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111-505: Although the hospital was built by the Spanish National Health System , its management model is a foundation, similar to a public company, so its operating rules differ, in some aspects, from those of other public hospitals. The hospital was allowed to negotiate its own contracts with workers. The governance of the hospital includes regional and local governments and university partners. The hospital's organizational structure

222-497: A Spanish building or structure is a stub . You can help Misplaced Pages by expanding it . This article about a hospital in Europe is a stub . You can help Misplaced Pages by expanding it . Spanish National Health System The Spanish National Health System ( Spanish : Sistema Nacional de Salud , SNS ) is the agglomeration of public healthcare services that has existed in Spain since it

333-460: A basic level of medical care and disease prevention. A major public health concern in developing countries is poor maternal and child health , exacerbated by malnutrition and poverty coupled with governments' reluctance in implementing public health policies. Developed nations are at greater risk of certain public health crises, including childhood obesity, although overweight populations in low- and middle-income countries are catching up. From

444-613: A basic level of medical care and disease prevention. As a result, a large majority of disease and mortality in developing countries results from and contributes to extreme poverty . For example, many African governments spend less than $ 100 USD per person per year on health care, while, in the United States, the federal government spent approximately $ 10,600 USD per capita in 2019. However, expenditures on health care should not be confused with spending on public health. Public health measures may not generally be considered "health care" in

555-410: A component of preventive medicine and public health. It is implemented as part of primary care rather than a specialty in its own right. Valles argues that the term social medicine has a narrower and more biomedical focus than the term population health. The purpose of a public health intervention is to prevent and mitigate diseases, injuries , and other health conditions. The overall goal

666-441: A country's overall health care system. Many interventions of public health interest are delivered outside of health facilities , such as food safety surveillance, distribution of condoms and needle-exchange programs for the prevention of transmissible diseases. Public health requires Geographic Information Systems (GIS) because risk, vulnerability and exposure involve geographic aspects. A dilemma in public health ethics

777-446: A decentralized system, it attempts to establish certain basic, common safeguards throughout the country. This law attempts to establish collaboration of public health authorities with respect to benefits provided, pharmacy, health professionals, research, health information systems, and the overall quality of the health system. Toward these ends, the law created or empowered several specialized organs and agencies, all of which are open to

888-663: A form of "health fascism" by a number of scholars, objectifying the individual with no considerations of emotional or social factors. When public health initiatives began to emerge in England in modern times (18th century onwards) there were three core strands of public health which were all related to statecraft: Supply of clean water and sanitation (for example London sewerage system ); control of infectious diseases (including vaccination and quarantine ); an evolving infrastructure of various sciences, e.g. statistics, microbiology, epidemiology, sciences of engineering. Great Britain

999-488: A handful of people or as large as a village or an entire city. The concept of health takes into account physical, psychological , and social well-being . As such, according to the World Health Organization , "health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". Public health is related to global health which is the health of populations in

1110-462: A health care system sufficient for the needs of their respective jurisdictions. Article 149.1.16 or the Constitution, a further basis for the present law, establishes substantive principles and criteria that allow general and common characteristics to be consistent throughout the new system, providing a common basis for health services throughout Spanish territory. The administrative device set up by

1221-643: A la Dependencia y a la Discapacidad ). The objective of this reorganization is to reinforce the role of the single ministry as the instrument of cohesion for the National Health System (SNS), adding to the portfolio of the Secretary General of Health purview in matters of the quality of the SNS by adding to it the Agency of Quality of the National Health System ( Agencia de Calidad del Sistema Nacional de Salud ) and

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1332-463: A million avoidable child deaths each year. Intermittent preventive therapy aimed at treating and preventing malaria episodes among pregnant women and young children is one public health measure in endemic countries. Since the 1980s, the growing field of population health has broadened the focus of public health from individual behaviors and risk factors to population-level issues such as inequality , poverty, and education. Modern public health

1443-514: A plenary body, by delegated committees, through technical commissions, and through work groups. It meets as a plenary body at the initiative of its president or at the initiative of one-third of its members; plenary meetings occur at least four times a year. To some extent, this is a formality: resolutions from CISNS commissions are typically adopted by consensus. Cooperation agreements to conduct joint health actions are formalized in CISNS agreements. Under

1554-738: A population between 5,000 and 20,000 inhabitants. The Basic Health Zone is served by a single general hospital and specialists' center. Article 12 of the Law of Cohesion establishes the concept of "primary care," the basic level of patient care that guarantees the comprehensiveness and continuity of care throughout the patient's life, acting as manager and coordinator of cases and regulator of issues. Primary care includes health promotion, health education, prevention of illness, health care, maintenance and recuperation of health, as well as physical rehabilitation and social work. Primary health care includes service provided either on-demand, scheduled, or urgently, both in

1665-407: A review of research on what local authorities can do to tackle obesity. The review covers interventions in the food environment (what people buy and eat), the built and natural environments , schools, and the community, as well as those focussing on active travel , leisure services and public sports, weight management programmes , and system-wide approaches . Health inequalities, driven by

1776-470: A right of all citizens, and Title VIII, which foresaw that purview over matters of health would devolve to the autonomous communities . The General Health Law of 1986 ( Ley 14/1986 General de Sanidad ) was formulated on two bases. First, it carries out a mandate of the Spanish Constitution, whose articles 43 and 49 establish the right of all citizens to protection of their health. The law recognizes

1887-460: A right to health services for all citizens and for foreigners resident in Spain. Second, Title VIII of the Constitution confers upon the autonomous communities broad purview in matters of health and health care. The autonomous communities have first-order importance in this area, and the law permits devolution of these functions from the central government to the autonomous communities, in order to provide

1998-470: A sector ( Dirección de sector ), or of a comarca , district, department, or other territorial unit used in that autonomous community. Although the autonomous communities differ among themselves in layering subdivisions of their health areas, all eventually come down to a Health Zone ( Zona de Salud ) or Basic Health Zone ( Zona Básica de Salud ) as the unit for a primary health care team. In Andalusia, for example, each existing Basic Health Zone takes care of

2109-502: A series of publications on this topic in the late 1980s and early 1990s criticizing the UK's the Health of The Nation campaign. These publications exposed abuse of epidemiology and statistics by the public health movement to support lifestyle interventions and screening programs. A combination of inculcating a fear of ill-health and a strong notion of individual responsibility has been criticized as

2220-491: A significant increase after World War II as concerns over the spread of disease as a result of globalization increased and the HIV/AIDS epidemic in sub-Saharan Africa surfaced. From 1990 to 2010, total health aid from developed countries increased from 5.5 billion to 26.87 billion with wealthy countries continuously donating billions of dollars every year with the goal of improving population health. Some efforts, however, receive

2331-465: A significantly larger proportion of funds such as HIV which received an increase in funds of over $ 6 billion between 2000 and 2010 which was more than twice the increase seen in any other sector during those years. Health aid has seen an expansion through multiple channels including private philanthropy, non-governmental organizations , private foundations such as the Rockefeller Foundation or

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2442-531: Is a fundamental part of population health. Scholars such as Coggon and Pielke express concerns about bringing general issues of wealth distribution into population health. Pielke worries about "stealth issue advocacy" in population health. Jung, Boris and Lushniak consider population health to be a concept that is the goal of an activity called public health practiced through the specialty preventive medicine. Lifestyle medicine uses individual lifestyle modification to prevent or revert disease and can be considered

2553-545: Is an interdisciplinary field. For example, epidemiology , biostatistics , social sciences and management of health services are all relevant. Other important sub-fields include environmental health , community health , behavioral health , health economics , public policy , mental health , health education , health politics , occupational safety , disability , oral health , gender issues in health, and sexual and reproductive health . Public health, together with primary care , secondary care, and tertiary care ,

2664-409: Is dealing with the conflict between individual rights and maximizing right to health . Public health is justified by consequentialist utilitarian ideas, but is constrained and critiqued by liberal , deontological , principlist and libertarian philosophies Stephen Holland argues that it can be easy to find a particular framework to justify any viewpoint on public health issues, but that

2775-451: Is due to the activation of an evolved reward system for substances such as drugs, tobacco, alcohol , refined salt , fat , and carbohydrates . New technologies such as modern transportation also cause reduced physical activity . Research has found that behavior is more effectively changed by taking evolutionary motivations into consideration instead of only presenting information about health effects. The marketing industry has long known

2886-537: Is established in the laws of autonomic financing. Inclusion of a new service in the catalog of services of the National Health System is accompanied by an economic memo that contains the positive or negative financial impact it is expected to imply. This memo is brought up to the Council of Fiscal Policy and Finance for analysis and approval as to whether to proceed. Prior to 1986, public financing of health care occurred mostly through highly regressive payroll taxes. In 1986,

2997-430: Is jointly composed, and coordinates the basic lines of health policy in matters affecting contracts; acquisition of health and pharmaceutical products, as well as other related goods and services; as well as basic health personnel policies. The 2003 Law of Cohesion and Quality of the SNS introduced significant changes in the composition, functioning, and purview of the CISNS. Under this law, the CISNS functions variously as

3108-465: Is limited. Public health programs providing vaccinations have made major progress in promoting health, including substantially reducing the occurrence of cholera and polio and eradicating smallpox , diseases that have plagued humanity for thousands of years. The World Health Organization (WHO) identifies core functions of public health programs including: In particular, public health surveillance programs can: The "Truth" campaign, launched by

3219-434: Is often concerned with addressing determinants of health across a population. There is a recognition that health is affected by many factors including class, race, income, educational status, region of residence, and social relationships ; these are known as " social determinants of health ". The upstream drivers such as environment, education, employment, income, food security, housing, social inclusion and many others effect

3330-569: Is one of Europe's most labor-intensive industries. In late 2020, it accounted for more than 21 million employment in the European Union when combined with social work. According to the WHO , several countries began the COVID-19 pandemic with insufficient health and care professionals, inappropriate skill mixtures, and unequal geographical distributions. These issues were worsened by the pandemic, reiterating

3441-530: Is part of a country's overall healthcare system. Public health is implemented through the surveillance of cases and health indicators , and through the promotion of healthy behaviors . Common public health initiatives include promotion of hand-washing and breastfeeding , delivery of vaccinations , promoting ventilation and improved air quality both indoors and outdoors , suicide prevention , smoking cessation , obesity education , increasing healthcare accessibility and distribution of condoms to control

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3552-487: Is poor maternal and child health, exacerbated by malnutrition and poverty. The WHO reports that a lack of exclusive breastfeeding during the first six months of life contributes to over a million avoidable child deaths each year. Public health surveillance has led to the identification and prioritization of many public health issues facing the world today, including HIV/AIDS , diabetes , waterborne diseases , zoonotic diseases , and antibiotic resistance leading to

3663-514: Is related to public health. The American Board of Preventive Medicine separates three categories of preventive medicine: aerospace health, occupational health , and public health and general preventative medicine. Jung, Boris and Lushniak argue that preventive medicine should be considered the medical specialty for public health but note that the American College of Preventive Medicine and American Board of Preventive Medicine do not prominently use

3774-540: Is the control of tobacco smoking . Many nations have implemented major initiatives to cut smoking, such as increased taxation and bans on smoking in some or all public places. Supporters argue by presenting evidence that smoking is one of the major killers, and that therefore governments have a duty to reduce the death rate, both through limiting passive (second-hand) smoking and by providing fewer opportunities for people to smoke. Opponents say that this undermines individual freedom and personal responsibility, and worry that

3885-615: Is thought to have been one of the inspirations behind the creation of the United Kingdom's system of NHS Foundation Trusts . In October 2014, the hospital was reported to be treating a case of Ebola virus disease under strict biosecurity precautions. The patient had arrived at the hospital by ambulance on October 6. After diagnosis, she was later transferred to the Hospital Carlos III in Madrid for treatment. This article about

3996-1515: Is to improve the health of individuals and populations, and to increase life expectancy . Public health is a complex term, composed of many elements and different practices. It is a multi-faceted, interdisciplinary field. For example, epidemiology , biostatistics , social sciences and management of health services are all relevant. Other important sub-fields include environmental health , community health , behavioral health , health economics , public policy , mental health , health education , health politics , occupational safety , disability , gender issues in health, and sexual and reproductive health . Modern public health practice requires multidisciplinary teams of public health workers and professionals. Teams might include epidemiologists , biostatisticians , physician assistants , public health nurses , midwives , medical microbiologists , pharmacists , economists , sociologists , geneticists , data managers , environmental health officers ( public health inspectors ), bioethicists , gender experts, sexual and reproductive health specialists, physicians , and veterinarians . The elements and priorities of public health have evolved over time, and are continuing to evolve. Common public health initiatives include promotion of hand-washing and breastfeeding , delivery of vaccinations , suicide prevention , smoking cessation , obesity education , increasing healthcare accessibility and distribution of condoms to control

4107-504: The Bill & Melinda Gates Foundation , bilateral donors, and multilateral donors such as the World Bank or UNICEF . The result has been a sharp rise in uncoordinated and fragmented funding of an ever-increasing number of initiatives and projects. To promote better strategic cooperation and coordination between partners, particularly among bilateral development agencies and funding organizations,

4218-525: The Institute for Health Metrics and Evaluation and the World Health Organization has shown a link between international health aid in developing countries and a reduction in adult mortality rates. However, a 2014–2016 study suggests that a potential confounding variable for this outcome is the possibility that aid was directed at countries once they were already on track for improvement. That same study, however, also suggests that 1 billion dollars in health aid

4329-583: The Spanish Civil War , the Ley de Bases de 1944 perpetuated this . The Law of 14 December 1942 create a system of obligatory health insurance under the already extant National Insurance Institute ( Instituto Nacional de Previsión , INP). The system was based on a percentage tax linked to employment. This was further modified by the General Law of Social Security ( Ley General de la Seguridad Social ) in 1974, toward

4440-686: The Swedish International Development Cooperation Agency (Sida) spearheaded the establishment of ESSENCE, an initiative to facilitate dialogue between donors/funders, allowing them to identify synergies. ESSENCE brings together a wide range of funding agencies to coordinate funding efforts. In 2009 health aid from the OECD amounted to $ 12.47 billion which amounted to 11.4% of its total bilateral aid. In 2009, Multilateral donors were found to spend 15.3% of their total aid on bettering public healthcare. Debates exist questioning

4551-627: The United Nations hosting its first General Assembly Special Summit on the issue of non-communicable diseases in September 2011. There is a significant disparity in access to health care and public health initiatives between developed countries and developing countries , as well as within developing countries. In developing countries, public health infrastructures are still forming. There may not be enough trained health workers , monetary resources or, in some cases, sufficient knowledge to provide even

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4662-566: The bienio progresista , the Law of 28 November 1855 established the basis for a General Health Directorate ( Dirección General de Sanidad ), which was created a few years later and which would last into the 20th century. The Royal Decree of 12 January 1904 approved the General Health Instruction ( Instrucción General de Sanidad ), which altered little of the 1855 scheme besides the name; the name would later change to General Inspectorate of Health ( Inspección General de Sanidad ). After

4773-588: The American Legacy Foundation in 2000. This campaign aimed to educate and discourage young people from smoking by exposing the tobacco industry's deceptive practices. Through a combination of powerful visuals, persuasive storytelling, and relatable messaging, the "Truth" campaign successfully reduced smoking rates among teenagers and young adults. Many health problems are due to maladaptive personal behaviors. From an evolutionary psychology perspective, over consumption of novel substances that are harmful

4884-705: The Charles III Institute of Health ( Instituto de Salud Carlos III ), the Institute of Health Information ( Instituto de Información Sanitaria ), the Quality Agency of the National Health System ( Agencia de Calidad del Sistema Nacional de Salud ) and the Observatory of the National Health System ( Observatorio del Sistema Nacional de Salud ). The basic organ of cohesion is the Interterritorial Council of

4995-520: The Councilors with purview over matters of health of the autonomous communities, elected by all of the Councilors who make up the body. The CISNS will come to know, debate among other things, and, as appropriate, make recommendations on the following matters: The prior functions shall be exercised without prejudice to the legislative purview of the Cortes Generales and, as appropriate, the norms of

5106-592: The General Administration of the State; likewise the normal developmental, executive and organizational purview of the autonomous communities. Article 41 of the General Health Law establishes that: The State finances, through general taxes, all health benefits and a percentage of pharmaceutical benefits. This tax is shared among the several autonomous communities according to various sharing criteria now that

5217-618: The General Directorate of Advanced Therapies and Transplants ( Dirección General de Terapias Avanzadas y Trasplantes ). The General Health Law of 1986 created the Interterritorial Council of the Spanish National Health Service ( Consejo Interterritorial del Servicio Nacional de Salud , CISNS) as the organ of general coordination in matters related to health between the central State and the autonomous communities who were given authority in health matters under that law. It

5328-430: The General Health Law sets out that ayuntamientos — municipal governments —have the following responsibilities with respect to health, without prejudice to the purview of other public administrative bodies: As a consequence of the decentralization contemplated by the Spanish Constitution, each autonomous community has received adequate transfers to create a health service, the administrative structure that manages all of

5439-458: The Law of Cohesion establishes that the financing of the Spanish health system is the responsibility of the autonomous communities in conformity with the accords of transfer and the current system of autonomic financing, notwithstanding the existence of a third party liable to pay. Sufficient financing of services is determined by the resources assigned to the autonomous communities in conformity to what

5550-422: The Law of Cohesion, CISNS functions mainly through the adoption of and compliance with joint accords, through the political use of the plenary sessions, with each member making an uncompromising defense of the interests of its region. Presentations, committees, and working groups have been very important, some more than others. Important committees include: Articles 69, 70 and 71 of the Law of Cohesion regulate

5661-539: The Ministry of Health and Consumer Affairs— Ministerio de Sanidad y Consumo —in 2009). The activity of these services is harmonized by the Interterritorial Council of the Spanish National Health Service ( Consejo Interterritorial del Servicio Nacional de Salud de España , CISNS) in order to give cohesion to the system and to guarantee the rights of citizens throughout Spain. Article 46 of the Ley General de Sanidad establishes

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5772-473: The National Health System. Therefore, the 2003 law establishes coordination and cooperation of public health authorities as a means to ensure citizens the right to health protection, with the common goal of ensuring equity, quality and social participation National Health System. The law defines a core set of functions common to all of the autonomous health services. Without interfering with the diversity of forms of organization, management and services inherent in

5883-542: The National Institute of Health Management, INGESA. Under Chapter III of the 1978 Spanish Constitution, all Spanish citizens are beneficiaries of public health services. Concretely, it establishes that: Further, the Organic Law 4/2000 ( Ley Orgánica 4/2000 ) establishes the rights and liberties of foreigners resident in Spain. Its effect on the healthcare provision can be seen in the following articles: Article 10 of

5994-490: The Spanish National Health Service ( Consejo Interterritorial del Servicio Nacional de Salud de España ), which has great flexibility in decision making, as well as mechanisms to build consensus and to bring together the parties taking such decisions. A system of inspection, the Alta Inspección , assures that accords are followed. The Royal Decree-Law 16/2012 was introduced on April 20, 2012. It puts into law severe cuts in

6105-652: The Spanish National Health System, including the following: The Ministry of Health and Social Policy develops the policies of the Government of Spain in matters of health, in planning and delivery of services, as well as exercising the purview of the General Administration of the State to assure citizens the right to protection of their health. The ministry has its headquarters on the Paseo del Prado in Madrid , across

6216-471: The administrative document that accredits its holder and provides certain basic data. In order to best facilitate collaboration, quality, and continuity of services, the each card includes a standardized form of basic identification data for the holder, and indicates in which autonomic health service the person is enrolled. In particular, the cards incorporate a digital form of this information; health facilities throughout Spain have appropriate equipment to read

6327-452: The age of five were overweight in 2014. Once considered a problem in high-income countries, it is now on the rise in low-income countries, especially in urban settings. Many public health programs are increasingly dedicating attention and resources to the issue of obesity, with objectives to address the underlying causes including healthy diet and physical exercise . The National Institute for Health and Care Research (NIHR) has published

6438-405: The authors opined that "The fact that type 2 diabetes, a largely preventable disorder, has reached epidemic proportion is a public health humiliation." The risk of type 2 diabetes is closely linked with the growing problem of obesity . The WHO's latest estimates as of June 2016 highlighted that globally approximately 1.9 billion adults were overweight in 2014, and 41 million children under

6549-405: The autonomous communities had gradually assumed purview in matters of health and had established stable models to finance the assumed purview. Meanwhile, in the 17 years since the original law, Spanish society had undergone many cultural, technological and socioeconomic changes that affected people's ways of life and affected the country's patterns of disease and illness. These posed new challenges to

6660-522: The beginning of the 19th century, the Balmis Expedition (1803) to administer the smallpox vaccine throughout the Spanish colonies was a public health undertaking of unprecedented geographical scope. The Cortes of Cádiz debated a sanitary code (the Código Sanitario de 1812 ), but nothing was approved due to lack of scientific and technical consensus about the actions to be undertaken. During

6771-422: The beginnings of human civilization , communities promoted health and fought disease at the population level. In complex , pre-industrialized societies , interventions designed to reduce health risks could be the initiative of different stakeholders, such as army generals, the clergy or rulers. Great Britain became a leader in the development of public health initiatives, beginning in the 19th century, due to

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6882-419: The centers, services and establishments of the community itself, as well as its deputations, municipal governments, and whatever other territorial administrations fall within that community. The Law of Cohesion establishes the Interterritorial Council (CISNS) as the organ of coordination and cooperation of the SNS. In the autonomous cities of Ceuta and Melilla the corresponding health services are provided by

6993-573: The clinic as well as in the patient's home. Article 13 of the Law of Cohesion regulates characteristics of health care offered in Spain by medical specialists , which is provided at the request of primary care physicians. This may be in-patient hospital care or out-patient consultation at specialist centers or day hospitals . It includes care, diagnosis, therapy, rehabilitation and certain preventive care, as well as health promotion, health education and prevention of illness whose nature makes it appropriate to handle at this level. Specialized care guarantees

7104-527: The clinical history document is sometimes known as a "health history" ( historia de salud ) or "life history" ( historia de vida ). The Clinical History of the [Spanish] National Health System ( Historia Clínica Digital del Sistema Nacional de Salud , HCDSNS) is intended to guarantee citizens and health professionals access to whatever clinical information is relevant for medical care of a particular patient. This history should be available at all authorized locations, but nowhere else: except as needed for treatment,

7215-474: The combination of care for those patients, generally those with a chronic illness , whose would benefit from the simultaneous and synergistic provision of health services and social services to increase their personal autonomy, palliate their limitation or hardships, and facilitate their social reinsertion. This group includes: Public health Public health is "the science and art of preventing disease, prolonging life and promoting health through

7326-433: The communities are responsible for health in their respective territories. Each year the CISNS, after deliberation, establishes the portfolio of services covered by the National Health System, which is published by a Royal Decree of the Ministry of Health. Each autonomous community then establishes its respective portfolio of services, which includes at least the service portfolio of the National Health System. Article 42 of

7437-423: The continuity of integrated patient care once the capabilities of primary care have been exhausted and until matters can be returned to that level. Insofar as patient condition allows, specialized care is offered in out-patient consultation and in day hospitals. As of 2010, Spain recognizes fifty distinct medical specialties. Article 14 of the Law of Cohesion defines social-health care ( atención sociosanitaria ) as

7548-458: The correct approach is to find a framework that best describes a situation and see what it implies about public health policy. The definition of health is vague and there are many conceptualizations. Public health practitioners definition of health can different markedly from members of the public or clinicians . This can mean that members of the public view the values behind public health interventions as alien which can cause resentment amongst

7659-499: The digital information from the cards. A cardholder should thereby be able to access all the services of all relevant health professionals throughout the country. A patient's clinical history is a medical-legal document that arises from the interactions between health professionals and their clients. From a medical and legal point of view, the clinical history is the only document valid to track this history of interactions. In primary care, where methods of health promotion are important,

7770-419: The distribution of health between and within populations and are often shaped by policy. A social gradient in health runs through society. The poorest generally have the worst health, but even the middle classes will generally have worse health outcomes than those of a higher social level. The new public health advocates for population-based policies that improve health in an equitable manner. The health sector

7881-404: The effects of chronic diseases as life expectancy increases, the poorer communities being heavily affected by both chronic and infectious diseases. Another major public health concern in the developing world is poor maternal and child health, exacerbated by malnutrition and poverty. The WHO reports that a lack of exclusive breastfeeding during the first six months of life contributes to over

7992-422: The efficacy of international health aid. Supporters of aid claim that health aid from wealthy countries is necessary in order for developing countries to escape the poverty trap . Opponents of health aid claim that international health aid actually disrupts developing countries' course of development, causes dependence on aid, and in many cases the aid fails to reach its recipients. For example, recently, health aid

8103-588: The end of the Franco regime. Social Security had taken on an increasing number of diseases within its package of services, as well as covering a larger number of individuals and communities. The General Health Law ( Ley General de Sanidad ) of 25 April 1986 and the creation of Health Councils ( Consejerías de Sanidad ) and a Ministry of Health, fulfilled the mandate of the Spanish Constitution of 1978 , in particular Articles 43 and 49 which made protection of health

8214-755: The fact that it was the first modern urban nation worldwide. The public health initiatives that began to emerge initially focused on sanitation (for example, the Liverpool and London sewerage systems ), control of infectious diseases (including vaccination and quarantine ) and an evolving infrastructure of various sciences, e.g. statistics, microbiology, epidemiology, sciences of engineering. Public health has been defined as "the science and art of preventing disease ", prolonging life and improving quality of life through organized efforts and informed choices of society , organizations (public and private), communities and individuals . The public can be as small as

8325-535: The fundamental characteristics of the SNS: Public intervention in collective health problems has always been of interest to governments and societies, especially in the control of epidemics through the establishment of naval quarantines , the closing of city walls and prohibitions on travel in times of plague , but also in terms of hygienic and palliative measures. Al-Andalus — Muslim -ruled medieval Spain—was distinguished by its level of medical knowledge relative to

8436-448: The harmful and undesirable effects of tobacco smoking on other persons and imposing smoking bans in public places have been particularly effective in reducing tobacco smoking. Public libraries can also be beneficial tools for public health changes. They provide access to healthcare information, link people to healthcare services, and even can provide direct care in certain situations. As well as seeking to improve population health through

8547-796: The highest possible level of health". The WHO's broad mandate includes advocating for universal healthcare, monitoring public health risks, coordinating responses to health emergencies, and promoting human health and well-being. The WHO has played a leading role in several public health achievements, most notably the eradication of smallpox , the near- eradication of polio , and the development of an Ebola vaccine . Its current priorities include communicable diseases , particularly HIV/AIDS , Ebola , COVID-19 , malaria and tuberculosis ; non-communicable diseases such as heart disease and cancer; healthy diet , nutrition, and food security ; occupational health ; and substance abuse . Most countries have their own governmental public health agency, often called

8658-446: The implementation of specific population-level interventions, public health contributes to medical care by identifying and assessing population needs for health care services, including: Some programs and policies associated with public health promotion and prevention can be controversial. One such example is programs focusing on the prevention of HIV transmission through safe sex campaigns and needle-exchange programs . Another

8769-487: The importance of associating products with high status and attractiveness to others. Films are increasingly being recognized as a public health tool, with the Harvard University 's T.H. Chan School of Public Health categorizing such films as "impact filmmaking." In fact, film festivals and competitions have been established to specifically promote films about health. Conversely, it has been argued that emphasizing

8880-441: The importance of public health programs in reducing the incidence of disease, disability, and the effects of aging and other physical and mental health conditions. However, public health generally receives significantly less government funding compared with medicine. Although the collaboration of local health and government agencies is considered best practice to improve public health, the pieces of evidence available to support this

8991-477: The importance of public health. In the United States, a history of underinvestment in public health undermined the public health workforce and support for population health, long before the pandemic added to stress, mental distress, job dissatisfaction, and accelerated departures among public health workers. Health aid to developing countries is an important source of public health funding for many developing countries. Health aid to developing countries has shown

9102-420: The information is considered confidential and access is restricted. The term "Health Area" ( Área de Salud ) refers to an administrative district that brings together a functional and organizational group of health centers and primary care professionals. A Health Area may be exclusively focused on primary care or may include specialists as well. Some autonomous communities use different term, such as Direction of

9213-489: The law is the National Health System. The presumption underlying the adopted model is that in each autonomous community, authorities are adequately equipped with necessary territorial perspective, so that the benefits of autonomy do not conflict with the needs of management efficiency. The National Health System is thus conceived as the set of health services of the Autonomous Communities properly coordinated. Thus,

9324-532: The law that established the Spanish National Health System also shifted financing toward progressive general taxes and away from payroll taxes. In a 2000 report, the World Health Organization ranked Spain 26th of 191 countries in its fairness in financing. In 1999, reform to income tax deductions allowed high income earners to deduct more for private insurance. Although this reform was intended to decrease overconsumption of health care services, it had

9435-434: The market. It has been argued to be the beginning of deregulation. The General Health Law was complemented in 2003 by the Law of Cohesion and Quality of the National Health System ( Ley 16/2003 de cohesión y calidad del Sistema Nacional de Salud ), which maintained the basic lines of the General Health Law, but modified and broadened the articulation of that law to reflect existent social and political reality. By 2003, all of

9546-892: The ministry of health, with responsibility for domestic health issues. For example, in the United States , state and local health departments are on the front line of public health initiatives. In addition to their national duties, the United States Public Health Service (PHS), led by the Surgeon General of the United States Public Health Service , and the Centers for Disease Control and Prevention , headquartered in Atlanta , are also involved with international health activities. Most governments recognize

9657-532: The needs of the normative group. Identifying bias within public health research and practice is essential to ensuring public health efforts mitigate and don't aggravate health inequities. The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution, which establishes the agency's governing structure and principles, states its main objective as "the attainment by all peoples of

9768-530: The organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the determinants of health of a population and the threats it faces is the basis for public health. The public can be as small as a handful of people or as large as a village or an entire city; in the case of a pandemic it may encompass several continents. The concept of health takes into account physical, psychological , and social well-being , among other factors. Public health

9879-529: The participation of the autonomous communities. Among these are the Agency of Evaluation of Technologies ( Agencia de Evaluación de Tecnologías , Spanish Agency of Medicines and Medical Devices ( Agencia Española de Medicamentos y Productos Sanitarios ), the Human Resources Committee ( Comisión de Recursos Humanos ), the Committee to Assess Health Research ( Comisión Asesora de Investigación en Salud ),

9990-452: The prevalence of infectious diseases decreased through the 20th century , public health began to put more focus on chronic diseases such as cancer and heart disease . Previous efforts in many developed countries had already led to dramatic reductions in the infant mortality rate using preventive methods. In Britain, the infant mortality rate fell from over 15% in 1870 to 7% by 1930. A major public health concern in developing countries

10101-480: The principal functions of the Interterritorial Council of the SNS. The principal aspects of the Interterritorial Council are: The Interterritorial Council is constituted by the Minister of Health and Consumer Affairs [now of Health and Social Policy], who holds its presidency, and by the Councilors with purview over matters of health of the autonomous communities. The vicepresidency of the body will be fulfilled by one of

10212-484: The public towards certain interventions. Such vagueness can be a problem for health promotion . Critics have argued that public health tends to place more focus on individual factors associated with health at the expense of factors operating at the population level. Historically, public health campaigns have been criticized as a form of " healthism ", as moralistic in nature rather than being focused on health. Medical doctors, Petr Shkrabanek and James McCormick wrote

10323-473: The reemergence of infectious diseases such as tuberculosis . Antibiotic resistance , also known as drug resistance, was the theme of World Health Day 2011 . For example, the WHO reports that at least 220 million people worldwide have diabetes. Its incidence is increasing rapidly, and it is projected that the number of diabetes deaths will double by 2030. In a June 2010 editorial in the medical journal The Lancet ,

10434-587: The rest of Europe, particularly among the physicians of the Golden age of Jewish culture in Spain . In the years after the Reconquista , the Real Tribunal del Protomedicato regulated the practice of medicine in Spain and in its colonies. However, the system of medical faculties at the various universities was very decentralized. Surgery and pharmacy were quite separate from medicine and were considerably less prestigious;

10545-430: The side effect of more regressive financing of public health services. Nevertheless, that same year payroll taxes were completely phased out while higher indirect taxes (on excise goods such as alcohol and tobacco) were earmarked for health care. Article 57 of the Law of Cohesion establishes that citizens' access to health services will be facilitated by use of an individual health card ( tarjeta sanitaria individual ), as

10656-409: The simple act of handwashing with soap can prevent the spread of many contagious diseases . In other cases, treating a disease or controlling a pathogen can be vital to preventing its spread to others, either during an outbreak of infectious disease or through contamination of food or water supplies. Public health, together with primary care , secondary care, and tertiary care , is part of

10767-591: The social determinants of health, are also a growing area of concern in public health. A central challenge to securing health equity is that the same social structures that contribute to health inequities also operate and are reproduced by public health organizations. In other words, public health organizations have evolved to better meet the needs of some groups more than others. The result is often that those most in need of preventative interventions are least likely to receive them and interventions can actually aggravate inequities as they are often inadvertently tailored to

10878-409: The spread of sexually transmitted diseases . Public health aims are achieved through surveillance of cases and the promotion of healthy behaviors , communities and environments . Analyzing the determinants of health of a population and the threats it faces is the basis for public health. Many diseases are preventable through simple, nonmedical methods. For example, research has shown that

10989-438: The spread of sexually transmitted diseases . There is a significant disparity in access to health care and public health initiatives between developed countries and developing countries , as well as within developing countries. In developing countries, public health infrastructures are still forming. There may not be enough trained healthcare workers , monetary resources, or, in some cases, sufficient knowledge to provide even

11100-418: The state may be encouraged to remove more and more choice in the name of better population health overall. Psychological research confirms this tension between concerns about public health and concerns about personal liberty: (i) the best predictor of complying with public health recommendations such as hand-washing, mask-wearing, and staying at home (except for essential activity) during the COVID-19 pandemic

11211-599: The street from the Museo del Prado . The Royal Decree 1041/2009 of 29 June lays out the basic organic structure of the Spanish Ministry of Health and Social Policy. From the date of that decree, the new ministry assumed the functions of, and superseded the former Ministry of Health and Consumption ( Ministerio de Sanidad y Consumo ) and Secretary of State for Social Policy, Family, and Attention to Dependency and Disability ( Secretaría de Estado de Política Social, Familia y Atención

11322-511: The strictest sense. For example, mandating the use of seat belts in cars can save countless lives and contribute to the health of a population, but typically money spent enforcing this rule would not count as money spent on health care. Large parts of the world remained plagued by largely preventable or treatable infectious diseases. In addition to this however, many developing countries are also experiencing an epidemiological shift and polarization in which populations are now experiencing more of

11433-628: The systems of Galen and Hippocrates dominated medical practice during most of the era of the Antiguo Régimen . Medicine was one of the principal fields of activity for the novatores of the late 17th century, but their initiatives were individualized and localized. There is some continuity from their work to the broader work during the Age of Enlightenment , such as through the Colegio de Cirugía de San Carlos ("San Carlos College of Surgery") in Madrid . At

11544-502: The term "public health". Preventive medicine specialists are trained as clinicians and address complex health needs of a population such as by assessing the need for disease prevention programs, using the best methods to implement them, and assessing their effectiveness. Since the 1990s many scholars in public health have been using the term population health . There are no medical specialties directly related to population health. Valles argues that consideration of health equity

11655-409: The various health services fall under the responsibility of the respective autonomous communities, but also under basic direction and coordination by the central state. The respective health services of the autonomous communities would gradually realize a transfer of health resources from the central government to the autonomous communities. The law of 1997 allowed private health care companies to enter

11766-462: The worldwide context. It has been defined as "the area of study, research and practice that places a priority on improving health and achieving equity in " Health for all " people worldwide". International health is a field of health care, usually with a public health emphasis, dealing with health across regional or national boundaries. Public health is not the same as public healthcare ( publicly funded health care ). The term preventive medicine

11877-418: Was a leader in the development of public health during that time period out of necessity: Great Britain was the first modern urban nation (by 1851 more than half of the population lived in settlements of more than 2000 people). This led to a certain type of distress which then led to public health initiatives. Later that particular concern faded away. With the onset of the epidemiological transition and as

11988-882: Was associated with 364,000 fewer deaths occurring between ages 0 and 5 in 2011. To address current and future challenges in addressing health issues in the world, the United Nations have developed the Sustainable Development Goals to be completed by 2030. These goals in their entirety encompass the entire spectrum of development across nations, however Goals 1–6 directly address health disparities , primarily in developing countries. These six goals address key issues in global public health , poverty , hunger and food security , health, education, gender equality and women's empowerment , and water and sanitation . Public health officials can use these goals to set their own agenda and plan for smaller scale initiatives for their organizations. These goals are designed to lessen

12099-473: Was established through and structured by the Ley General de Sanidad (the "Health General Law") of 1986. Management of these services has been progressively transferred to the distinct autonomous communities of Spain, while some continue to be operated by the National Institute of Health Management ( Instituto Nacional de Gestión Sanitaria , INGESA), part of the Ministry of Health and Social Policy (which superseded

12210-408: Was funneled towards initiatives such as financing new technologies like antiretroviral medication , insecticide-treated mosquito nets , and new vaccines. The positive impacts of these initiatives can be seen in the eradication of smallpox and polio ; however, critics claim that misuse or misplacement of funds may cause many of these efforts to never come into achievement. Economic modeling based on

12321-420: Was people's perceived duties to prevent harm but (ii) the best predictor of flouting such public health recommendations was valuing liberty more than equality. Simultaneously, while communicable diseases have historically ranged uppermost as a global health priority, non-communicable diseases and the underlying behavior-related risk factors have been at the bottom. This is changing, however, as illustrated by

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