Setting Objectives for Public Health

  • L. Breslow


In 1966 the World Health Organization (WHO) established as an objective the interruption of smallpox transmission throughout the world by 31 December 1976 [24]. The last known case actually occurred in Somalia 26 October 1977, except for two laboratory infections in England during 1978. That tremendous success, the global eradication of a major disease practically on schedule, dramatized the potential for deliberately setting public health objectives and achieving them. Public health endeavor has long been guided by at least implicit objectives. For example, during the 1950s and 1960s American health leaders commonly referred to the substantially lower infant mortality rates that the Scandinavian countries had attained; and public health professionals in the United States internalized these rates as appropriate for “advanced” countries. They became a tacit objective for this country. In tuberculosis control, the ratio of reported cases to deaths from the disease was often taken as an indication of progress during the days when case-finding and isolation were the principal means of combatting tuberculosis. Higher and higher ratios (3: 1, 5: 1, 10: 1) were implicitly adopted as guidelines. Also, immunization of 80% of a community’s children was widely accepted as sufficient to preclude significant outbreaks of disease for which antigens were available.


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© Springer-Verlag Berlin Heidelberg 1990

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  • L. Breslow

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