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Health In Society - The New Public Health (Baum) summary of all mandatory chapters

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In this summary I resumed all of the mandatory (tested) chapters of Baum's The new public health

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  • 10 octobre 2023
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  • 2023/2024
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Baum Chapter 1 – Understanding Health: Definitions and Perspectives

Health: the clockwork model of medicine
- Health is defined as the body operating efficiently like a machine
- Specific diseases were labelled and systematically classified
- What biomedicine has not done well is to consider disease within the context of lies
of people with disease
- Biomedicine does distinguish between disease and illness

Health as the absence of illness
- The biomedical model of health assumes a mind/body dichotomy, and it does not
place much emphasis on how individual’s mental health might affect physical health
status

Health and well-being
- The WHO defined health in 1948 as ‘ the complete state of physical, mental and
social well-being, and not merely the absence of disease or infirmity’ , providing a
vision of health beyond that suggested by the biomedical model
- The recent focus on mental health has led to definitions that go beyond the
concentration on physical factors

Definitions of health (Blaxter’s survey of british sample (2010))
- Health as not ill/diseased
- Health as a reserve
- Health as behaviour, health as the ‘healthy lifestyle’
- Health as physical fitness
- Health as energy, vitality
- Health as social relationships
- Health as function: being able to do things
- Health as psycho-social well-being (being happy)

Health in cultural and economic contexts
Crawford (1984) found two notions of health:
- Health was seen by some as self-control
o Also a set of related concepts that include self-discipline, self-denial and
willpower
o Health is something to be achieved through healthy behaviour
o The body is seen as an object op rational control
- Health was seen by some respondents as a release mechanism
o Related with feeling good as distinct from following rules of medical authority
o Life is seen as a series of pressures, anxiety, frustration and worry
o Health is not rejected as a value but is often repudiated as a goal to be
achieved through instrumental action

Population versus individual health: the heart of public health
- There is a difference between individual (clinical) and population health

,- Individual health focuses on the actions of individuals and how to influence their
health behaviour
o Example: ‘How can we stop individuals smoking?’
- Population health focuses on the circumstances that influence health of groups of
people
o Example: ‘How can we change the social and economic environment, so it
discourages smoking?’

,Baum Chapter 2 – A History of Public Health

History of public health in Australia
- Era of Indigenous control (estimated to be in excess of 40.000 years)
- Colonial era (from white invasion until 1890s)
- Affluence, medicine and infrastructure (1950s-early 1970s)
- Lifestyle era (late 1960s-mid-1980s)
- New public health era (mid-1980s-mid-1990s)
- Global new public health (mid-1990s to twenty-first century)

Effects of events on public health
- Era of Indigenous control (estimated to be in excess of 40.000 years)
o In Australia, before there was public health control, the Indigenous people
controlled their peoples health
o In differ of Europe, there was a sacred sphere with traditional healers
o Due to moving around they did not have the public health problems
associated with permanent settlements (hunger)
- Colonial era (from white invasion until 1890s)
o During the colonization, societies created their own public health:
 Religion encourages sobriety, cleanliness, isolation of people with
infectious disease and the ritual abstention from food likely to convey
parasites
 European societies were the first to focus considerable public effort on
controlling disease and attempting to create healthier living
environments
- Affluence, medicine and infrastructure (1950s-early 1970s)
o The postwar period was one of considerable affluence for industrial countries:
unemployment was low, immigration high, per capita income had never been
higher and successive governments were prepared to invest in social
infrastructure
o The tuberculosis and polio campaigns of the 1950s were major events and
examples of the focus shifting from a structural and social approach (through
better housing, more jobs) to a medical one based on immunization,
screening and treatment
o Due to a scientific growth, after 1950 also many new medicine were
developed
- Lifestyle era (late 1960s-mid-1980s)
- New public health era (mid-1980s-mid-1990s)
- Global new public health (mid-1990s to twenty-first century)

Theories of disease causation during the 19th century
- The ‘miasma’ theory held that disease resulted from inhaling bad smells from filth
 Advocated cleaning up cities
- The ‘germ’ or contagion theory held that pathogens (air or waterborne) were
responsible for disease
 Supported quarantining of people and foods
- Supernatural theories were also common

, Baum Chapter 3 – The New Public Health Evolves

The new public health is innovative because:
- It puts the pursuit of equity at the centre of public health endeavors
- It is based on the assumption that social; and environmental factors are responsible
for much ill health
- It argues for health promoting health services that are based on a strong system of
primary health care
- It stresses the role of all sectors on health and the importance of health in all policies
- It stresses the importance of participation and involvement in all new public health
endeavors

International developments in the new public health
- The 1970s: medicine questioned and lifestyles to the forefront
o The idea that medical advances had been responsible for extending average
life expectancy in Britain was being challenged
o Cost of medicine increased
- The discovery of ‘lifestyle’
o The notion of healthy lifestyles was first embraced within health policy
- Health for all by the year of 2000
o The watershed of 1970 led to the goal set by WHO to achieve ‘Health for All
by the Year 2000)
o They designed key elements within a strategy that later were a start of the
new public health

The 1980s: developing a new public health
- The new public health bible: the Ottowa Charter (1986)
o The Ottowa Charter describes five strategies for public health
o The Ottowa Charter is based on the belief that health requires peace, shelter,
education, food, income, a stable ecosystem, social justice and equity as
prerequisites
o The Ottowa Charter stresses the importance of, and recommends:
 Advocacy for health
 Enabling people to achieve their full potential
 Mediation between different interests in society for the pursuit of
health

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