1. No category

Session 1 -
Public Health; Past Present &
Future
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Introductions and
Icebreaker
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Ground Rules!
• Listen to others and value the diversity of opinions in the
group
• Be constructive
• Value the differences; there are no rights or wrongs, no
good or bad
• Be open and honest
• Keep to agreed time, especially start and finish
• Mobile phones!
(extracted from, Working with Groups. General
Improvement Skills. Modernisation Agency)
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Outline of Session
• Explore the concept of health and different models of health
• Discuss the history of public health
• Identify what are health inequalities and discuss the influence
of public health policy within the ‘New Public Health’
• Explain how public health attempts to tackle health
inequalities
• Explore how public health can be put into practice
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Group Work
Definitions of Health
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Is health achievable?
• The word ‘health’ is derived from the old
English word for heal which means
‘whole’, signalling that health concerns
the whole person and his or her
integrity, soundness or well-being.
• -ve – absence of disease
• +ve – state of well-being
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3 Predominant models of
health
• Biomedical model
• Lay model of health
• Social model of health
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Medical Model of Health
• The absence of disease and illness
• Medical treatment can restore health
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Lay concepts of health
• Health is a positive concept
• Differs depending on e.g. age, culture,
ethnicity
Example 1- .Older people - wholeness, inner strength &
ability to cope.
Example 2 - Young people – fitness, energy & strength
Example 3 - Middle class vs working class
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Social Model of Health – Dahlgren &
Whitehead
Social Ecological Theory
Living and working
conditions
Unemployment
Work
environment
Water &
sanitation
Education
Health care
services
Agriculture
and food
production
Housing
Age, sex and
constitutional
factors
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Coffee
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Public Health
• The science and art of preventing disease,
prolonging life and promoting health
through the organised effects and
informed choices of society, organisations,
public and private, communities and
individuals” (Wanless 2002)
• Public Health Policy Time Line
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Who is this?
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Health Inequalities
Main measures of health
inequality:
• Infant mortality statistics
• Mortality statistics
• Morbidity statistics – including chronic
disease management
• Life Expectancy at Birth
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Title
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Title
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How public health can help tackle health
inequalities – Zola’s River Analogy
‘You know’, he said, ‘sometimes it feels like this. There
I am standing by the sort of a swiftly flowing river and I
hear a cry of a drowning man. So I jump into the river,
put my arms around him, pull him to shore and apply
artificial respiration. Just when he begins to breathe,
there is another cry for help. So back in the river again,
reaching, pulling, applying, breathing and then another
yell. I am so busy jumping in, pulling them to shore,
applying artificial respiration, that I have no time to see
who the hell is upstream pushing them in’ (Zola 1972)
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Group Work
In small groups choose a public health topic
e.g. obesity, falls, and identify what
interventions and policies that they would
implement that would be considered
upstream & downstream in nature
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The Principles that run through
all Public Health Work
The elements of public health practice are;
Assessing the health needs of a population.
Working with local people to identify needs.
Identifying groups most in need of health care and most likely to benefit from
health care; identifying health inequalities and working to improve the health of
the socially excluded.
Determining the social, economic and environmental factors that impinge on
health.
Planning and implementing programmes that promotes and protect health,
both within the health sector and with other sectors to address the wider
threats [determinants](eg. Housing, transport).
Assessing the impact of interventions on the health of the population.
(Wanless, 2004; Hall and Elliman, 2004)
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