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
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
