The Future of Public Health (1988) / Chapter Skim
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3. A History of the Public Health System
3. A History of the Public Health System
Pages 56-72
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From page 56... ...
As scientific knowledge grew, public authorities expanded to take on new tasks, including sanitation, immunization, regulation, health education, and personal health care. (shave, 1984; Fee, 1987)
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From page 57... ...
THE EIGHTEENTH CENTURY By the eighteenth century, isolation of the ill and quarantine of the exposed became common measures for containing specified contagious diseases. Several American port cities adopted rules for trade quarantine and isolation of the sick.
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From page 58... ...
By the eighteenth century, several communities had reached a size that demanded more formal arrangements for care of their ill than Poor Law practices. The first American voluntary hospitals were established in Philadelphia in 1752 and in New York in 1771.
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From page 59... ...
The Development of Public Activities in Health Edwin Chadwick, a London lawyer and secretary of the Poor Law Commission in 1838, is one of the most recognized names in the sanitary reform movement. Under Chadwick's authority, the commission conducted studies of the life and health of the London working class in 1838 and that of the entire country in 1842.
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From page 60... ...
The report, which influenced later developments in public health in England and the United States, documented the extent of disease and suffering in the population, promoted sanitation and engineering as means of controlling disease, and laid the foundation for public infrastructure for combating and preventing contagious disease. In the United States, similar studies were taking place.
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From page 61... ...
Similarly, in New York, John Griscom published The Sanitary Condition of the Labouring Population of New York in 1848. This report eventually led to the establishment of the first public agency for health, the New York City Health Department, in 1866.
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From page 62... ...
In the early nineteenth century, under Poor Law practices, communities that could not place their poor mentally ill citizens in more appropriate institutions put them in municipal jails and almshouses. Beginning in the middle of the century, Dix led a crusade to publicize the inhumane treatment mentally ill citizens were receiving in jails and campaigned for the establishment of more public institutions for care of the insane.
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From page 63... ...
The first were established in Massachusetts, as a cooperative venture between the State Board of Health and the Massachusetts Institute of Technology, and in New York City, as a part of the New York City Health Department. These were quickly followed by a state hygienic laboratory in Ann Arbor, Michigan, and a municipal public health laboratory in Providence.
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From page 64... ...
In New York, the city health department laboratory also promoted diagnosis of contagious diseases in individuals. New York was one of the first health departments to begin producing antitoxins for physicians' use, and the department offered free laboratory analyses.
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From page 65... ...
EARLY TWENTIETH CENTURY: THE MOVE TOWARD PERSONAL CARE Further Development of State and Local Health Agencies In the early twentieth century, the role of the state and local public health departments expanded greatly. Although disease control was based on bacteriology, it became increasingly clear that individual persons were more often the source of disease transmission than things.
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From page 66... ...
By 1915, there were more than 500 tuberculosis clinics and 538 baby clinics in America, predominantly run by city health departments. These clinics concentrated on providing medical care and health education.
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From page 67... ...
In order to receive federal funds, states were required to develop a plan for providing nursing, home care, health education, and obstetric care to mothers in the state; to designate a state agency to administer the program; and to report on operations and expenditures of the program to the federal board. The Sheppard-Towner Act was the impetus for the federal practice of setting guidelines for public health programs and providing funding to states to implement programs meeting the guidelines.
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From page 68... ...
By the 1970s NIH grew to include an Institute for Neurological and Communicative Disorders and Stroke, an Institute for Child Health and Human Development, an Institute for Environmental Health Sciences, and an Institute of Mental Health, among others. In 1938, Congress passed a second venereal disease control act, which provided federal funds to states for investigation and control of venereal diseases.
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From page 69... ...
Maternal and child health, family planning, immunization, venereal disease control, and tuberculosis control offered financial and technical assistance to local health departments to provide these services. Other federal programs developed at this time allowed funds and technical assistance to be provided directly to private health care providers, bypassing state and local government authorities.
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From page 70... ...
Containing health costs became a national objective. The Health Maintenance Act of 1973, promoting health maintenance organizations as a less costly means of health care, and the National Health Planning and Resources Development Act of 1974, setting up a certification system for new health services, are examples of this effort.
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From page 71... ...
Changing values over both time and place have allowed great variety in the implementation of public health programs across the country. The following chapter, which summarizes the current public health system in the United States and public health activities in six states visited by the committee, illustrates the variety of approaches to public health which have evolved throughout the current system.
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From page 72... ...
A.1923. The Evolution and Significance of the Modern Public Health Campaign.
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