 Hello everyone, welcome back to a new session on dentistry and more today's session is on changing concepts and public health In last session we had seen the changing concepts in health And let's see how the various concepts evolved and public health management So the health definition given by World Health Organization is giving Emphasis on physical mental and social aspects of health rather than just absence of disease So similarly the public health whereas health is pertaining to a single individual But the public health it is the health pertaining to a group of people or a big population so it is nothing but science of preventing disease Prolonging life and promoting health through organized efforts of a society So the role of society is very much important because it is public health So it is nothing but preventing disease prolonging life and promoting health through the organized efforts of society So an individual cannot do anything just like health Public health should be a combined effect of society So basically we have four changing concepts just like our health in public health So mostly it get confused with health and public health but keep in mind that health is about an individual but The public health is about a group of people and The idea behind both concepts were almost similar, but the names are different and the approaches were different If you see disease control phase, it is almost like biomedical ways because The concept was controlling the disease Controlling and it was based on the germ theory then the health promotional phase that it was Psychosocial That it was ecological that was different But in third phase it was psychosocial and the last one was holistic phase, but the second phase We have health promotional phase Social engineering phase and the last one is health for all phase and we have clear-cut Time duration for each phase first two phases were almost 40 years and the last two phase were 20 years duration So let's see what happened in disease control phase So as I was saying it was almost like the concept was just like biomedical concept because The biomedical concept was based on the germ theory and the first phase was disease control phase It was during 1880 to 1920 We know that the germ theory was very prevalent during this time and it was known as the golden age of bacteriology, so most of the disease Caused by germs, so that was the belief that time so obviously disease control phase also Will be on this scientific evidence of germ theory, so in order to protect a group of people or a population How to apply this germ theory? So It was believed that making sanitary legislation and sanitary reforms because the contamination of our water supply and by the sanitary Matters or the vehicle matters or the Could be the reason for cholera disease so that time the cholera was very prevalent and The environment cleanliness is very important because that's the Area where the pathogens was most of the time and that could be the Reason for many of the disease that was the belief that time So it was believed that if we clean our environment if we have a good environment most of our disease Will be stopped or will be eliminated because by cleaning cleaning the environment By sanitary reforms or any other methods. We are preventing the germs Thereby diseases So that's how we are controlling our diseases by water supply and sewage disposal improvement so They were actually not aimed at any specific disease, but mainly the communicable diseases so Whatever we say it was It was like a great moment the great sanitary awakening Which happened at the 19th century, but our country is still The same thing has not happened in our country So it was anyway a very great moment which improved the health of people very drastically and the communicable disease where Almost eliminate friend of countries, especially in European countries. Okay So after that the germ theory concept was almost Almost become obsolete. So then came the health promotional phase. So promoting health that involving all aspects of life like social political environmental Educational everything comes into action. So that is health promotional phase in 1920 to 1960 so in this phase all of the sectors which could affect in any Way the health of a people are taken into consideration just like mother and child health services improvement of the school health services by providing nutrients and educating the school children industrial health services providing or providing a better safety of people working at industrial site and Better mental health and rehabilitation services. So all these factors which has an impact in Public health at are taken into consideration That was not in the disease control phase. This is control phase was mainly aimed at cleaning the area or sanitary reforms and the environmental cleanliness it was a different concept, but in health promotional phase the totality of a health is considered So all these sectors were considered in Health promotional phase, so it was 1920 to 1960 so in this time what happened was people started creating for the health services where available to the people by some basic health services Provisions such as primary health centers and sub centers So these centers were at their doorsteps and they could access it with access it very easily so that their very minor problems are Solved at the very beginning stage so they don't have to travel to a Very long distance or a better hospital So they are having a health care facility at their doorstep that was the idea of Primary health centers and sub centers So it was a totalitarian thinking of health So all sectors of health is considered in health promotional phase So one of the moment in health promotional phase was creation of these basic health services using primary health centers and sub centers Second one was the involvement of the community the community development program So it is an attempt to bring out the social and economic change of the rural area or village by the People within the village so the community involvement is very much Very much key to the development of the same community The health sector cannot improve The everyone's health Just like the rural areas where the accessibility is very less for the very Hospitals or the tertiary care centers. So what? It was believed that let the people or they let the community Could give a good give a helping hand or they could do a better part in the Health Better part in health maintaining a health of people. So the active involvement of the community Was a landmark change in providing health services to the Village people so village development and the participation of all community was a Moment in health promotional phase. So these two where the great moments happened during the health promotion phase one was The basic health services through PhDs and sub centers and the community involvement and village development So the third phase was social engineering phase So by this time or most of the communicable diseases were almost cured Because of the salary reforms and other things, but what happened was the post World War era There was a lot of Transition and transformation in the people's lifestyle and eating habits people started getting Chronic diseases or the lifestyle diseases. So the chronic diseases has to be addressed in a different format So the cancer diabetes cardiovascular disease alcoholism trick addiction Are the new diseases in the town? So these diseases has to be Managed using a new strategy. So that was a risk factor So before that a particular disease was caused by a particular Microbe or there was a direct association between the factor and outcome, but risk factor is a new concept Single risk factor can cause many diseases and a single disease can have many risk factors So risk factors we had seen risk factors. What were the risk factors? We had seen it already in the concept of causation so risk factor management was the task in third phase that is social engineering phase So risk factor management Was done by social and behavioral aspect of disease So social and behavioral means Social the people's lifestyle should be changed the reading pattern should be changed Because their behavior has been changed. So behavioral change is a big factor. We cannot Change the behavior using any medicine. So we need to change the behavior using Motivation using counseling using health education. So all these measures were aware to be used to change the behavioral pattern and social stratification or the social change in people will take and care because some social Social class were having so much of problems like obesity and other problems. So Such problems also started rising. So all these problems has to be taken care in social engineering phase so There should be there are smoking the second-hand smoke. There are family problems there are aging problems and Other illness, pollution and exposure to radiation. All these factors has to be taken care because the society has improved very much industrially and they are similar way the pattern behavior of people also changed. So all these should be taken into consideration to control the lifestyle or chronic diseases So at last the health for all concept just like the holistic concept in our health health for all concept was developed by World Health Organization during a conference In 1981 conference, so this was the the idea was behind this was the Contradiction which was seen in developing and developed countries because the most of the people in developed country like European countries or USA are having the benefit of accessibility and they are enjoying all the Elements of a health because they have everything at their hand a better health all the medical facilities But what happens is only 10 to 20 percentage of the people in developing country countries having this Ready access to health service. So the 80 percentage is completely minimal Accessibility to the health facilities. So that contradiction should be removed. All should have a health All are all are all are able to live a healthy life by accessibility to health services and Removing the gap between this Developed and developing country health accessibility health care accessibility So that was the main goal of it was an idealistic concept health for all by 2000 anyway, it was not achieved and it was They knew when they built in 1981 it was not going to be achieved But it was idealistic thought to provide health for all that is mainly for the people in developing country So that was the ultimate aim for us Because health should be available or health should be attained by everyone a good productive So we can summarize this The disease control phase was mainly Sanitary legislation and sanitary reforms It was due to the poor sanitation rules in between the 40 years period that is 1880 to 1920 Then the health promotional phase started 1920 to 1960 That was the basic health services and community development program then the social aspect came into action because 1920 to 1960 the risk factors came in So the risk factors social and behavioral pattern should be It should be taken into consideration that is social engineering phase and ultimately WHO Suggested a health for all phase that is to Reduce the gap between rich and poor within the country because in developing country only 20 percentage Get the better Provision of health and the 80% is not targeting or it is minimally hitting the provision for health So that should be controlled. So that's all about the various phases of public health that is disease control phase health promotion phase social engineering by social engineering phase and health for all phase Okay, so I'll come up with a new session