Public Health and Communicable Disease Control
HIGHLIGHTS
The Constitution grants the states broad powers to protect the public health.
Public health puts the safety of society above the rights of the individual.
All medical care practitioners have duties under the public health laws.
Disease reporting is critical for controlling existing and emerging infectious diseases.
Medical care practitioners have many statutory reporting duties.
Introduction
From Pasteur’s and Koch’s discoveries in the 1800s through the conquering of polio in the 1950s, public health was one of the most prominent and powerful medical specialties. All physicians received training in basic public health and public health officers were respected members of the community. With the advent of magic bullets, effective vaccines, and widespread sanitation, public health fell into disrepute. When the National Institutes of Health studied the public health system in the United States, it found a system in chaos, with little consistent professional leadership. [Institute of Medicine (U.S.). Committee for the Study of the Future of Public Health. The Future of Public Health. Washington, DC: National Academy Press; 1988.]
In retrospect, it is clear that the disorganized public health system hastened the spread of HIV/ AIDS in the United States. The advent of new emerging infectious diseases and the resurgence of old foes such as tuberculosis and foodborne illness has made public health newsworthy again. With the realization that bacterial and viral resistance is bringing the golden age of antimicrobials to an end, public health is again becoming a concern for every medical care practitioner. The internist who diagnoses salmonellosis in a patient, the emergency room physician who suspects that a child may have been abused, and the family practitioner who signs a death certificate, wear the cloak of public health in these endeavors. Many medical care practitioners are unaware of these public health responsibilities. This section introduces the basic legal and medical issues in public health that every medical care practitioner should know. [Maxcy KF, Rosenau MJ, Wallace RB. Public health and preventive medicine. Stamford, CT: Appleton & Lange; 1998.]