring actual changes in their populations with the activities they perform, it should not be surprising when measurable changes are not reported. Perrault et al. advocate for public health agencies to work with those in the discipline of Health Communication to craft objectives that are measurable outcomes, and to assist agencies in developing tools and methods to be able to track more proximal changes in their target populations (e.g., knowledge and attitude shifts) that may be influenced by the activities the agencies are performing.

References

EMsmile (talk) 14:09, 4 June 2021 (UTC)

Moved content that was actually about global health to other articles

Today I have moved some text blocks that didn't really belong here to the other articles on Global health and Global Health Initiatives. I think it's important to try and keep the boundaries between the articles on public health and global health, and also public healthcare fairly clean. I have added some content to the definitions section to explain the differences between public health, global health and international health but this is not complete yet. EMsmile (talk) 14:54, 4 June 2021 (UTC)

Took out a quote

There's a push and pull, as you know, between cheap alternatives for industry and public health concerns... We're always looking at retrospectively what the data shows... Unfortunately, for example, take tobacco: It took 50, 60 years of research before policy catches up with what the science is showing." — Laura Anderko, professor at Georgetown University and director of the Mid-Atlantic Center for Children's Health and the Environment commenting on public health practices in response to proposal to ban chlorpyrifos pesticide

I have removed this quote (see on the right), as I felt it was a long quote without saying very much. If we think it's important, let's rather convert it to encyclopedic content with an in-line citation. EMsmile (talk) 08:02, 7 June 2021 (UTC)

References

Working with external reviewer (July 2021)

I am currently working with an external reviewer to improve this article. This reviewer sent me some comments via e-mail and a summary of the issues as follows: "It seems to me that currently it is poorly organised; is unclear what public health means; and omits much which explains why public health is as it is e.g. the post war history of the rise of lifestyle and the resurgence of epidemics; and the history of international organisations and public health agreements and targets is also notably lacking." Hopefully over the coming weeks, we'll be able to improve the article accordingly. I've already made some small changes along those lines today. EMsmile (talk) 13:25, 30 June 2021 (UTC)