4/2/01
Each year, the first week of April is designated as National Public Health Week in order to increase the general public’s awareness of the importance of public health in their daily lives. In conjunction with the national recognition, Governor John Rowland signed a proclamation designating the week of April 2-8, 2001 as Public Health Week in Connecticut.
When asked to define public health, most people would not be able to answer, or would offer a definition very limited in scope. The reality is, public health is important to both the quality and the quantity of everyone’s life, and encompasses a wide variety of services and concerns. Largely due to the achievements realized during the 20th century, Americans have increased their life span since 1900 by approximately 30 years. As Connecticut’s Public Health Commissioner Dr. Joxel Garcia explains, “public health is a sophisticated system of people and services dedicated to preserving and improving the health of the world by promoting wellness and preventing disease, injury, and disability.”
The beginning of a new century has provided an opportunity to reflect on the achievements of the public health field during the last 100 years; the result of this review has allowed for the classification of public health improvements into 10 basic categories.
They are:
Vaccination – The immunization of children in the United States has greatly reduced, and nearly eradicated, the occurrence of diseases such as polio, measles, diphtheria, rubella, and whooping cough. According to a survey conducted by the Centers for Disease Control, Connecticut had the highest immunization rate (91%) in 1998 of all 50 states and had the highest rate again in 2000.
Safer and healthier foods – Decreasing contamination in foods as well as increasing the nutritional content of foods have resulted from public health efforts. Public health officials conduct conduct inspections in a variety of locations, including processing plants, grocery stores, restaurants, public cafeterias, and agricultural breeding facilities; they investigate outbreaks of food-borne illness, and enforce public health regulations. Public health programs have been instrumental in establishing nutritional standards and developing food fortification programs and nutrition education programs
--consequently, many major nutritional deficiency diseases such as rickets, goiter, and pellagra are extremely rare in the United States.
Occupational safety – Many work-related problems, such as black lung in coal miners, have been greatly reduced. There has also been a notable decrease in the number of severe injuries and deaths in occupational settings such as construction, manufacturing, mining, and transportation. The Morbidity and Mortality Report issued by the Centers for Disease Control reveals that safer workplaces have led to a 40% reduction in the rate of fatal occupational injuries.
Motor vehicle safety – Public health efforts to change personal behavior and educate the public have contributed to large reductions in motor-vehicle-related deaths. Such changes include the use of seatbelts and child-safety seats, wearing helmets when riding motorcycles, and a reduction in the incidence of drinking and driving. Since 1925, the annual death rate from motor vehicle accidents has decreased 90%, even though more people drive, more cars are on the road, and greater distances are traveled than ever before.
Control of infectious diseases – Improved sanitation and clean water, as well as the discovery and use of antibiotics, have greatly enhanced public health measures designed to control infectious diseases such as typhoid, cholera, tuberculosis, and sexually transmitted diseases. Thanks to strict oversight by public health officials, residents of Connecticut enjoy some of the cleanest water in the nation.
Fluoridation of drinking water – In 1945, fluoridation of public drinking water began, and by 1999, approximately 144 million people in the U.S. had access to fluoridated water. The first city in the world to fluoridate its drinking water was Grand Rapids, Michigan; the rate of tooth decay dropped by 60% there as a result. Thanks to the fluoridation of water, dental advances, and public education about good dental hygiene, tooth decay has been significantly reduced and the majority of American adults will retain most of their teeth throughout their lifetimes.
Decline in deaths from coronary heart disease and stroke—Public health programs have been very successful in modifying behaviors that reduce risk factors associated with cardiovascular diseases. Blood pressure control, smoking cessation, increased physical exercise, and healthier diets, combined with access to earlier detection and better treatment, has led to a 51% decrease in death rates for coronary heart disease since 1972. A better understanding of disease epidemiology, prevention techniques, diagnoses, and treatment has resulted in what some consider to be one of the most important public health achievements of the 20th century.
Infant and maternal health – The combination of several public health initiatives has yielded impressive results in the area of maternal and infant health. Better hygiene, improved nutrition, greater access to health care, the availability of antibiotics and vaccines, and technologic advances during the past 100 years have resulted in a 90% decrease in infant mortality and a 99% decline in maternal mortality since 1900.
Recognition of tobacco use as a health hazard – In the beginning of the 20th century, smoking and the use of tobacco products was considered the norm. Today, smoking is recognized as being the number one preventable cause of death and disability in the United States. The use of cigarettes reached a peak in the 1960’s, with an average of 4000 cigarettes per person being smoked each year. That rate dropped to 2261 cigarettes per person consumed in 1998. Smoking prevalence decreased among persons over 18 years of age from 40% in the mid 1960’s to 25% in 1999.
Family planning –By enabling families to limit their size and increase the interval between the births of their children, access to family planning services and information has led to fewer infant, child, and maternal deaths and has helped to reduce the transmission of sexually transmitted diseases.
In addition to the strides made in theses 10 areas, the role of public health has expanded to include several additional areas affecting society’s well being. The promotion of environmental health is one such area; programs aimed at reducing lead in the environment to protect children’s health is an example of this. An expanding area of involvement for public health professionals is the promotion and encouragement of healthy behaviors in an effort to address social concerns such as teen violence and suicide, substance abuse, mental illness, domestic violence, and teen pregnancies. Public health officials are also responsible for the monitoring of certain diseases trends, providing public immunization clinics, sponsoring health screenings, and enforcing health and safety codes in housing, businesses, and public places such as schools, restaurants, public pools, and day care facilities. Public health departments also warn the public and health care providers about possible health threats such as the spread of contagious diseases, identifying individuals, isolating infections, and developing a plan of action to contain and combat the threat. Educating the public about health and safety concerns is another component of public health. And in the event of a disaster, whether man-made or natural, it is the role of public health officials to respond and assist communities in their recovery. Providing on-site assistance, crisis counseling, setting up shelters, and oversight of sanitation, food and water supplies, and monitoring the incidence illness and injury are services which might be provided in a disaster.
Given the important and multi-faceted role public health plays in everyone’s lives, setting aside a week each year to raise the level of awareness among the public is a good idea. To learn more about the public health services available to residents of Berlin, Rocky Hill, and Wethersfield, contact the Central Connecticut Health District at 721-2822.