Health care is often thought of as something that happens one patient at a time in a clinic or hospital. Public health takes a broader view and is focused on improving the health of entire populations. In 1854, a London physician helped stop a deadly cholera outbreak by removing a simple pump handle. That moment would become one of the earliest and most powerful examples of public health in action. Back then, no one understood how cholera spread. Many believed it was caused by “bad air” or mysterious environmental forces. They did not know that it was actually caused by a bacterium that was spread through contaminated water sources.
Dr. John Snow noticed a pattern. In London’s Soho neighborhood, a cluster of cholera cases seemed concentrated around a single public water source, the Broad Street pump. When he mapped where people lived, most of the infections pointed back to that pump. Even those who lived farther away, but became ill reported getting their water from the same source. Meanwhile, workers at a nearby brewery, who drank beer instead of water, were largely spared. The brewing process, along with the alcohol and acidity of the beer made it difficult for the cholera bacteria or other pathogens to survive.
Armed with this evidence, Dr. Snow convinced local officials to remove the pump handle. This cut off public access to the contaminated water. After this happened, the number of new infections quickly declined. That simple act marked the beginning of modern public health; using data, observation, and intervention to stop disease at its source.
Today, public health has evolved from reacting to outbreaks to preventing illness before it starts. Public health professionals work behind the scenes to protect and improve the health of communities. They do this by providing education, guiding policy, and conducting research. They are the unsung heroes of healthcare. When Public Health works well, it can be almost invisible or easy to ignore. However, when there is a breakdown in Public Health services, the results can be devastating to a community and the effects are obvious.
Federal, state and local health departments prepare for emergencies, monitor for disease outbreaks, ensure food safety, and safeguard water quality. They also advocate for health screenings in underserved or high-risk populations. Public Health officials work to reduce barriers to care and promote healthier lifestyles for everyone. They may not be removing pump handles anymore, but they are still working every day to protect our water, our food, and our communities. They are helping us all, as we say on the show, to stay healthy out there people.
Richard P. Holm, MD passed away in March 2020 after a battle with pancreatic cancer. He is founder of The Prairie Doc®. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook. Dr. Jill Kruse is a hospitalist at the Brookings Health System in Brookings, SD.
