Public Health at the Crossroads: Achievements and Prospects

Cover......Page 1
Half-title......Page 3
Title......Page 7
Copyright......Page 8
Contents......Page 9
Preface......Page 13
Acknowledgements......Page 16
PART I Global health......Page 17
1.2 Health status or disease status?......Page 19
1.4.1 What is the ‘health transition’?......Page 22
1.4.2 Health transition: periods, pathways and models......Page 23
1.4.3 What propels the health transition?......Page 25
1.4.4 The health transition: a critique......Page 26
1.5 Summary......Page 27
References......Page 28
2.1 The global picture: measures of progress......Page 31
2.1.1 Life expectancy......Page 32
2.1.2 Counting the dead......Page 34
2.1.3 Fifty-six million deaths worldwide......Page 35
2.2.1 Past trends......Page 38
2.2.2 The present......Page 39
2.3.2 The present......Page 42
2.4.2 The present......Page 44
2.4.3 Recent trends in causes of adult deaths in wealthy countries......Page 48
2.4.5 Deaths in older people......Page 49
2.4.6 Avoidable deaths......Page 50
2.5.1 Measuring the impact of disease and disability......Page 51
2.5.2 The global disease burden......Page 53
2.5.3 Health expectancy measures......Page 55
2.6 Inequalities in health......Page 57
2.7 Explaining trends in mortality......Page 58
2.8 Emerging issues......Page 61
2.9 Summary......Page 62
References......Page 64
3.1 Introduction......Page 70
3.2.1 Health, wealth and poverty......Page 72
3.2.2 Other socio-economic causes......Page 79
3.2.3 Literacy and education......Page 82
3.3 Global environmental changes......Page 84
3.4.1 Population growth......Page 89
3.4.2 Over-consumption......Page 92
3.5.1 Tobacco smoking......Page 93
3.5.2 Alcohol......Page 98
3.5.3 Dietary imbalance: underconsumption and overconsumption......Page 99
3.5.4 Physical inactivity......Page 100
3.5.5 Unsafe sex......Page 101
3.6 Injury: unintentional and intentional......Page 106
3.6.1 Car crashes......Page 107
3.6.2 Occupational hazards......Page 108
3.6.3 Violence: personal, civil and international......Page 109
3.7 Summary......Page 111
References......Page 112
PART II Epidemiology......Page 121
4.2.1 Early origins......Page 123
4.2.2 Seventeenth- and eighteenth-century influences......Page 126
4.2.3 The nineteenth-century blossoming of epidemiology......Page 127
4.3.1 Non-communicable disease epidemiology......Page 133
4.3.2 Phases of modern epidemiology......Page 135
4.4 Ideas and methods......Page 137
4.4.1 Causal inference......Page 138
4.4.2 Study design......Page 139
Case control studies......Page 140
Experimental studies......Page 141
Ecological studies......Page 143
4.4.3 Epidemiological analyses......Page 144
4.5 Conclusions......Page 145
References......Page 146
5.2.1 The growth of epidemiology......Page 152
5.2.2 Epidemiology and health status improvement: essential but not sufficient......Page 154
5.2.3 Contributions to medical care......Page 156
5.3 Limitations......Page 157
5.3.1 ‘Risk factor’ epidemiology......Page 158
5.3.2 Data quality and scientific standards......Page 159
5.3.3 Asocial epidemiology......Page 160
5.4 Conclusions......Page 161
References......Page 162
6.2 Improving basic epidemiological information......Page 166
6.3 Causal inference......Page 168
6.4 Global problems require global solutions......Page 170
6.5.1 Building links with policy makers......Page 171
6.5.2 Communicating risk......Page 174
6.5.3 Overcoming isolation......Page 176
6.5.4 Achieving breadth and depth......Page 178
6.6 The ethical challenge......Page 179
References......Page 182
PART III Public health......Page 187
7.2 The nature and scope of public health......Page 189
7.3 A ‘Golden Age’ of public health?......Page 191
7.4 Role of the state......Page 195
7.5 Individual liberty and collective responsibility......Page 197
7.6 The role of scientific knowledge......Page 199
7.7 The professionalisation of public health......Page 200
7.8 Globalisation of public health......Page 202
References......Page 205
8.1 Introduction......Page 209
8.2 Public health in the United Kingdom......Page 210
8.3 Public health in Europe......Page 215
8.4 Public health in the United States of America......Page 218
8.4.1 Organisation of public health services......Page 219
8.4.2 The Institute of Medicine’s Report and its impact......Page 220
8.4.3 Tobacco control in the USA......Page 223
8.5 Public health in Japan......Page 224
8.6 Public health in Sweden......Page 227
8.7 Public health in New Zealand......Page 232
8.8 Conclusions......Page 235
References......Page 236
9.2 China: public health a political priority – but faltering progress......Page 243
9.3 Cuba: public health at all cost......Page 248
9.4 Kerala State: public health at low cost – but faltering progress......Page 252
9.5 Africa: poor health at high cost and with major setbacks......Page 257
9.6 Conclusions......Page 260
References......Page 261
10.1 Introduction......Page 266
10.2 Public health: definitions and scope......Page 267
10.3.1 New public health......Page 270
10.3.2 The Ottawa Charter: new dimensions to health promotion......Page 271
10.3.3 Ecological public health......Page 272
10.4 A critical connection: public health and epidemiology......Page 273
10.5 A growing foundation: public health education and training......Page 274
10.6 The promise of public health research......Page 276
10.7 Public health advocacy: an important skill......Page 277
10.8 Participation: the key to a strong public health movement......Page 278
10.9 Public health, human rights and ecological constraints......Page 280
10.9.1 Principles of public health ethics......Page 281
10.10.1 The daunting global context......Page 282
10.10.2 WHO: struggling to respond to multiple global health challenges......Page 285
10.10.3 Recent global health initiatives: the promise of public–private partnerships......Page 287
10.11 Prospects for public health: cautious optimism still justified......Page 291
10.12 Conclusions......Page 294
References......Page 295
Index......Page 301