Public Health 101

I have been employed in the field of public health in one way or another for more than 30 years. So I take the term for granted, along with the concepts it embodies and the nature of the work that is done by public health researchers and practitioners. So I continually have to remind myself that many, if not most people, don't know what "public health" means. Often, people seem to think that it means providing medical services to poor people. Some people think it just means infectious disease control.

I work at a school of public health and I do public health research and I teach public health. So here are three definitions I offer to my students in an introductory lecture to my introductory course in public health. So I really do know what it means.

Definition 1 is from the Institute of Medicine, in 1988:

‘the science and art of preventing disease, prolonging life, and promoting health … through organized community effort’

That's succinct. As you can readily see, it would include such activities as reducing the rate at which people are shot. Why is the Institute of Medicine defining public health? Good question! Medicine does focus on the individual, while public health addresses the population level. But physicians have come to care more about public health than they did in the past because they know that medical intervention accounts for less than half of health and longevity.

Definition 2 is from Harvard professor C.E. Winslow, in 1932. He was a founder of the field.

“Public Health is the science and the art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community efforts for the sanitation of the environment, the control of community infections, the education of the individual in principles of personal hygiene, the organization of medical and nursing service for the early diagnosis and preventive treatment of disease, and the development of the social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health; organizing these benefits in such fashion as to enable every citizen to realize his birthright of health and longevity.”

As you can see he includes medicine, particularly early diagnosis and prevention, as a part of public health, but only a small part.

The third definition is from the textbook I use, by M. Schneider:

At its most idealistic, public health is a broad social movement, a campaign to maximize health for everyone in the population through distributing benefits and responsibilities in an equitable way.  Health is therefore “a political endeavor as much as, or at times even more than, a medical one.”

 Public health is multi-disciplinary. It is defined by its mission, not any specific set of analytical or practical skills. You can get a degree in public health, up to a doctorate, meaning you probably know about a lot of stuff but some of it in less depth than a specialist in public health:

Economics
Law
Human Biology
Ethics
Environmental Toxicology
Nutrition
Medicine
Communication
Psychology
Sociology/Anthropology
Biostatistics
Epidemiology
Political Science
Management
Urban Planning
Civil Engineering . . .

And a whole lot more. We do research that informs every government agency from the Environmental Protection Agency to the National Transportation Safety Board to the National Highway Traffic Safety Administration to the Department of Justice and the Department of Defense.

Just so we're clear.