Public Health and Community Medicine

In this blog, you can download free pdf of Public Health and Community Medicine edited by BHAWAL R, GUPTA RK, KUNTE R, TILAK R and VAIDYA R .

About Book

The last two decades of the 20th century witnessed a resurgence of interest in public health, disease prevention, communicable and chronic disease control, health protection, and health promotion among the global population. Not that public health is a new concept; in the mid-nineteenth century, Edwin Chadwick in the United Kingdom (report on an inquiry into the sanitary conditions of the labouring population in Great Britain, 1842) and Lemuel Shattuck in Massachusetts (Report of the sanitary commission of Massachusetts) initiated major public health movements (1,2). These two publications launched the great movement that is today known as public health, an essential component of which is preventive medicine, and which has saved billions of lives and reduced human suffering over the past century.

Nearly all governments, whether from developed or developing nations, have recently shown a growing interest in public health due to the realisation that continued investment in clinical care yields diminishing returns, whereas gains can be maximised through health promotion and disease prevention among populations at large.

Public health and preventive medicine are perpetually hampered by the fact that their emphasis on prevention renders them more abstract than curative medicine, making it more challenging to evaluate their accomplishments. The patient, her loved ones, and even the citizens of the community are thankful to the physician who has cured them. On the other side, public health cannot identify the individuals whose lives have been saved by its efforts. As the famous quote goes, "—— If we had but the gift of second sight to transmute abstract figures into flesh and blood, so that as we walk along the street, we could say, "that man would have been dead of typhoid fever," "that woman would have succumbed to anaemia of pregnancy," and "that rosy infant would have been in its coffin due to diarrhoea and dehydration," -then only would we have a faint conception In reality, it is this "quiet" that largely explains why individuals in a position to organise public opinion or make public decisions pay such little attention to public health. In developing nations, hardly even one percent of the national budget is allocated to public health; the situation is no better in rich nations. Even in the United States, about 1% of overall health expenditures are allocated to public health. In 1992, when the average cost of medical treatment per American was $3,007, public health spending was only $ 34 per person (3)!

Public health, including preventive medicine, as a concept and as a science, faces the aforementioned challenges, but it has clearly been a key force in advancing the cause of human health and development. During the 20th century, simple public health measures such as safe water supply, sanitary excreta disposal, vaccination, and insectvector-control measures saved many more lives and prevented many more diseases than would have been saved by all of the dazzling advances in therapeutics and diagnostics combined! According to a report, life expectancy in the United States increased from 45 years at the beginning of the 20th century to over 75 years in the following century, with only 5 years of this 30 year increase attributable to the work of the curative medical care system. The vast majority of this gain has been attributable to improvements in public health, broadly defined to include better housing, nutrition, sanitation, immunisation, and occupational safety (4).

It might be beneficial to review the meanings of several terminology commonly used in the fields of public health, preventive medicine, and community medicine at the outset. Indeed, meanings evolve over time. Long-standing terminologies acquire expanded meanings, such as the phrase "Preventive Medicine" itself, while new names are formed to reflect a shift in emphasis. Certain terms' meanings may overlap, and several shades of meaning may be connected with their use. As is obvious throughout this book, Public Health, Preventive Medicine, and Community Medicine contain many overlapping concepts; hence, their definitions are likely to overlap.

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