Over the past couple of years, many people have learned more about the field of public health and its role in our country and local communities. However, the public health field has been in existence for many years — quietly making a difference in the health of our country. The history of public health in the United States is an important part of American history; without sanitation, vaccination, food safety regulations, and numerous other advancements in public health, our society would be very different. In this two-part series, we’re going to look at a brief history of public health in the United States, and next month, we’ll look more closely at the history of Green County Public Health.
The first public health agency in the United States was the Marine Hospital Service (MHS), formed in 1798 to care for sick and injured seamen. The agency was made up of hospitals with professionals who provided medical care. Over time, the Marine Hospital Service’s duties increased, and the organization served communities outside of the seamen population.
In the nineteenth and early twentieth centuries, public health became an important governmental function with federal, state, local, and tribal public health agencies. These organizations were formed to address the population-level health issues the country and local communities were facing. Since the creation of a formal public health system, the country’s health needs have changed, and public health has adapted to address them.
Throughout much of human history, communicable diseases have been one of the largest concerns for public health. These are diseases that can be spread from person to person, from an animal to a person, or from a surface or food. Examples include influenza, Lyme disease, and salmonella. In the nineteenth and twentieth centuries, communicable diseases were the primary focus of public health in the United States because they were the leading causes of death in the country. Advancements in public health, such as water treatment, the development of sewage and solid waste disposal systems, the creation of food safety guidelines and regulations, and hygiene education, such as information about handwashing, helped prevent the spread of communicable diseases. In addition to these, quarantine and isolation were used to prevent diseases from spreading from one person to another. This involves separating people who were sick with an illness and those who had been exposed to an illness away from other people to prevent further spread.
Into the mid-twentieth century, there were great medical advancements that helped protect the health of the public. During this time, vaccines were researched and began to be approved for use; widespread vaccination efforts to make vaccines available and educate people about vaccination led to the eradication of certain diseases in the United States and worldwide. For example, in 1977, smallpox was eliminated worldwide after vaccination efforts involving 33 countries. In the 1940s, penicillin, the first antibiotic, began to be used to treat infections like strep throat and staph infections, gonorrhea, and syphilis.
Public health agencies began to focus on safety and chronic disease (heart disease, diabetes, cancer, etc.) prevention in the mid- to late-1900s as the prevalence of communicable diseases decreased. Just one example of this public health’s efforts to prevent the use of cigarettes, to help prevent lung cancer, heart disease, and other chronic conditions. The first Surgeon General’s Report on the negative health effects of tobacco was published in 1964. Since then, public health has implemented educational initiatives and worked with lawmakers to create policy changes that have drastically decreased smoking rates in the United States. Other examples of accomplishments around this time include widespread use of seat belts, lead poisoning prevention, and increased medical screenings for chronic diseases.
At this time, the field of public health is shifting towards “Public Health 3.0”, which is a model that encourages public health agencies to go beyond traditional public health programs and services. “Public Health 3.0” focuses on having public health organizations collaborate with other community organizations to prevent disease and improve health. This looks like public health organizations working with businesses, non-profit organizations, local government, community groups, healthcare organizations and others to implement changes that improve the community’s health.
Even while addressing more modern public health issues, public health agencies are still called upon for services similar to those they did early on in their history. Communicable diseases still exist, and public health works to provide guidance and education to individuals who become sick and to intervene to prevent further spread or investigate disease outbreaks. Public health still ensures food safety at national, state, and local levels, as well as serves as a source for vaccinations, especially for community members who are uninsured or underinsured.
This was just an overview of some of the public health achievements in the United States. To learn more in-depth history of the field of public health, go to www.cdc.gov/museum/history.htm. Check back next month to learn about your local public health department, Green County Public Health.
— Bridget Zimmerman is the Public Health Educator for the Green County Public Health Department and can be reached at bzimmerman@greengountywi.org or 608-328-9509.
