Principles of Public Health

By

Dr. Shagufta Shahjahan

Director General (Retd.)

Environmental Protection Agency,
Punjab
 Env-E-511 ENVIRONMENTAL HEALTH AND SAFETY
(3 CREDIT HOURS)
Course Contents
Week Contents Remarks
1-2 Principles of Public Health
3–4 Communicable Diseases
Water Borne
5-6 Air Borne Diseases and Control Measures
7 Sanitation Related Diseases and Control Measures.
Group Presentation
7 Mid Term Quiz
8 Mid Term Examination
9 Industrial Hygiene and safety
10-11 Accident Prevention and Elimination Plans
12-13 Group Presentation
14 Fire Protection Techniques
15 Group Presentation
16 Safety Equipment’s.
17 FinalTerm Quiz
18 Mid Term Examination
What Is Health?

The most frequently used definition of Health is the

one created in 1948 by the World Health
Organization (WHO):

“HEALTH is a state of complete physical, mental,

and social wellbeing, and not merely the absence
of disease or infirmity” (WHO, 1948)

 This definition opened the way of

conceptualizing health in much broader and
holistic terms and
 highlighted the need for life‐span disease and
injury prevention as well as early diagnosis and
treatment.
 Public Health
The term “public health” used here is to represent the entire field
of public health, including but not limited to government
institutions and schools of public health.

 Prevents disease, prolongs life, and promotes health

 Organized community effort for
 sanitation of the environment,
 control of communicable infections,
 education in personal hygiene,
 organization of medical & nursing services,
 development of the social machinery
 Ensures everyone a standard of living, adequate for the
maintenance of health.
 Entire populations are improved with the mission of public health:
 Effect reaches beyond territories, groups & individuals
 Scope encompasses physical, mental, social, economic, and
environmental variables in our lives
 Public Health Functions
Core functions of almost all levels of Public Health
agencies are:
i) Assessment
ii) Policy Dev.
iii) Assurance
i) ASSESSMENT
 Every Public Health agency regularly and systematically
should collect, assemble, analyze,

 information on the health of the community.

 This information may include:

 statistics on health status,

 community health needs, and

 epidemiologic and other studies of health problems.

 This information must be available for further perusal

Various tools for Assessment
i. Monitor Health
ii. Diagnose and Investigate

The Future of Public Health, Institute of Medicine 1988

 Policy Development
Every Public Health agency should exercise its responsibility
to serve the public interest in the development of
comprehensive public policies by promoting the use of the
scientific knowledge base in decision‐making about Public
Health and by leading in developing Public Health Policy.

Agencies must take a strategic approach, developed on the

basis of positive appreciation for the democratic political
process. i.e PHP must be appreciated/approved by political
leadership/Government

Important tools
i. Inform, Educate and Empower
ii. Mobilize Community partnership
iii. Develop Policies
 Assurance
Public Health agencies must assure their constituents that
services necessary to achieve agreed upon goals are
provided, either by encouraging other entities (private or
public sector) by requiring such action through regulation, or
by providing services directly.

 Public Health serves communities and the individuals

within them by providing an array of essential services.
 Local Health Departments and agencies work within
communities to achieve the essential services.
Important tools
i. Enforce laws
ii. Link to / Provide care
iii. Assure Competent Workforce
iv. Evaluate
 Principles of the Ethical Practice of Public Health

1. Public health should address principally the fundamental

causes of disease and requirements for health, aiming to
prevent adverse health outcomes.

 This Principle gives priority not only to prevention of disease

or promotion of health at most fundamental levels.

 It also acknowledges that public health (agencies/deptt.)will

also concern with some immediate causes and some
curative roles. For example, the treatment of curable
infections is important to the prevention of transmission of
infection to others.
2. Public health should achieve community health in a
way that respects the rights of individuals in the
community.

 This Principle identifies the common need in public health

to weigh the concerns of both the individual and the
community. There is no ethical principle that can provide a
solution to this

 It can be highlighted, however, that the interest of the

community is the primary interest of public health. Still,
there remains the need to pay attention to the rights of
individuals when exercising the police powers of public
health.
3. Public health policies, programs, and priorities should
be developed and evaluated through processes that
ensure an opportunity for input from community members.

 A process for input can be direct or representative. In

either case, it involves processes that work to establish a
consensus. While democratic processes can be
cumbersome, once a policy is established, public health
institutions have the mandate to respond quickly to urgent
situations.
 Input from the community should not end once a policy or
program is implemented. However,
 There remains a need for the community to evaluate
whether the institution is implementing the program as
planned and whether it is having the intended effect.
 The ability for the public to provide this input and sense
that it is being heard is critical in the development and
maintenance of public trust in the institution.
 4. Public health should advocate and work for the
empowerment of disenfranchised community members,
aiming to ensure that the basic resources and conditions
necessary for health are accessible to all.
 This Principle speaks to two issues:
a) ensuring that all in a community have a voice; and
b) highlighting that public health has a particular interest in
those members of a community that are underserved or
marginalized.
 While a society cannot provide resources for health at a level
enjoyed by the wealthy, it can ensure a decent minimum
standard of resources.
 The Code cannot prescribe action when it comes to ensuring
the health of those who are marginalized because of illegal
behaviors. It can only stress the principle of ensuring the
resources necessary for health to all. Each institution must
decide for itself what risks it will take to achieve that.
5. Public health should seek the information needed to
implement effective policies and programs that protect
and promote health.
 This Principle is a mandate to seek information to inform
actions.
 As well as information necessary to evaluate programs is
also implied.
6. Public health institutions should provide communities
with the information they have that is needed for
decisions on policies or programs and should obtain the
community’s consent for their implementation.
 Applicable for an informed community.
 The information obtained by public health institutions is to be
considered public property and made available to the public.
 Particularly when a program has not been duly developed
with evaluation, the community should be informed of the
potential risks and benefits, and implementation of the
program should be allowed after the consent of the
community (mode to obtain consent not given)
7. Public health institutions should act in a timely
manner on the information they have within the
resources and the mandate given to them by the public.

 Public health is active rather than passive, information

should not be collected for idle interest.
 Ability to act is associated with
 Available resources and opportunities &
 Competing needs
 Ability to respond urgent situations also depends on
established mandate by democratic process
8. Public health programs and policies should incorporate
a variety of approaches that anticipate and respect
diverse values, beliefs, and cultures in the community.

 Public health programs should have built-in flexibility that

anticipates diversity in the needs which have a significant
impact on the effectiveness of the program.
 Any list of diversity would be arbitrary and inadequate.

9. Public health programs and policies should be

implemented in a manner that most enhances the
physical and social environment.
10. Public health institutions should protect the
confidentiality of information that can bring harm to an
individual or community if made public. Exceptions must be
justified on the basis of the high likelihood of significant
harm to the individual or others.

11. Public health institutions should ensure the

professional competence of their employees.

12. Public health institutions and their employees should

engage in collaborations and affiliations in ways that build
the public’s trust and the institution’s effectiveness.