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Medicine and Disease

Epidemics

How old is the concept of public health?

Public health is an old concept, dating back to when people first began living in communities. Through the ages, governments have shown varying degrees of concern for the public health. The ancients Greeks, and the Romans after them, tried to ensure the health of their citizens by providing a supply of clean water (via aqueducts and pipelines), managing the disposal of waste, and working to control disease by hiring public physicians to treat the sick. These measures may have helped prevent the spread of certain diseases, but epidemics still occurred. After the fall of the Roman Empire (c. 476), Europe’s civilizations largely ignored matters of public health. Once disease was introduced to a community, it would spread quickly. Epidemics of leprosy, the plague, cholera, and yellow fever ensued.

During the late 1800s European governments began turning their attention to matters of public health in an effort to control the spread of disease. In the United States, the public health became an official concern when in 1866 a cholera epidemic struck the nation—for the eighteenth consecutive year. It was part of a worldwide epidemic that persisted for 12 years. Though governments set up health facilities, including laboratories for the study of infectious disease, by 1893 another cholera pandemic (widespread epidemic) began. During the twentieth century, the measures taken by national governments to safeguard their citizens from health risks have been strengthened by the establishment of regional and local laboratories, public education programs, and the research conducted at universities and other institutions. These combined efforts have made outbreaks of diseases such as diphtheria, dysentery, typhoid fever, and scarlet fever increasingly less common in developed nations. In developing nations, public health officials continue working with international agencies (such as the World Health Organization and other United Nations agencies) to reduce instances and the spread of infectious disease.