2. OUTLINE
• INTRODUCTION
• WHAT IS A PUBLIC HEALTH PROBLEM?
• FACTORS CAUSING INCREASING DEMAND ON
HEALTH CARE
• CRITERIA FOR PUBLIC HEALTH PROBLEMS
• DEFINITIONS OF HEALTH, DISEASE, ILLNESS,
ILL HEALTH.
• CONCLUSION.
3. INTRODUCTION
• Public health is the science and art of
preventing disease, prolonging life and
promoting health through the organized efforts
of society (Acheson 1988)
• Dental public health is the science and art of
preventing oral disease, promoting oral health
and prolonging life through the organized
efforts of the society (Downer et al., 1994)
4. • The focus of public health intervention is to
prevent rather than treat a disease through
surveillance of cases and the promotion of
healthy behaviors. In addition to these
activities, in many cases treating a disease can
be vital to preventing it in others, such as
during an outbreak of an infectious disease.
Vaccination schedules and distribution of
condoms are examples of public health
measures.
5. • It also promotes the establishment of healthy
environments by working in settings such as
schools and cities; aimed at strengthening
community action & personal skill for health
protection.
6. WHAT IS A PUBLIC HEALTH PROBLEM?
• It is now widely recognized that demands on
health care systems will always be greater
than the resources available to meet these
needs.
• This dilemma is not confined to the
developing world where resources are limited.
7. • The richest countries in the world, such as the
USA, Germany, and the UK are faced with similar
problems of increasing demands and escalating
health care expenditure.
• For example, expenditure on health care in the
USA rose from 3.6% of gross domestic product in
1929 to 13.6% in 1995,and was as high as 16% in
2012 and there is a prediction that it may reach
20% in the next few decades (Burt and Eklund
1999). In the UK spending on the General Dental
Services has risen steadily over recent years. In
1977/78 the figure was £270 million and by
1997/98 the figure was £1528 million, a six-fold
increase over a 10-year period (Dental Practice
Board 1998).
8. FACTORS CAUSING INCREASED
DEMAND ON HEALTH CARE
• Population increase
• Ageing
• Increased awareness
• Unhealthy environment
• Epidemic/pandemic
• Increased health risk factors
9. CRITERIA
• The solution to this problem is to
prioritize, pushing resources to those areas of
more pressing need. Those areas can be
determined using the following criteria:-
– PREVALENCE OF CONDITION
– IMPACT OF CONDITION ON INDIVIDUAL
– IMPACT OF CONDITION ON SOCIETY
– CONDITION IS PREVENTABLE & EFFECTIVE
TREATMENTS ARE AVAILABLE
10. • The first criterion relates to the prevalence of
the health problem, in essence Is the disease
widespread? Who has the disease?
• What percentage of the total population is
affected? What is the distribution of the
disease within the community?
• Is the prevalence of the condition increasing
or decreasing?
11. • The second aspect relates to the impact of the
condition at the individual level.
• How severe are the effects of the disease to the
patient? For example, do people die as a result of
it?
• Do they suffer pain, discomfort, or loss of
function?
• Can they perform their normal social roles? Are
they prevented from going to school or becoming
employed because of the problem?
12. • The third aspect relates to the effects of the
disease across society.
• What are the costs to the health service of
treating the condition? How much time do
people take off work to get treatment and
care?
• What effect does the condition have on
economic performance and productivity
country?
13. • Finally, it is important to consider the potential
for prevention and treatment of the disease.
• Is the natural history of the disease fully
understood?
• Can the early stages of the condition be
recognized?
• If so, are there interventions that can be
implemented to stop the disease progressing?
• If it does progress, are there effective treatment
available?
14. DEFINITIONS OF HEALTH, DISEASE,
ILLNESS & ILL HEALTH.
• HEALTH
– Many attempts have been made to define health
and to explore individuals’ perceptions of the
concept. After the Second World War, the WHO
(1946) proposed a definition:
• Health is a complete state of physical, mental
& social well being and not merely the
absence of infirmity
15. • A pioneering French study (Herzlich 1973)
identified that health was described in a variety
of ways by lay people:
As a state of being, and the absence of illness.
• As something to have, an inner strength or
resistance to ill health.
• As a state of doing and being able to fulfil the
maximum potential for life.
• Blaxter (1990), based upon a review of the
concept, had another description:
16. • Health can be defined negatively, as the
absence of illness, functionally as the ability to
cope with everyday activities, or positively, as
fitness and well-being
• Ewles and Simnett (1999) have outlined the
dimensions that they consider to be part of a
complete view of health, termed ‘a holistic
concept of health’ described in six separate
areas called the dimensions of health
17. DIMENSIONS OF HEALTH
• PHYSICAL HEALTH: concerned with the
functioning of the body.
• MENTAL HEALTH: the ability to think clearly
and coherently.
• EMOTIONAL HEALTH: to recognize and express
emotion such as fear, joy, grief.
• SOCIAL HEALTH: to form and maintain
relationships.
• SPIRITUAL HEALTH: concerned with either
religious beliefs and practices or personal
creeds and principles of behavior.
• SOCIETAL HEALTH: a person’s health is closely
linked to the environment he or she lives .
18. • It is very important to note that these areas are
not separate but are in fact part of a whole. We
may feel that not all of them apply to us as an
individual.
• The importance of each is likely to vary at
different times in our life. For example, the need
to form social relationships is of particular
importance when leaving home for the first
time, while for the majority of people their
physical health is of little concern at this time but
becomes more so later in life.
19. • So, modern concepts of health have moved
from an ‘absence of disease focus’ to a
concept that has a number of dimensions, and
health has become defined in terms of social,
psychological and physical functioning.
(Reisine 1985). Health is a dynamic subjective
concept which is influenced by an array of
factors.
20. • A more recent WHO (1984) definition of
health summarizes well the nature of
contemporary understanding of the concept:
• Health is the extent to which an individual or
group is able, on one hand to realize
aspirations and satisfy needs; and on the
other hand, to change or cope with the
environment
21. DISEASE
• Disease can be described as named
pathological entities diagnosed by means of
clinical signs and symptoms, for example
cancer or caries.
• Diseases are determined by professionals
based upon information collected in history
taking and through clinical investigations and
tests.
22. ILLNESS
• Illness refers to the subjective response of the
lay individual to being unwell. It refers to how
the person feels and what effect this has on
their normal every day life(Naidoo and Wills
1996).
23. ILL HEALTH
• Illness and disease are clearly not the same. A
person can have a disease and have no
symptoms. for example, periodontal disease.
• However, if that person reports bleeding gums
and loose teeth then they have symptoms and
periodontal disease may be confirmed by
evidence of attachment loss clinically and bone
loss on radiographs.
• The disease and the illness coincide. Ill health is
an ‘umbrella term used to refer to the experience
of diseases plus illness’ (Naidoo and Wills 1996).
24. CONCLUSION
• The problem of public health can be
drastically reduced if governments formulate
policy whereby the population can be
reduced, commit reasonable amount of
resources to the health sector to build well
equipped health centre, and if individual can
maintain healthy environment and maintain
his health
