Chapter 2: Public Health Then and Now

Vocabulary List

(Merriam-Webster, 2023)


Public health is a discipline that deals with health on a population level. In this chapter, we will review a brief history of public health and discuss what it is —how it started and where it is going. You will also be introduced to the five core discipline areas of public health. Understanding the five core discipline areas will help you narrow your focus to the public health setting you want to pursue.

The History of Public Health

People have likely been practicing public health for as long as groups of people gathered together. Before the time of Christ, Romans built complex structures to bring safe drinking water into cities, as well as take out human waste (Karabatos et al., 2021). Ancient cultures may have used the spread of disease as a weapon in their warfare (Wheelis, 2002), but they also took measures to stop the spread of disease through laws and cultural norms. The oldest record of this type of public health measure is found in the Bible, in the Book of Leviticus. Hippocrates—the founder of Western medicine—expressed public health sentiments when he discussed the need to consider water and air quality in diagnosing and treating disease (Hippocrates, 400 C.E.)

In 1796, Edward Jenner, a British physician, began experimenting with inoculating people with smallpox in the hope of lessening the devastating results the disease was having (Riedel, 2005). Jenner published a paper describing the process that led to the development of the smallpox vaccine. 

Interest in public health expanded in the mid-1800s. Localities started publishing reports on the sanitary conditions to which their populations were exposed. This interest in sanitation conditions, coupled with increasingly rigorous scientific methods, expanded the ability and reliability of public health efforts. One famous example is that of John Snow, who, in 1854, conducted investigations into a cholera outbreak in the heart of a large, densely populated city: London, England. Snow’s investigations showed that the disease outbreak was centered at a water pump where water was contaminated with sewage (Tulchinsky, 2018). This investigation started our modern research and understanding of waterborne diseases and how to protect societies against them. 

The culmination of John Snow’s cholera outbreak research and increased interest and understanding of public health led to national public health associations being formed in the mid-1800s to the present day. The U.K.’s Royal Society of Public Health (RSPH) was established in 1856, and the American Public Health Association (APHA) was established a few years later in 1872. The World Health Organization (WHO) was organized in 1948 (World Health Organization, 2022a) and the World Federation of Public Health Associations (WFPHA) was founded in 1967 (World Federation of Public Health Associations, 2020)

List of National Public Health Associations
1856Royal Society for Public Health
1872American Public Health Association
1877French Society Of Public Health
1878Italian Society of Hygiene, Preventive Medicine and Public Health
1879Cuban Society of Public Health
1902Public Health Society of Panama
1910Canadian Public Health Association
1929Public Health Association of Georgia
1929Norwegian Public Health Association
1938Japan Public Health Association
1942National Health Association of Thailand
1957Korea Public Health Association
1950Indonesian Public Health Association
1950Iranian Public Health Association
1952Chilean Public Health Society
1952Bangladesh Public Health Association
1952Egyptian Association of Public Health Promotion
1956Indian Public Health Association
1956Society for Social Medicine & Population Health
1958Bolivian Society of Public Health
1968Society for Social Medicine in Finland
1972Taiwan Public Health Association
1972Swiss Society of Public Health
1972Faculty of Public Health
1974Slovenian Medical Society
1979Public Health Association of Australia
1979Brazilian Association of Collective Health
1980Tanzania Public Health Association
1987The National Institute of Public Health of Mexico
1987China Preventive Medicine Association
1988Public Health Association of New Zealand
1989Ethiopian Public Health Association
1990Nepal Public Health Association
1991Uganda National Association of Community & Occupational Health
1992Swedish Association Of Social Medicine
1992Portuguese Association for Public Health Promotion
1992Spanish Society for Public Health and Health Administration
1992The European Public Health Association
1992Belgian Association of Public Health
1992Danish Society of Public Health
1994Armenian Public Health Association
1995Sudanese Public Health Association
1995South Sudan Public Health Association
1995Public Health Association of Latvia
1995Polish Association of Public Health
1995Austrian Public Health Association
1995Austrian Public Health Association
1997German Public Health Association
1997Health Promotion Union of Estonia
2000Netherlands Public Health Federation
2002Vietnam Public Health Association
2002Mongolian Public Health Professionals Association
2002Serbian Public Health Association
2002Albanian Epidemiological Association
2002Macedonian Medical Society/Association for Social Medicine
2002Romanian Public Health and Health Management Association
2002Albanian Epidemiological Association
2003Slovak Public Health Association
2004Public Health Association of South Africa
2004Society of Social Medicine - Public Health of Bosnia and Herzegovina
2005Armenian Public Health Association
2006Kenya Community Health Association
2007Dubai Health Authority, Public Health & Safety Dept
2008Hungarian Association of Public Health Training and Research Institutions
2009Eastern Mediterranean Public Health Network
2011African Federation of Public Health Associations
2012Costa Rican Public Health Association
2012Central Asian Public Health Association
2015Asociacion Colombiana de Salud Publica
2015Zimbabwe Public Health Association
2021Russian Society for the Prevention of Noncommunicable Diseases
2022Cyprus Epidemiology and Public Health Association

(Africa Public Health Foundation, n.d.; European Public Health Association, n.d.; World Federation of Public Health Associations, n.d.)

In the last two centuries, public health efforts have been used to:

In short, public health efforts work to protect against environmental hazards, prevent the spread of disease, encourage healthy behaviors, and respond to disasters.

Public Health and The Church of Jesus Christ of Latter-day Saints

The Church of Jesus Christ of Latter-day Saints provides assistance that affects public health worldwide. This assistance aims to “relieve suffering, foster self-reliance, and provide opportunities for service” (The Church of Jesus Christ of Latter-day Saints, 2022). The donations of Church members primarily fund church humanitarian assistance. The Church sponsors “relief and development projects in 195 countries and territories and assist without regard to race, religious affiliation, or nationality. Aid is based on the core principles of personal responsibility, community support, self-reliance, and sustainability” (The Church of Jesus Christ of Latter-day Saints, 2022)

The public health efforts of The Church of Jesus Christ of Latter-day Saints include projects relating to:

Optional Resources

  • The World Federation of Public Health Associations member state page. This includes an interactive map with all the member states represented. 

  • A repository of short videos describing projects supported by Latter-day Saint Charities.

Five Core Areas of Public Health

As you have been learning, public health is a health-related discipline responsible for addressing and preventing health concerns among the general public, as opposed to medicine that diagnoses and treats individuals with signs and symptoms of a disease, public health attempts to either prevent disease or shorten its course through a specific population. To complete this mission, public health professionals must have broad skills and abilities. Individuals who work in public health should have a background in:

Public health workers should also be familiar with the needs of culturally diverse populations and how to communicate health messages using mass media. In this section, you will familiarize yourself with the components of each of these skills.

Five core areas comprise public health. You will see each of these five core areas of public health in government agencies, healthcare settings, nonprofits, coalitions, and anywhere public health workers are present. 


Biostatistics is a field of math that applies data to solve health problems. For example, in 1856, John Snow used biostatistics to find the cause of the cholera outbreak in London. He recorded the location of all the people affected by cholera, where they lived, and where they got their water. He then calculated which water pumps were making people sick. Biostatisticians are skilled mathematicians who help clarify public health issues based on data.


Epidemiology is the field of science that investigates the cause of diseases and their spread. From our previous example, John Snow was engaging in epidemiology when he figured out which pump was causing the cholera outbreak. “Epidemiology is the method used to find the causes of health outcomes and diseases in populations. In epidemiology, the patient is the community, and individuals are viewed collectively. By definition, epidemiology is the study (scientific, systematic, and data-driven) of the distribution (frequency, pattern) and determinants (causes, risk factors) of health-related states and events (not just diseases) in specified populations (neighborhoods, schools, city, state, country, global). It is also the application of this study to control health problems” (Centers for Disease Control and Prevention, 2016).  

Environmental Health

Environmental health studies how the environment influences human health. In John Snow’s cholera investigation, he focused on the area's water quality and sanitation practices, both of which are areas covered by environmental health. It also covers other human-environment interactions, such as chemicals or toxins released in the environment. It covers pest control, like mosquito abatement, to protect people against malaria. Environmental health is concerned with food safety. During the most recent COVID pandemic, environmental health specialists studied how the disease spread and suggested how to keep the air in public spaces safe for those who needed to share the space.

Health and policy management

Because public health is a community-based approach to health, governmental agencies have a vested interest in public health. Governmental support of laws or standards around public health ensures community members have safe access to shared resources. For example, after John Snow figured out which pump was contaminated, the authorities in the area took away the pump. This had several consequences, one of which was that the cholera outbreak was contained. However, other effects of this action might have looked like governmental overreach to people who had to travel further distances to get water. Three parties contribute to health and policy management: 

Each of these parties needs to be willing to work together to enable the end result of policies that ensure the health of the population (World Health Organization, 2022b). In our example, how would the outcome have changed if the government decided to do nothing with John Snow’s research? How would the outcome have been different if the person or people assigned to disassemble the pump had not done so promptly? What would have happened if the citizens of the area decided that they didn’t want to travel that far for water? Or if they chose not to let the government or health service provider fulfill their end of the project or if citizens had found a way to keep using the pump. In times of civil unrest, it is often this core area of public health that breaks down and leads to health consequences. 

Behavioral Health

Behavioral health studies how and why people change their health behaviors. Behavioral health specialists study the determinants of health: things that improve or damage health. They can suggest behaviors to help people improve their health. In our example, John Snow’s behavioral health intervention was removing the pump handle at the infected pump. This action was taken because the people using the pump would not make that change independently. The act of removing the pump handle was an act of behavioral health. This principle can be applied in many ways to public health settings. Information about healthy eating is the work of behavioral health scientists. Other health issues that rely heavily on behavioral health specialists include:

Optional Resources

10 Essential Public Health Services

The following information is provided by the U.S. Centers for Disease Control and Prevention. It outlines a framework for accomplishing public health work (Centers for Disease Control and Prevention, 2021a). This information has not been changed from its original and is shared with permission (Centers for Disease Control and Prevention, 2021b)

Optional Resources

  • 10 Essential Public Health Services – Full
    Provides a detailed description of each Essential Public Health Service

Job Skills: Scholarly Research

Scholarly Research

You will be required to conduct research in many of your university classes. The term research used here refers to your ability to find and understand information contained in professional literature. This professional literature is usually included in peer-reviewed journals. You gain access to these peer-reviewed journals primarily through databases such as Google Scholar.

Peer review is the process used to maintain high-quality and well-constructed research publications. When people want to publish the findings of their research or projects, they should write their results in a paper and submit it to a journal. Publishers of these journals ask professional researchers (usually university professors or research scientists with government agencies) to review the quality and findings of the paper without knowing the author of the paper. These reviewers critique the paper for quality in research design, clarity in writing, and accuracy in interpreting the statistics. The reviewers make a recommendation to the publisher to accept the paper (after revisions) for publication. You can usually be assured that an article appearing in a well-respected peer-reviewed journal has achieved a significant level of peer review and revision, indicating the results contribute to the profession. 

Reading Scholarly Research

Research articles can seem daunting at first, but usually follow the same format: abstract, introduction, methods, results, discussion, and conclusions. The following information will help you read research articles quickly so you can gather important information from them.

Taking notes about your topic can be helpful as you read the articles. You will need to report on what you read in your paper, but you will not be allowed to copy or quote from your articles. Taking notes while you read can help you understand what you are reading and will help you put it in your own words as you write your paper.

APA Format

Basic APA formatting and writing style includes a basic layout for your work. Using the same format for your academic papers establishes a standard of written communication for every reader. The uniformity and consistency of the APA format allow readers to focus on the ideas presented in the paper rather than trying to figure out an unfamiliar format. This makes it easier for readers to find the information they are looking for. 

The basic format includes the following: 

Each chapter will include instructions and format examples based on the sections of your Term Paper that you are writing. Chapter 2 focuses on the Title Page and the Reference Page and includes example images along with instructions. 

One part of the basic format that many students have trouble with is double spacing. Below are two examples of what the different spacing types look like. 

Single Spacing

Double Spacing

spacing that is required on your Term Papers. 

Title Page 

This is how your finished Title Page should look. Each arrow designates a different part of the title page. 

Title Page Format. For a more in-depth description, see the appendix.

For a description of the image, access the appendix 

Reference Page 

Your reference list will begin at the end of your paper and will be the last page. The reference page provides the information readers need to find the sources that you used in your research and writing. Every source you reference in your paper must be included on your reference page, and every source you list on your reference page needs to be cited in your writing with an in-text citation (more about these later in the course).  

Your reference page should begin on a new page after your conclusion. Follow the instructions in the images below to ensure your reference page is formatted correctly.

This is how your finished References Page should look.


 A document showing the References page. For a more in-depth description of the image, see the appendix.

For a description of the image, access the appendix

Reference Information:

For each Reference entry, you will include the required information in the following order:

The references page like the one above, but in the last reference, each part is highlighted to match the order the reference is supposed to be in (author(s), date, title, source)

Each Reference should be formatted in the following ways:

The references page showing just the first reference, title, and page number, with the last name of the author, first initial, period, comma, and year of publication in parentheses highlighted.

The same references page, now used to reference how each of the references is in alphabetical order, the title is at the top, everything's double-spaced with no extra spaces in-between, and hanging indents are used

If you follow all formatting rules, your reference page should look like the image above. Make sure that every source you find online is cited with the URL of the page where you found your information. 

Optional Resources


Africa Public Health Foundation. (n.d.). Who we are. Africa Public Health Foundation.

Centers for Disease Control and Prevention. (2016). What is Epidemiology? | Teacher Roadmap | Career Paths to Public Health | CDC. Teacher Roadmap: What Is Epidemiology?

Centers for Disease Control and Prevention. (2021a). CDC - 10 Essential Public Health Services—CSTLTS. Public Health Professionals Gateway: Public Health Systems & Best Practices.

Centers for Disease Control and Prevention. (2021b, May 27). Using Centers for Disease Control and Prevention.

European Public Health Association. (n.d.). EUPHA Members. EUPHA.

Hippocrates. (400 C.E.). On Airs, Waters, and Places.

Karabatos, I., Tsagkaris, C., & Kalachanis, K. (2021). All roads lead to Rome: Aspects of public health in ancient Rome. Le Infezioni in Medicina, 29(3), 488.

Merriam-Webster. (2023). Merriam-Webster Dictionary. Merriam-Webster.

Riedel, S. (2005). Edward Jenner and the History of Smallpox and Vaccination. Baylor University Medical Center Proceedings, 18(1), 21–25.

The Church of Jesus Christ of Latter-day Saints. (2022). Latter-day Saint Charities: About Us.

Tulchinsky, T. H. (2018). John Snow, Cholera, the Broad Street Pump; Waterborne Diseases Then and Now. In Case Studies in Public Health (pp. 77–99). Elsevier.

Wheelis, M. (2002). Biological Warfare at the 1346 Siege of Caffa. Emerging Infectious Diseases, 8(9), 971–975.

World Federation of Public Health Associations. (n.d.). Members. WFPHA.

World Federation of Public Health Associations. (2020). WFPHA: History.

World Health Organization. (2022a). About WHO.

World Health Organization. (2022b). Health Systems Governance. Health Topics: Health System Governance.

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