Public health is about improving and maintaining the health of populations. It is because of public health, you can eat out in a restaurant without getting sick, visit far flung places safely, have clean running water and good sanitation and live beyond childhood because of vaccination programmes that have removed threats of deadly diseases. Public health was formerly known as community or preventive medicine but in the 21st century, it draws upon an integration of disciplines, including social-behavioural, environment and biological sciences as well as medicine.
Many people think that public health work is
health promotion. It is part of the job but not all of it.
Public health work covers 3 domains:
health improvement, health protection and health care (i.e. improving
quality of health services).
The Faculty of Public Health (UK) sees public health as:
- being population based
- emphasising collective responsibility for health, its protection and disease prevention
- recognising the key role of the state, linked to a concern for the underlying socio-economic and wider determinants of health, as well as disease emphasises partnerships with all those who contribute to the health of the population
Who does public health work?
Public Health work is done by three groups of people. There are the academics who do research on health like epidemiology and clincial trials. Then you have the public health specialists, such as public health doctors, public health managers and health intelligence teams who survey population health, manage communicable diseases, improve quality of health services and develop strategies and action plans for improving the health of populations. Finally, there are people who do a bit of public health as part of their job. Whether it be a health visitor giving advice on breastfeeding or immunisation or a GP promoting cancer screening programmes. Or it could be you helping your family and community to live longer and have a better quality of life.
Overall, all public health specialists and practitioners help people to help themselves with their health. This includes protecting them from disease, chemical incidents, cancer and accidents, improving their health and well-being and help them to get the best value out of health and social services.
In recent years, public health specialists have been focusing on improving healthy life expectancy (as opposed to just life expectancy). With more and more people living longer, the importance now is on how we have they living healthier for longer. You will now come across measures such as healthy life expectancy(HLE) at birth, HLE at age 65, disability-free life expectancy (DFLE) at birth and DFLE at age 65.
Domains of Public Health
- Surveillance and monitoring of specific diseases and risk factors
- Healthy Life Expectancy
- Infectious diseases
- Chemicals and poisons
- Emergency response
- Environmental health hazards
- Quality improvement
- Clinical effectiveness
- Efficiency & Cost effectiveness
- Service planning
- Audit and evaluation
- Clinical governance
- Equity and access
- Preventative agenda (managing demand, reduction of avoidable admissions, digital offer, supporting patients)
- New models of delivery (proactive care, access, building capacity)
What do we mean about prevention?