There have been many definitions of public health proposed over the years. They each tend to represent a particular point of view and collectively give a good overall picture of the practice of public health. Traditionally a distinction has been made between health care which deals with individuals and public health which deals with populations or communities. Even public health services to an individual, for example, a vaccination, treatment of a sexually transmitted disease or treatment of tuberculosis, are undertaken to protect the population from disease that can be communicated person to person and cause widespread illness.
My preferred way of telling people what public health is all about is to reference the 10 Essential Public Health Services developed in the Fall of 1994 by the Public Health Functions Steering Committee and published in the report, "Public Health in America". A link to a summary of this report is www.health.gov/phfunctions/public.htm. This report describes public health and then summarizes the committee's findings with the 10 Essential Services:
Public Health
- Prevents epidemics and the spread of disease
- Protects against environmental hazards
- Prevents injuries
- Promotes and encourages healthy behaviors
- Responds to disasters and assists communities in recovery
- Assures the quality and accessibility of health services
Essential Public Health Services
- Monitor health status to identify community health problems
- Diagnose and investigate health problems and health hazards in the community
- Inform, educate, and empower people about health issues
- Mobilize community partnerships to identify and solve health problems
- Develop policies and plans that support individual and community health efforts
- Enforce laws and regulations that protect health and ensure safety
- Link people to needed personal health services and assure the provision of health care when otherwise unavailable
- Assure a competent public health and personal health care workforce
- Evaluate effectiveness, accessibility, and quality of personal and population-based health services
- Research for new insights and innovative solutions to health problems
As you look at the above list it is my hope that you will more easily be able to see that public health is truly distinct from health care provided by hospitals and health care professionals. While it is true that some health department operate primary care clinics, most don't. Those that do are fulfilling essential service number 7, "Link people to needed personal health services and assure the provision of health care when otherwise unavailable". Public health is also not healthcare for the poor, another common misconception. Again, some health departments provide healthcare to low-income residents but that is only one part of one of the 10 essential services.
Public health departments receive mandatory reports of communicable diseases and constantly monitor and analyze and investigate the reports for patterns that might indicate a disease outbreak. When an outbreak occurs it is intensively investigated and contained through public health activities and by working cooperatively with the healthcare community.
Public health departments also enforce codes that have the force of law in order to prevent illness and injury. Restaurant inspections, daycare inspections and lodging facility inspections are three examples of regulatory oversight activity that is intended to prevent disease outbreaks and injuries.
You will also notice that a number of the 10 essential services deal with assessing a community, developing policy based on the results of such assessment and working to mobilize the community through partnerships and citizen action in order to move policies forward.
Finally, education is a major emphasis as stated in Essential Service 3, " Inform, educate, and empower people about health issues ". An informed community of individual citizens can affect the overall health status of the community more effectively than any health department or health care provider. Citizens washing their hands regularly, exercising, eating balanced, nutritious diets, avoiding risky behaviors and taking control of their own health can dramatically affect of morbidity (illness) and mortality (death).statistics in the community.
More information on the practice of public health is available on the web. Start by entering "public health practice" in www.google.com and you'll find a wealth of information. Enjoy your exploration of the public health community!