© Borgis - Postępy Nauk Medycznych 4/2009, s. 319-320
„Health is the greatest treasure; the joy of life, energy, self-confidence, cheerfulness and satisfaction results from it. It is a weapon giving us the possibility of fruitful work and service for family, for society, and for humanity.”
The author of this in-depth, multifaceted, complex concept of health, still relevant today, is the great Polish doctor, philosopher and thinker, for many years Professor and Rector of the Medical Academy of Warsaw, Marcin Kacprzak (1888-1968).
The ideas encapsulated in this definition can be found in all definitions of health that would appear later, including the most well-known: „a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO Constitution, 1948).
The authors of numerous modifications and descriptions of the term „health” have a common aim: to show the complexity of determinants of this desired state. Economic, legal, axiological, spiritual and other aspects appear, and the list still remains open.
Of huge significance for the performance of actions for health is the acknowledgement that „...enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being” (WHO Constitution).
Health as the right of everyone explicitly establishes the need for actions supporting health in the functioning of each democratic law-governed state.
The articles included in this issue of Postępy Nauk Medycznych (Progress in Medical Science) present selected examples of issues within public health that are carried out in the CMKP School of Public Health.
In the article by Maria Miller and Janusz Opolski, an outline of public health as a field of knowledge, science and practice is presented – its scope and also the dependence of the scope and directions of research on the health situation of societies. Particularly essential seem to be the references to the recommendations of the World Health Organization. The concept of the essential public health functions is presented, which as a result of the broad context of health factors means that the most characteristic feature of public health is its multisectoral and interdisciplinary nature.
The authors identify with the opinion that in public health the strategy of action and problem solving is health promotion, and the basic tool is epidemiology.
The next studies by Maria Miller and Anita Gębska-Kuczerowska present epidemiology as a method of measurement of the state of health of the community, and also a method enabling decisions concerning the choice of health priorities. Also an assessment of the epidemiological situation in Poland and some other countries relating to the main health problems is presented. A comparative analysis of the mortality rates which are its main cause, i.e. diseases of the circulatory system, cancers and so-called external causes of deaths, was carried out by taking into consideration also the variability of the demographic situation of Polish society, the most characteristic feature of which is aging.
We have observed in the space of several years an improvement in the most presented indicators of the health status of the Polish population. We live longer and longer, society grows older, and together with this process the structure of chronic diseases changes, the contribution of diseases of the circulatory system decreases in the structure of mortality, and the importance of cancers increases. Not all of them are characteristic for advanced age (cervical cancer, breast cancer, lung cancer). Together with the change of the structure of age and distribution of chronic diseases the problem of disability arises; the number of people incapable of an independent existence increases.
The article by Anna Wilmowska-Pietruszyńska is devoted to social protection against the risk of disease and its results. Apart from presenting the protection system with particular emphasis on the role of doctor´s certification and rehabilitation, also results of the reforms of the system in the previous years, and proposals for the next changes are described.
In the next article by Anna Wilmowska-Pietruszyńska and Jacek Putz the concept of nursing care social insurance as a solution of the needs of those incapable of independent existence is described in detail.
In the public health sphere there are also issues concerning access of societies to appropriate, in terms of quality and availability, health benefits, organized in an efficient and effective way.
In the next articles (Alicja Sobczak and Janusz Opolski) health services and health insurances are described. The paper discusses the dilemma: health – a public or a private good? By adopting the fundamental values concerning health there follow broad consequences concerning among other things the insurance system and the „basket” of health services.
The organizational systems of health care throughout the world are undergoing changes; a continuous process of their mutual merging can be observed. The fashion for „one-size-fits-all” is gone, and solutions best fitting individual countries, possible to use in a particular society, are being sought. These processes have a continuous character. It is also apparent today that the time of revolution in the health systems has passed; just as their objective feature is variability, so their praxeological requirement is calm reflection and gradual change.
With this in mind the examples of two health systems – the Danish and Irish – are presented in the paper by Marek Sanecki and Janusz Opolski.
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