What is Public Health?
Public health is an often under-recognized component of our health system, yet most improvements in life expectancy and other key markers of healthy populations are the result of effective public health programs. Through public health efforts such as the introduction of clean water and mass immunization programmes, mortality and morbidity have been reduced around the world. Aspects of public health include health promotion – activities taken to encourage healthy behaviours – and health protection, actions taken to protect individuals from spreading harms.
Developing effective public health policies is immensely complex, involving different levels of government, numerous stakeholders with diverse needs and interests, and a need to manage scientific uncertainty. Understanding public health policy development can assist policy makers in improving the delivery of public health and avoiding some of the pitfalls that have contributed to the emergence of public health crises in the past.
One of the challenges to studying governance aspects of Public Health is to establish an appropriate definition of what public health is and distinguish it from health care. There is considerable variability in the definitions of public health and the scope of what people consider to be public health continues to expand.
Some definitions are as follows:
US Institute of Medicine:
“Public health is what we, as a society, do collectively to assure the conditions for people to be healthy. This requires that continuing and emerging threats to the health of the public be successfully countered. These threats include immediate crises, such as the AIDS epidemic; enduring problems, such as injuries and chronic illness; and growing challenges, such as the aging of our population and the toxic by-products of a modern economy, transmitted through air, water, soil, or food. These and many other problems raise in common the need to protect the nation’s health through effective, organized, and sustained efforts led by the public sector.”
The Acheson report, in the UK:
The chief responsibilities of Public health are: “the surveillance of the health of a population, the identification of its health needs, the fostering of policies which promote health, and the evaluation of health services”
Saltman and Figueras in their analysis of European Health Care reform for the World Health Organization:
“the promotion of health and prevention of disease through the organized efforts of society”
The Components of Public Health:
The previous definitions suggest two broad components of public health: health promotion and health protection.
Health promotion, involves actions taken by governments to encourage behaviours amongst citizens that will produce better health. Health promotion activities include anti-smoking campaigns, encouraging healthy lifestyles and promoting better nutrition.
Health protection, on the other hand, involves actions taken directly by governments to prevent the development and spread of disease and illness. It includes activities such as health surveillance and the introduction of regulations to prevent the exposure of individuals to health hazards.