Public health, a history

By Jerry Messana

April 3 through 9 is National Public Health Week, a time to celebrate and recognize the many contributions of public health and the positive influence it’s had on the health of populations locally and across the globe. According to the Center for Disease Control and Prevention, public health “is credited with adding 25 years to the life expectancy of people in the United States…” in the 20th century.

The CDC Foundation defines public health “…as the science of protecting and improving the health of families and communities through promotion of healthy lifestyles, research for disease and injury prevention and detection and control of infectious diseases.”

Evidence of public health awareness can be found as far back as 3000 B.C. in ancient paintings showing Egyptians washing their hands. Every year during flu season we are reminded of the recommendations to wash and sanitize our hands to prevent the spread of disease. Public health has progressed since then; however, a milestone occurred in the mid 1800s, and epidemiology, (the science of public health) was discovered in England by a physician apprentice known as John Snow. Snow observed the relationship between a contaminated drinking water supply and the spread of cholera, a fatal intestinal disease. This observation and the measures he took subsequent to his discovery prevented further illness and death in the community.

The CDC defines epidemiology as “the study (scientific, systematic, and data-driven) of the distribution (frequency, pattern) and determinants (causes, risk factors) of health-related states and events (not just diseases) in specified populations (neighborhood, school, city, state, and country, global).”

Epidemiologic methods have been used to determine cause and effect of many diseases such as small pox, dysentery, diphtheria and typhoid, and the methods for controlling the disease and reducing the spread. In the late 1800s and early 1900s, public health efforts focused on prevention of communicable disease with an emphasis on education. In response, agencies were created, standards were developed and regulations evolved around drinking water, sanitation and personal hygiene.

Throughout the early and middle parts of the 20th century, public health efforts began to expand into the workplace, focusing on the health and safety of workers and the hazards they face in their jobs. Safety issues were more obvious in industries such as meatpacking, mining, fishing, manufacturing and construction. What was less obvious at the time were health-related issues in the work setting such as loss of hearing from constant exposure to noise, damage to internal organs from long term exposure to toxic substances and cancer related to a number of different environments.

Throughout the century, a number of public health related federal agencies were created, many of which are frequently in the news and familiar to the public. A few of the more well-known regulatory agencies include the Food and Drug Administration (FDA) founded in 1906, the Center for Disease Control and Prevention (CDC) in 1946, the United States Department of Agriculture (USDA) in 1962, and the Environmental Protection Agency (EPA) along with the Occupational Safety and Health Association (OSHA) both established in 1970. These and other agencies are tasked with creating guidelines and accountability standards to keep the public safe.

As we moved into the later part of the 20th century and up through today the focus of public health efforts has expanded and now includes health issues related to something other than viruses and bacteria. Societal and cultural changes over the last several decades have led to a significant increase in conditions and diseases resulting from lifestyles and personal choices.

Public health has not and will not ignore diseases such as tuberculosis, salmonella, E.coli, chlamydia and the flu. However, diseases such as cancer, diabetes, hypertension, in addition to substance abuse illnesses are now very much in the forefront and have grabbed the attention of public health professionals.

Proper diagnosis and treatment is certainly essential in managing these conditions. Education and prevention efforts hold the key to reducing the incidence of people being affected by these diseases. These efforts include nutrition counseling, tobacco cessation, as well as public awareness and knowledge of health hazards from toxic substances. Although public health programs are available for everyone, special efforts are aimed at children in hopes that education and intervention at an early age can influence choices well into adulthood.

Public health has demonstrated its repeated ability to adapt to changing conditions. In fact, public health not only has the ability to adapt, but by its nature, public health as a community has the ability to respond and react. Ingrained in most public health professionals is a sense of urgency.

This sense of urgency has its roots in the training of public health professionals where you might hear phrases such as “Stop it before it spreads,” “Do we know the source of the virus,” and “Who else ate at that restaurant?” When it comes to infectious disease, reaction time is critical and in some cases can save lives; consequently, when an outbreak is suspected priorities are redirected to address the issue.

Locally in Marquette County, 2016 marked the 50th year of operation for the Marquette County Health Department (MCHD). Originally organized in July 1966 the newly formed Board of Health held its first meeting the following month and Marquette became the last Michigan County to comply with the State requirement “to form a health department or be part of a district health department.” Prior to the formation of the Marquette County Health Department, limited public health services were provided by the cities and townships and included primarily monitoring and controlling the spread of infectious disease.

MCHD operations began in what is now known as the Old City Hall Building in Marquette and was staffed with a director and one LPN. Initially home visiting services were provided and by 1967 a sanitary code was adopted and staff was providing hearing/vision screening in schools, immunizations and services for handicapped children.

Over the past 50 years the Marquette County Health Department has added and eliminated a variety of programs and services and, at times, employed more than 100 people.

At different points in time the health department has provided private duty and home health services and also operated two dental clinics. As funding levels and reimbursement has changed over the years so too has the mix of programs and services provided.

The Marquette County Health Department continues to provide a wide range of community health, environmental health and outreach programs available to the community. The health department is very fortunate to have a knowledgeable and dedicated staff and we look forward to serving the residents of Marquette County for another 50 years.

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