Public health thinking needs radical reform. This study reviews the evolution of public health theory and practice that took place in past two or three centuries, and examines current and future challenges and summarizes a rethinking issue. In times of economic hardship, public health is too easy to fall into the political plan. It is considered valuable, but not a political concern. However, there is strong indication that health is determined socially. 1 Public health is high in the public's concept of good society. 2 Health is considered as the foundation of economics. According to me, move from public health to ecological public health seems to be the public health fate as concepts, reality, and movements to shift between vague edges and political sensitivity.
For example, I survey ABC healthcare centre here public health model only tends to focus on the overall picture of the society, threatening vested interests. In addition, public health advocates have authorized themselves to be included in the fine strategy of choice and individualism. In the 20th century alone, public health described an area; before that, public health basically meant what it articulated on label: public health.
In my view, public health is primarily related to the shaping of the terms that make health embellishment. In the terms of policy, conditions can achieve results. Today, this means addressing the Megatrends or transformations that have shaped the 21st century and the public health that must now be reshaped and now we move from public health to ecological public health. This move from public health to ecological public health and the shift is closely related to the need to use community-based participatory study methods involving participants at all stages of a research process to increase community awareness while enabling people to proactively respond to all health problems. There are many public health descriptions, including traditional, old, new and ecological(Bentley, 2013). The goal of this public health is to shift public health from the individualistic focus more on ecological and social approaches; to integrate healthy social, cultural, community and environmental aspects. I feel that ecological public health changed in the 1970s as well as 1980s, when societal movements actively participated in the gay liberation,women's rights along with environmental protection movements. I believe that the root cause of ecological public health lies in Victorian era, when the structural interventions, together withlegislationandpolicies, were considered significant mechanisms for the public health action. It can be said that there is a tension between these terms and between the structure and the agent (Dyakova, 2017).
I feel models for understanding the social, ecological and other determinants of health outcomes are health - environment, biomedicine, technology - economics, society - behaviour and ecological public health. For me, advantages of these public health models are that it leverages as well as integrates or divides parts of different models. Second, it addresses modern thinking regarding complexity plus system dynamics, such as, addressing nonlinear problems, as well as scale, feedback, and other emerging quality changes in nature, biology, and human behaviour. I saw some of these ideas in the vision of the government's chief scientist(Jackson,2012). Third, the models for understanding social, ecological and other determinants of health outcomes is aimed at building knowledge – continuous intellectual engagement, not just limiting “evidence-based” pursuits. Fourth, systems approach to public health includes evolutionary perspectives ranging from nutritional mismatch to biofeedback issues. Fifth, this is an obvious interdisciplinary moreover multi-role model; systems approach to public health needs to act in multiple ways. According to me, the public health system approach is a main purpose of the knowledge and behavioural patterns. Health improvement requires understanding biological causality. Economic and technological growth is the main elevator for health. Health based on a winning co-existence of a natural world along with social relationships. Considering the over-restricted heritage of social, ecological thinking, I totally believe that 21st century models for understanding social, ecological and other determinants of health outcomes must address intrinsic complexity of simply shaping aspects, which we call 4 dimensions of the existence. Public health requirements in 21st century require policies as well as actions to participate in all dimensions in a most effective manner (Lang & Rayner 2015).
I feel ecological public health interventions focus more on working across scales and sectors to address systemic causes of poor health. For example, environmental factors of social equity and public health pose many defies to sustainable urbanisation - oil dependence, water scarcity andclimate change. There are many ways to get from the urban environments to the human health. Many links have been defined, but few of the primary mechanisms behind these relations are not well clear (Lang& Rayner, 2012). The combination of theory along with method is a means to understand and make clear how basic structure of the urban environment is related to social equity andpublic health. I review that eco-public health interventions include working across scales and sectors to address systemic causes of ill health. These departments are committed to addressing systemic causes of less serious health problems. From my point of view there are many major contributors to the ecological thinking in the public health. This new or innovative public health emphasizes prevention, not treatment intervention. These new sectors and work of all sizes focus on reducing health disparities between social groups, healthy living plus good work environments, moreover promoting community participation along with personal empowerment. From this new point of view, health is no longer a disease, but a resource for everyday life. The essential of this environmental public health thinking isanotion of fairness. For departments that are committed to addressing the systemic reason of ill health, the history of health equity comes from the theory of fairness andjustice. In an environmental sense, justice and fairness are environmental and social issues. For example, the purpose of political environment is that there is not anynatural, cultural divide, and the indigenous people of Australia have long recognized this gap.
In 20th century, public health began to explain the field; it basically meant what was said on a label: public health(Major, 2014). In my opinion, public health is primarily in the form of conditions that develop health. As far as policy is concerned, the reason is that conditions can bring results. Today it means that public health should solve and dare to transform the megatrends or transformations that formed the 21st century. I see actions that public health must adopt as a series of guidelines: population, epidemiology, urban, energy, economic, nutritional, bio ecology, culture and democracy (Morris, 2013). Only by solving these problems can public health gain its central social significance. Some of these changes have been well documented and adopted in the field of public health, in particular demographic and epidemiological changes. I feel some people begin to be recognized, such as urbanisation or change in food supply, to create a nutritional shift that is important for the creation of non-communicable diseases. Other transitions, such as energy transitions, are hardly documented in the context of a public health, although in the past, for example, public health activists have seen progress in domestic and industrial energy, and pollution has changed to coal and oil. Today's transformation of energy rightly draws attention to the climate change, but pollution is less recognized. Likewise, psychological impact of the Virtual Operator of the cultural situation of modern business, media and human life requires an immediate action health name. Current political responses to corporate social responsibility, partnership, and so-called common values are very narrow. Long-term efforts for democracy are a major problem for the public health. What other concept without democracy - the meaning of society and life and actual participation - in relation to the whole world and many people have been excluded from the control or the separation of life? How can we think again about the social exclusion, mental health, as well as health inequality? The continuation of health moreover progress has been implicated in consumerism, as if it had no health consequences for health. Public health is often confused with health care. While the improvement of medical knowledge is very good, the scope of health care requires realism. In a world where large supermarkets provide too many calories, regardless of health moreover antibiotic resistance undermines real drug development, 21st century public health require animprovedor better model on how the human healthcare depends upon a composite process of bio-compatibility and quicksocioeconomic change. A disparity between people and disease is a major challenge for the public. In my opinion, this needs an ecological thinking; moreover, therefore we use ecological public healthcare as an appropriate model of the 21st century (Rayner, 2009).
As a case study I present adaption of climate change in low- and middle-income nations. Many cities in low as well as in middle income countries face the risk of direct plus indirect impacts of the climate change. If there is no effective, locally adapted adaptation, it will have very serious impacts for them and the national economy. However, the damage or damage that can be avoided is limited and the capacity of urban adaptation institutions in most low- and middle-income countries also has very serious shortcomings. This makes it more urgent to reach worldwide agreements to reduce greenhouse gas emissions. Successful, well-managed cities have greatly reduced the risks of climate change for low-income people; failed, poorly managed cities, and this risk will increase considerably. Given that water, soil structure, biodiversity, energy and bio resilience are becoming problems in times of climate change, this link is again at the core. Something like that, modern health care has almost forgotten the superiority of the human-environment interface, even though it is part of an original health vision. For example, Edwin Chadwick and others fully recognize how urban health depends on sustainability of the agriculture. The boundary between human health and ecosystem health should nowadays be at the heart of decision-making. The degree of damage caused by extreme climatic events in urban communities and economies in recent years has highlighted its vulnerability. Worldwide, the number of deaths or severely affected deaths from floods and storms has increased rapidly and caused economic losses; a large part of these influences is in the urban regions of low- and middle-income countries. Climate change can be a big part of this situation, but if not, it proves that urban populations are at risk of floods and storms and their frequency and intensity of climate change can increase in several places. Climate change always brings less stringent pressures, for example heat waves, moreover for several urban areas, fresh water supplies will be reduced; sea levels are growing in all coastal cities. If there are no major changes within the functioning of international and governmental agencies in the urban areas, level of these impacts increases day by day. For well-managed and most prosperous cities, adapting to the issues or risks that climate change can bring in the coming years does not seem to be a problem. Emphasis is placed on adapting infrastructure and buildings to these highly increased risks. Work with the most endangered populations and settlements to find new solutions to help them; as well as good preparedness for disasters. But we cannot adapt to an infrastructure that does not exist. Many city residents have no roads throughout the weather, no flowing water, no sewerage facilities, no electricity supply; living in subordinate housing on illegally occupied and divided land, and prevents any investment in resilient buildings. Mostly hinders the provision of infrastructure and services (Rayner & Lang, 2015).
In conclusion, a large proportion of tenants have a very limited ability to pay or compensate for their homes - their owners have no enticement to invest in building improved buildings. There is a clear and visible link amid adaptation to the climate change as well as other areas of environmental management and development. This should reduce the number of increased healthcare risks that the climate change can bring. Adaptation must focus on reducing the vulnerability of specific groups to specific aspects of the climate change for example, such as the particular vulnerability of infants and their occupations as well as older groups.
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- Dyakova M. Investing in healthy urban environments – a pathway to sustainable development and equity. European Journal of Public Health. 2017;27(suppl_3).
- Jackson T. Public health: what's the big idea?. BMJ. 2012;345(aug29 1):e5808-e5808.
- Lang T, Rayner G. Beyond the Golden Era of public health: charting a path from sanitarianism to ecological public health. Public Health. 2015;129(10):1369-1382.
- Lang T, Rayner G. Ecological public health: the 21st century's big idea? An essay by Tim Lang and Geof Rayner. BMJ. 2012;345(aug21 1):e5466-e5466.
- Major I. A Political Economy Application of the “Tragedy of the Anticommons”: The Greek Government Debt Crisis. International Advances in Economic Research. 2014;20(4):425-437.
- Morris G. Ecological public health: reshaping the conditions for good health. Public Health. 2013;127(1):103.
- Rayner G, Lang T. What is the point of public health in the 21st century?. Public Health. 2015;129(10):1309-1313.
- Rayner G. Conventional and ecological public health. Public Health. 2009;123(9):587-591.
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