Public health

“ Many years ago, Disraeli, keenly alive to influences affecting national prosperity, stated: “Public Health is the foundation on which reposes the happiness of the people and the power of a country. The care of the public health is the first duty of a statesman.” It may well be claimed that the care of individual and family health is the first and most patriotic duty of a citizen. ”

“ Education and the Public Health.—The basis of successful public health work is the education of people in hygiene and sanitation. If the people can be brought to realize the transcendent importance of the work, their co-operation will be given cheerfully. Where the health regulations are now disobeyed it is largely because their value to the individual, as well as to the community, has not been made clear. ”

“ What is the Existing Machinery of Public Health in what are called—with a grim sarcasm—our Rural Sanitary Districts? Is health or sickness, life or death, the greatest miracle in the present condition of things? To some of us the greatest miracle, repeated every day, is that we can live at all in the surroundings which our ignorance and neglect create. ”

“ PARKES, GUY, SIMON, AND PUBLIC HEALTH. “Prevention is better than cure” is the homely proverb which marks out a large proportion of the work of sanitary science. The prevention of disease and of its spread, and the promotion of the general healthiness of the people—these are objects which modern progress has brought into view. When they are completely attained we shall all die of old age unless cut off by accidents or violence; and this is a goal which many sanitarians of the present day have vividly before their mind. ”

“ To keep the public health,—to protect it by keeping one's body well, by taking care to commit no nuisance, to contaminate no source of public infection, and to lend one's self to participate in the correcting of abuses. ”

“ Practical experience has demonstrated that the work of educating the people in all that pertains to public hygiene is a most important factor in the successful accomplishment of our objects as sanitarians. At every step in our legislative halls with local health authorities, in communities, and in our experience with individual citizens, we encounter more or less opposition arising from a lack of intelligent comprehension of the causes of disease, the best method of preventing the spread of epidemics, and generally of the preservation of public health. ”

“ After more than three decades of work in preventive medicine and public health, the opportunity has arisen in connection with a year’s visit to America, to take a panoramic view of public health in England, of the progress which has been secured, of the factors which have impeded progress, and of the pressing desiderata for more efficient future action. ”

“ As soon as an individual becomes interested in caring for his own health and for the health of his family, his interest will not cease at individual hygiene; he will wish to improve the efficiency of the public health service by increased appropriations, improved equipment and personnel ”

“ Union action, which shall complement national policies, shall be directed towards improving public health, preventing physical and mental illness and diseases, and obviating sources of danger to physical and mental health. ”

“ Promote public health and sanitation by private instruction, by advice and by example. A great deal might be quietly done in this direction with the result of more health and less disease, — more happiness and less misery. Any exhortation on the subject of health may seem unnecessary. But we often come across instances in which the inestimable blessing of health is sacrificed in the too eager pursuit of inadequate objects. ”

“ In England, more perhaps than in America, the control of public health work has been shared by intelligent laymen on local and central authorities, and the fact that medical officers of health have found it necessary to convince these lay representatives of the general public of the need for the reforms recommended, has led to steady progress, seldom interrupted by relapses. ”

“ A properly organized system of public health services including medical and dental care, which would stress the prevention rather than the cure of illness should be extended to all our people in both rural and urban areas. This is an enterprise in which Dominion, Provincial and Municipal authorities, as well as the medical and dental professions can cooperate. ”

“ The State shall promote the improvement of public health by organizing and controlling health services, hospitals, dispensaries, sanatoria, nursing and convalescent homes and other health institutions. ”

“ If these complete services were provided, the medical treatment now provided largely at the expense of the community could be made a means for advancing the public health. This it can not at present claim to be. For nothing is more certain than that the prompt and adequate treatment of disease curtails its duration, diminishes its severity, and prevents its spread to others. ”

“ We are all interested in public health and sanitation, in the prevention of the spread of disease, in the lowering of the death rate, in immunity from exposure to disease, in the protection of the sources of our water supply, of our milk supply and of the meat diet offered in our markets. ”

“ And it must be freely admitted that when the [Pg 185] most active public health administration, including adequate medical aid for the sick, has attained its utmost efficiency, and has in every respect done all that it can to reduce disease, there will still remain a cruel residuum which can be attacked in no other way than by the removal of poverty, or by the removal from poverty of the elements of personal privation which affect the public health. ”

“ The evolution of public health in England proceeded by experimental steps, some mistaken and then retraced, others mistaken and not retraced, but steps oftenest in the direction of a complete service, which is the goal of our work. ”

“ The rapid growth of cities in the last fifty years has forced them to take measures for the preservation of health, and public health administration has become a distinct branch of medical science. It is the health problems which have arisen in the congested sections of our large cities, and those which are due to a sedentary life or to unhealthful conditions of certain trades and industries, which have incited the discoveries of medical science and which have created a new attitude toward sanitation and hygiene among city people. ”

“ Advances in public health in many directions can only be secured by continued and extended medical research, and public health, therefore, has a direct and immediate interest in promoting and subsidizing such research. ”

“ The fact that much of the dissipation and the disregard of health laws is due to ignorance rather than to want of thought is sufficient reason for the study of health laws. But, as the health of individuals is closely related to the health of the village, town, or city in which they live, and as "public health is public wealth," another reason is apparent for the popular study of hygiene. ”

“ The principles now affirmed in our statute-book are such as, if carried into full effect, would soon reduce to quite an insignificant amount our present very large proportions of preventable disease.... Large powers have been given to local authorities, and obligation expressly imposed on them, as regards their respective districts, to suppress all kinds of nuisance, and to provide all such works and establishments as the public health primarily requires; while auxiliary powers have been given for more or less optional exercise in matters deemed of less than primary importance to health.... ”

“ Among such measures may be mentioned the abolition of alcoholism, the provision of a pure and adequate milk-supply, increased attention to domestic and municipal sanitation, health teaching by public health nurses, and prompt and adequate medical and nursing assistance when required.
Ignorance
It may have surprised you that I have not placed ignorance in the forefront, before industrialism, urbanization, and poverty, as the chief enemy of personal and public health. ”

“ Whereas health care policies should emphasize public health and encourage the use of quality services and evidence-based treatment that is appropriate and safe and that discourages unnecessary treatment ”

“ Preventable sickness costs too much, causes too much wretchedness, and hampers too many modern educational and industrial activities to be neglected. If the medical profession does not fit itself to serve general interests, then cities, counties, and states will take to themselves the cure as well as the prevention of communicable and other preventable sickness. Human life and public health are more precious than the medical profession, more important even than theories and traditions against public interference in private matters. ”

“ Among the subjects continually described in newspapers and magazines, and even on billboards and in street-car advertising, is the subject of hygiene. No greater service can be rendered the community than for those who are conducting discussions of health to teach people how to read correctly this mass of information regarding health, to separate misinformation from information, and to apply the lessons learned to personal and public hygiene. ”

“ In public health, the elimination of the most dangerous infectious diseases, a steady improvement of sanitary conditions, and an education in preventive medicine, that can be proved by statistics to have been directly remunerative. ”

“ As we advance in our knowledge of this disease, as facts develop the source from which individuals receive it, the State authorities charged with the care of the public health, and Congress with that of the general commerce, will become able to regulate with effect their respective functions in these departments. ”

“ The increasing interest taken by the intelligent and well-meaning members of society in matters of public health, which have also an intimate connection with the public purse, cannot fail to assist the whole movement which is taking place in favor of hygienic science and its independent and well-endowed instruction. ”

“ Our task in a dispensary is the same. The patient almost always starts with the catastrophic point of [Pg 31] view, and can only be very gradually engineered into the other. And yet our work in relation to public health is largely to be summed up as finding out how,—that is by what history, through what chain of events, people come to be sick. Repetition and extension of disease can be checked only in case we succeed in finding such clues. ”

“ The passing of sanitary laws, and the granting to a certain department the power to enforce these laws, will not ensure good public health unless the public at large supports those laws intelligently, and it can only do this through State and municipal sanitary organizations. ”

“ For a very considerable period a movement has been gathering strength, especially among the members of the medical profession, in favor of a concentration of the instruments of the National Government which have to do with the promotion of public health. ”

“ In addition, the medical and scientific community, many public and private agencies, and institutions and concerned citizens have, over the years, undertaken valuable efforts to promote public awareness of FAS and related health concerns. ”

“ Nobody will deny that much has already been done in the development of preventive medicine and sanitary science. It will be claimed, and with justice, that more has been done than the public is willing and prepared to accept and live up to. We know that today municipalities continue to permit the unnecessary sacrifice of lives to epidemic disease, that politics is permitted to disorganize efficient boards of health in large and small communities and to put the best material interests of family and social life into untrained hands. ”

“ One of the first cares of a good government is to preserve and promote the public health. An illustration of this position occurred in the summer of 1856, when fears were entertained that the city would be visited by a frightful epidemic fever. ”

“ Finally, persons wanting not only to have intelligence as to matters promoting health, but actually to exert a helpful influence in their community, ought to want the published reports of the mayor, health department, the public schools, and other institutions, noting carefully all that is said about conditions relating to health and about efforts made to correct all unfavorable conditions. The best literature of our day, with regard to social needs, appears in the reports of our public and private institutions and societies. ”

“ That the work done on behalf of the community, plus the work accomplished by private medical practitioners, is not equal to national needs is obvious to any one considering the vast amount of avoidable disease in our midst. Why is this and what is the remedy? A partial answer is given by English experience. The medical provision made in a large proportion of cases is belated and inadequate; and in perhaps a still larger proportion of cases medical advice is not obtained, or being obtained, is not followed. This applies even more to hygienic than to clinical medical advice. ”

“ Every person has the right to the preservation of his health through sanitary and social measures relating to food, clothing, housing and medical care, to the extent permitted by public and community resources. ”

“ For its sins of omission, as for its sins of commission, the medical profession shares responsibility with laymen. For years leading educators, business men, hospital directors, public officials, have known that communicable diseases could be stamped out. ”