What is Public Health?

 A bit of history

 

Health was not always thought of as something public. It is only with the consolidation of modern national states that populations come to be considered as something to be preserved. The growth of cities and the increase in populations living in the same spaces gave rise to concerns about epidemics, birth rates, mortality and the organization of cities so that people could live better. Health as a public good begins in 17th century Europe. The movement towards the institutionalization of health, as a concern of the State, gained even more strength in the 19th century, with the institutionalization of Hygiene in France, which was seen as part of medicine and public administration, which needed to keep the population healthy.

 

In Brazil, interventions on the health of the community gained strength during the Old Republic, as a strategy for cleaning up the circulation spaces of the coffee economy. It is the time of Oswaldo Cruz and of the health campaigns, in which sanitation measures aimed at eradicating urban Yellow Fever and mandatory vaccination against smallpox stand out. However, the social security model presented by the SUS has existed for just over 30 years. Until the 1920s, the general population, and especially the low-income population, depended on the charity of the Santas Casas de Misericórdia to have access to health services, which were still very precarious. From the 1920s, we started to follow a model of Social Security, which assured health services to Social Security contributors.

 

 

And today, what is Public Health?

Public Health is currently considered the entire set of measures implemented by the State to guarantee the physical, mental and social well-being of the population.

 

At the international level, public health is coordinated by the World Health Organization – WHO, currently comprising 194 countries. The body consists of a specialized agency of the UN (United Nations) that works side by side with the governments of countries to improve the prevention and treatment of diseases, in addition to improving the quality of air, water and food.

 

In addition to the political-administrative context, public health is also the branch of science that seeks to prevent and treat diseases through the analysis of health indicators and their application in the fields of biology, epidemiology and other related fields.

 

Public health in Brazil

 

In Brazil, public health is foreseen in the Federal Constitution as a duty of the State (Article 196) and as a social right (Article 6), that is, a right that must be guaranteed homogeneously to individuals in order to to ensure the exercise of fundamental rights.

 

With the objective of guaranteeing this right, the Federal Constitution assigned to the Union, the States, the Federal District and the municipalities the competence to take care of public health. This means that, within a single system, each sphere of government will have a body responsible for executing and administering services aimed at local health.

 

It is worth mentioning that the 1988 Constitution was the first to treat health as a political agenda. Before it, there was no legislation subjecting the Public Power to invest in the area.

Health Unic System

 

The Unified Health System - SUS, was created by the Federal Constitution of 1988 and is regulated by Law No. 8.080/90 (Organic Health Law), which defines it as follows:

 

“The set of health actions and services, provided by federal, state and municipal public bodies and institutions, the direct and indirect Administration and foundations maintained by the Public Power, constitute the Unified Health System (SUS).”

 

Therefore, the Unified Health System is formed by all the measures implemented directly or indirectly by the State to improve public health.

 

The SUS is funded by social security resources from all federal entities and has the following guidelines:

Decentralization

 

In order to serve all regions of the country in a way that addresses local needs, the SUS is divided into regional bodies with administrative power. At the national level, the administration of the SUS takes place through the Ministry of Health. In the states, Federal District and municipalities, administration is the responsibility of the Health Secretariats, or equivalent bodies.

completeness

 

The SUS must serve all individuals, without distinction of any kind. In addition, the service should emphasize preventive activities (awareness campaigns, vaccines, etc.) without this implying coverage of treatments and curative measures.

community participation

 

The participation of the people must happen through health councils and conferences in which the population can vote and decide which health issues should be prioritized.

 

 

Principles of public health

 

Public health in Brazil revolves around the following principles set out in the Organic Law on Health:

 

· universal access to health services at all levels of care

 

· completeness of assistance

 

· preservation of people's autonomy in defense of their physical and moral integrity

 

· equality of health care

 

· right to information, to people assisted, about their health

 

· disclosure of information

 

· use of epidemiology to establish priorities

 

· community participation

 

· political-administrative decentralization, mainly in municipalities

 

· integration between health, environment and basic sanitation

 

· combination of resources from the Union, the States, the Federal District and the Municipalities

 

· ability to resolve services at all levels of assistance

 

· organization of specific and specialized public assistance for women and victims of domestic violence in general, which guarantees, among others, assistance, psychological support and reconstructive plastic surgery

 

With the exception of the last principle (which was inserted into the law only in 2017), these are the foundations of public health in the country since 1990, when the Organic Law on Health came into force.

 

PAHO (Pan American Health Organization) defines 11 essential public health functions in any country:

 

1. Monitoring, analysis and evaluation of the state's health situation.

 

2. Surveillance, investigation, control of risks and damage to Health.

 

3. Health Promotion.

 

4. Social Participation in Health.

 

5. Development of rules and institutional potential for public fitness making plans and management.

 

6. Regulatory, inspection, control and audit capacity in Health.

 

7. Promotion and guarantee of universal and equitable access to health services.

 

8. Administration, development and training of Human Resources in Health.

 

9. Promotion and quality assurance of health services.

 

10. Research and technological incorporation in Health.

 

11. Coordination of the Health Regionalization and Decentralization process

 

Now that you know a little more about public health, let's together strengthen the movement so that our right to health is respected in all public spheres.