Program Evaluation Research Proposal for an Environmental Health Service Dept

Program Evaluation Research Proposal

Introduction

Public health describes efforts to keep entire populations in good health; it requires the cooperation of scientists, physicians, and public officials, who together make policies to ensure the health of the general populace. At the turn of the twentieth century, public health was in a period of change owing to advances in bacteriology. In the nineteenth century, public health typically concentrated on controlling infectious disease by the improvement of sanitation in urban areas where diseases such as cholera often had flourished. Such efforts entailed bringing clean water into cities and building sufficient sewage facilities, as well as providing for garbage collection and disposal. The basic assumption of these measures was that dirt caused disease. But in the final decades of the nineteenth century, urban laboratories identified specific bacteria and developed the means to combat individual diseases. Instead of sanitation, public health measures emphasized therapy, using antitoxins developed by scientists in laboratories. For example, boards of health in U.S. cities such as Newark, New Jersey, began to use antitoxins against diphtheria in the late 1890s. Although this benefited many of those suffering from disease, it also de-emphasized the importance of public sanitation and diminished the sense of public responsibility for the state of the urban environment. Boards of health in Europe and North America used the discoveries of German scientists Paul Ehrlich (1854-1915) and Robert Koch (1843-1910), notably Koch's isolation of the bacterium causing tuberculosis, to focus instead on curing specific diseases with specific remedies. These therapeutic remedies would act, Ehrlich famously hoped, as magic bullets, identifying and killing the deadly organism without harming any other part of the victim's body.

Background

Despite the new methods, a more holistic approach to public health did not completely disappear in the twentieth century. This was partly because of the practical difficulty of isolating carriers of disease. Doing so would have required the state to impose its will on seemingly healthy individuals who, according to urine tests, happened to be carrying deadly diseases such as typhoid fever. Naturally those people who were suffering from the illness had to be treated differently than those who were living healthy lives while carrying the microbe. U.S. public health official Charles Chapin (1856-1941), in his book Sources and Modes of Infection (1910), argued that other approaches were required, such as training carriers to work in jobs that would be least likely to spread the disease (for example, carriers would avoid working in the food industry).

Literature Review

Public health was often connected to other impulses in society, such as social purification. The eugenics movement, popular in the United States, Britain, and Germany, sought to improve the health of the race as a whole by promoting social reforms to encourage or discourage breeding within the disparate groups of the population. In Germany, such efforts at Rassenhygiene (racial hygiene) were not part of an extreme political movement, but were integrated into mainstream public health measures. These were not, as later associations ...