Contemporary Public Health: Principles, Practice, and Policy

Contemporary Public Health: Principles, Practice, and Policy

Contemporary Public Health: Principles, Practice, and Policy

Contemporary Public Health: Principles, Practice, and Policy

Excerpt

The history of public health in the United States demonstrates cycles of action and inaction, funding and a lack thereof. From its inception in 1798 until the post–September 11, 2001, period, the development of public health, according to Fee and Brown, has been “consistently plagued by organizational inefficiencies, jurisdictional irrationalities, and chronic underfunding. It is apparent that public health—in addition to lacking the support it deserves—has long been subject to a social and cultural discounting, especially in comparison to high-technology medicine, which undermines its authority.” A review of its history results in understanding that public health is favored politically and fiscally during and immediately after periods of crisis, only to slip into obscurity once the crisis has passed. The result of such attention and inattention is the lack of a clear trajectory in providing for the health of the American population and its communities.

Seaport Epidemics and the First Boards of Health

On July 16, 1798, President John Adams signed an act passed by the Fifth Congress of the United States that provided for “the temporary relief and maintenance of sick or disabled seamen in the hospitals or other proper institutions now established in the several ports of the United States, or in ports where no such institutions exist, then in such other manner as he [the secretary of the treasury] shall direct.” The act was a response to epidemic diseases such as smallpox, typhoid fever, plague, and especially yellow fever that were ravaging the eastern seaports. Notions of public health were rudimentary at best, with quarantine being one of the most effective mechanisms for dealing with outbreaks of epidemics, which were often thought to be initiated by seamen returning from lengthy voyages to foreign lands. These returning merchant seamen, who were often ill and lacked family at their ports of . . .

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