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Unit 8 - promoting public health NOTES
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Unit 8 – promoting public healthhttps://campaignresources.phe.gov.uk/resources/
Definition of public health
‘The science and art of preventing disease, prolonging life and promoting health through the
organised efforts and informed choices of society, organisations, public and private,
communities and individuals.’ – (The Walness Report, 2004)
A1 – the origins of public health policy
Dr john snow and the london cholera outbreak
John Snow (1813- 1858) was a British physician.
He is considered to be one of the fathers of epidemiology, because of his work in tracing the
source of a cholera outbreak in Soho, London, in 1854.
• Cholera is caused by a bacterium (Vibrio cholerae).
• Symptoms include chronic diarrhoea, low blood pressure and dehydration.
• Infected patients can die within 3 hours if left untreated.
In 1854, there was a cholera outbreak in London. It had devastating outcomes with over 500
fatalities. Nearly all families lost at least one member (regardless of socioeconomic class).
By talking to local residents, Snow identified the source of the outbreak as the public water
pump on Broad Street. Snow later used a spot map to illustrate how cases of cholera were
centred around the pump. Snow concluded that all the people infected with cholera had
drunk water collected from the Broad Street well. It was later discovered that a leaking cess
pit containing sewage was only 3ft away from the well and was contaminating the water.
,Snow's studies of the pattern of the disease were convincing enough to persuade the local
council to disable the well pump by removing its handle. This caused the number of cholera
cases to decrease rapidly.
The origin of public health policy (ones that are hilighted need to be talked about to hand in
alongside with assingment – might of talked about some in unit 4 notes)
• 1942 Beveridge Report
• 1946 National Health Service Act
• 1974 Lalaonde Report – A new perspective on the health of Canadians
• 1976 – Prevention and Health: Everybody’s Business (UK DHSS)
• 1977 Health for All by the Year 2000 – launched at 30th World Health assembly
• 1978 Declaration of Alma Ata
• 1980 The Black Report on Health Inequalities
• 1985 World Health Organisation launches 38 Targets for Health in European
Region
• 1986 Ottawa Charter for Health Promotion (WHO)
• 1987 Healthy Cities Programme launched
• 1987 Promoting Better Health; Government programme for improving Primary
Care (DHSS)
• 1988 Adelaide Conference on Healthy Public Policy
• 1990 The Health of the Nation (DoH UK)
• 1998 Acheson Report into inequalities in health
• 1999 Saving Lives: Our Healthier Nation
• 2004 Choosing Health: Making Healthy Choices Easier
5th july 1948 the national health service
The NHS ensured that people in the UK would receive free health care at the point of
delivery no matter what their income. During and after the Second World War the
government and the major political parties became concerned about the health of the
public. Civilians had been injured during the bombing raids and there were concerns about
recovery. This was something that had not been seen before. People were also returning
from the war with injuries.
Up until this time people had private health insurance, if they could afford it, to help
towards medical bills. If people could not afford to see a doctor or pay for medicine they
went without proper medical help.
Sir William Beveridge
• The government commissioned Sir William Beveridge to investigate ways the
country could recover from the Second World War. Beveridge has lots of
experience in politics and was an expert on the problem on unemployment.
, • The Beveridge Report (1942) stated that the post war period was a time for
radical change. One recommendation was
that the government should find ways to
fight disease.
The Beveridge Report aimed to provide a
comprehensive system of social insurance 'from
cradle to grave'. It proposed that all working people
should pay a weekly contribution to the state. In
return, benefits would be paid to the unemployed,
the sick, the retired and the widowed.
The measels epidemic 1940
• Measles has been notifiable in England and Wales since 1940, and notifications
varied between 160,000 and 800,000 cases per year, the peaks occurring in two-
year cycles.
• Before the introduction of measles vaccination in 1968, around 100 children a
year in England and Wales died from the disease.
• Measles notifications fell from 1968 until by the late 1980s, annual notifications
had fallen to between just 50,000 and 100,000. Following the introduction of
MMR vaccine in October 1988 and the achievement of coverage levels in excess
of 90%, notifications of measles fell progressively to the lowest levels since
records began and the spread of measles was effectively halted by the mid
1990s.
• 2006 saw an increase in the number of confirmed cases in the UK as whole and
the first reported death from measles in the UK for 14 years. This increase
continued throughout the following years, during 2012 there were 2,030 cases of
confirmed measles in England and Wales with 118 in Wales.
• Between November 2012 and July 2013, a large outbreak of measles occurred in
Wales. The outbreak was centred around the Swansea area, but affected a
number of other areas in Mid and West Wales. During the outbreak there were
447 cases of measles confirmed from the Mid and West Wales area, 64 cases
were admitted to hospital and there was one death.
• The outbreak was a consequence of low historic levels of MMR vaccination
uptake in the area, temporally associated with media reports of MMR side-
effects which have since been proven to be unfounded and inaccurate.
• During a catch-up campaign which was implemented in 2013 in response to the
outbreak more than 77,000 doses of MMR vaccine were given and this has
reduced the potential for further outbreaks of this size in Wales. Analysis of data
, from this outbreak found that a two dose course of MMR vaccine was 99%
effective in protecting against measles
The national health service act
• In 1945 the new Labour Government took on the recommendations of the
Beveridge Report and the National Health Service Act was passed in 1946 and
came into force in 1948.
• The NHS would be completely financed by tax, would benefit every person in the
country and would be available from ‘cradle to grave’
• For the first time people could receive diagnosis and treatment of any illness
either at home or in hospital. This included dental and ophthalmic treatment
and was regardless of the ability to pay.
A1 – the aims of public health policy
The aims of piublic health policy are:
• Planning national provision of health care and promoting the health of the
population
• Identifying and monitoring needs
• Identifying and reducing inequalities
• Protecting Society from health threats
• Addressing national health problems
• Developing screening programmes
Aim – planning national provision of health care and promoting the health of the population
• The NHS started to provide a more accessible health service to meet the aim of
public health policy by ensuring services were available across the UK
• This move was to ensure an acceptable standard of good health would be
experienced by everyone, regardless of social standing or geographical location
• Public health policy needs to be responsive, statistics need to be gathered and the
government will commission reports into current trends of health as well as
predicting future health developments.
• Information on factors that influence health (lifestyle, unemployment, education,
housing, prevalence of disease etc) shape planning for health provision.
• Public expectations of health provision have increased, over the years more medical
conditions have become treatable.
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