Hello and welcome to this video where we
are going to talk about “Public Health”! “Public health” has made a significant
impact on the health of populations…….making people healthy and saving lives.
For example, in the United States, between 1900 to1999, people’s life
expectancy has increased by over 30 years… Did you know that 25 of these “extra years”
gained are due to public health interventions?! So in this video, we are going to
take a look at what public health is, how it is different to clinical medicine, who
is responsible for doing it and how it’s done! First of all…let’s have a
look at what “health” is. The World Health Organization defines
health as “a state of complete physical, mental and social well-being rather than
a mere absence of disease or infirmity.” This is a pretty bold and ambitious definition
that prompts people to look beyond diseases and focus not only on the physical aspect of health
but also the mental and social aspects as well. …..and public health??
Well…..public health is the science and art of preventing disease, prolonging life, and promoting
health through the organized efforts of society. Ok…..
So how is different to clinical medicine???
Let’s take a look at an example. Let’s say someone has an
accident and has a broken leg. A clinician’s main focus is the immediate
health problem……..fixing the fractured leg. Clinicians focus on the individual..
The public health approach would be holistic and would focus on figuring out how and why this
person had an accident so that actions can be taken to prevent it from happening again.
For example: Why did he have the accident?
Was there a problem with his vision? Was it a poor knowledge of driving
skills or bad attitudes towards driving? Was he under the influence of
alcohol or drugs when he was driving? Are there laws against this
and resources to enforce it? What are the community expectations
or attitudes towards driving? Does he have a good social support
network that will help in his recovery or prevent this from happening again?
Was the road he was driving in safe? Was he driving a safe car
that was well maintained? If not, why not?
Could he not afford it? If not, why could he not afford it?
Does he have a job that doesn’t pay well? Why is that?
Is it because he did not have access to good education?
Was there good access to health services which would determine his treatment and recovery?
As you can see from this example, health is determined by a complex interaction between many
different factors, or determinants of health. These include individual characteristics,
lifestyles and behaviours and also the physical, social and economic environments….
These are called the social determinants of health …In order to make a difference
in health, there is action needed across all the different determinants.
Public health focuses on these upstream factors to make changes that can benefit
the health of the population as a whole. This seems like a very broad
and complex task doesn’t it?? So…who is responsible for public health?
Ultimately, the responsibility of creating a healthy community rests
with all sectors of society. Health departments do have a central role in
public health…..however, improving the health of a population requires the coordinated
efforts of a broad range of stakeholders. This includes other areas of
government, the private sector, Non-Governmental Organizations, International
Organizations and communities to name a few… …all united with a shared goal of
improving the health of the public.. Now let’s have a look at
how public health works….. The World Federation of Public
Health Associations has developed a useful framework to understand
how public health is delivered. There are three core service areas of
public health and a group of enablers that ensure that these services can
occur effectively and efficiently. The three core areas of public health
are: Protection, Promotion and Prevention. Protection is about protecting
the health of the population. This includes the control of infectious diseases,
managing environmental hazards, ensuring a healthy workplace and managing health emergencies
Promotion is about improving the health of the population.
It covers a broad range of activities that not only focuses on
the individual like promoting health behaviours over a life course.
It also focuses
on improving the social-determinants of health. Prevention is about preventing health issues
before they occur. It includes activities such as vaccination and screening.
To enable these core areas to function there needs to be:
Good Governance…. Advocacy……to influence and obtain support and
commitment for actions that support a health goal. Capacity…. having an adequate, well-trained
and supported public health workforce. And having accurate, timely information to
support health actions such as relevant research, surveillance, monitoring and evaluation.
So that’s a quick introduction to the fascinating field of public health!
We’ve had a look at what it is, how it is different to clinical medicine, who
is responsible for doing it and how it’s done!
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