What is Public Health?

MEDICINE

·         Primary concerns is an individual

·         Doctor-Patient relationship and ethics reolved around individual 

·         Emphasis on disease diagnosis, treatment, and care for the individual patient

·         Medical paradigm places predominant emphasis on medical care

·         Uniform system for certifying specialists beyond professional medical degree

·         Lines of specialization organized, for example, by: 

-organ system (ophthalmology, neurology, cardiology, etc)

-patient group (obstetrics, pediatrics, Internists)

-etiology and pathophysiology (infectious disease, oncology)

-technical skill (radiology, surgery)

·         Biological sciences central, stimulated by needs of patients; research moves between laboratory and bedside

·         Numerical sciences increasing in prominence, though still a relatively minor part of training

·         Social sciences tend to be an elective part of medical education and teaches to integrate recovered person to his/her family or community

PUBLIC HEALTH

·         Main focus is on populations and groups
·         Comprehensive, broad and holistic in nature and much more cost effective approach to deliver healthcare to people

·         Public and health department relationship, social and public responsibility

·         Emphasis on disease prevention and health promotion for the whole community

·         Public health paradigm employs a spectrum of interventions aimed at the environment, human behavior and lifestyle, and medical care; designing, implementation and evaluation of health programs 

·         Variable certification of specialists beyond professional public health degree

·         Lines of specialization organized, for example, by: 

- analytical method (epidemiology, biostatistics, toxicology)

- setting and population (occupational health, school health, global health)

-substantive health problem (environmental health, nutrition)

-management (Planning, monitoring and evaluation)

-enforcement and advocacy (Public health legislations and politics)

-communication (Behavior change communication, health informations)

·         Life sciences central, with a prime focus on major threats to the health of populations; research moves between laboratory and field

·         Population sciences and quantitative disciplines essential features of analysis and training

·         Social and public policy disciplines an integral part of public health education and health promotion
·         Focus is more on dealing with Social and psychological Determinants of health 

·         Integral component of human development and human rights
·         It is a science and art of preventing disease, prolonging life, and promote health through organizing committee efforts handling all possible determinants of health of the people.

SUICIDAL IDEATION AMONG MEDICAL STUDENTS OF DELHI

Background

Suicide is becoming a public health problem and this act starts with suicidal ideation that is increasing amongst the younger age group, particularly students. However, little is known about this problem amongst medical students in India

Method 

A cross sectional study was carried out on 265 undergraduate students of a medical college in Delhi using pre-tested and self-administered questionnaire consist of socio-demographic profile, risk factors for suicide, and a validated scale to assess suicidal ideation and thought. Analysis was done using Microsoft Excel and WHO EPI-INFO 2005.

Results

The prevalence of suicidal ideation amongst medical students was 53.6%. Although everybody was aware of the meaning of suicide and the damage that it could cause to the individual and family, still 4.9% students seriously contemplated suicide and 2.6% have attempted suicide at least once in their life. Suicidal ideation was highest in first professional year medical students (64.4%) and lowest among the third professional year students (40.4%). Suicidal ideation was significantly associated with “impulsive or reckless behaviour in difficult situations” with 70.9% of the students showing reckless behaviour also having suicidal ideation compared to 30.7% not having such behaviour. Also, a significant association between the feeling of “it’s all too much to manage” and suicidal ideation was observed, with 78% of the students having this feeling also found to be having suicidal ideation as compared to 4.5% of those without this feeling.  A significant association was found between gender suicidal ideation. Also a significant association was found between the feeling of being “better off dead” and “non-working mothers”.  However, no association of suicidal ideation or attempted suicides was found with age, father’s education, and father’s occupation.

Conclusion

High prevalence of suicidal ideation amongst medical students suggests that there is an urgent need for a mental health program for medical students that provides counseling services and creates more opportunities for recreational activities.

Authors: Abhinav Goyal, Jugal Kishore, Tanu Anand, Akanksha Rathi

Journal of Mental health and human behavior 2012; 17 (1): 60-69; ipsnz.org/journal%20march_2012/8_org_article3.pdf