WHAT IS PUBLIC HEALTH?

Today we're going to explore the

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question what is public health I get
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asked this question about once a week
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what is public health what do you mean
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by public health now if you look up a
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definition of public health if you look
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it up online or look it up in a
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dictionary
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you're going to get something that's
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verbose it's going to be wordy it's
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going to be flowery what I'm going to do
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is a little different I'm going to say
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look let's have a very simple definition
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of public health and then as a separate
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question let's ask what do public health
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professionals do so really what we're
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going to have is a simple definition and
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then some complimentary jibber-jabber so
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here's my definition of public health
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public health is a discipline that
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addresses health at a population level
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no more no less that's the definition
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now we can add on some complimentary
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jibber-jabber to try and understand that
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a little better so for example we might
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want to talk about the fact that public
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health is different from clinical
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medicine and other paramedical
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disciplines like physiotherapy and
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occupational therapy which deal with
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patients at an individual level public
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health really looks at groups of people
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in those groups include sick and well
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people and those groups are delineated
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at any level that you want it could be a
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community it could be a country and of
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course it could be global health now
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let's take a closer look at the second
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question what do public health
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professionals do well public health
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professionals try to do two things
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really the first is to understand and
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the second is to act now let's look at
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each of these components separately and
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then we'll look at how they work
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together when I say that public health
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works to understand I really mean that
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we gather information and evidence that
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will inform how it is that we intervene
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and act to understand population health
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we do two things really we do
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surveillance and we do research we're
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trying to learn more about what we call
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exposure so exposure could be risk
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factors what could be interventions and
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we're trying to understand outcomes
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disability and disease and with respect
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to all of these factors we want to
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understand their distribution and their
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magnitude so magnitude is kind of
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self-explanatory it's how big how much
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and with respect to distribution we mean
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distribution geographically so
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physically where are these exposures and
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outcomes and of course we mean
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distribution sociologically across for
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example different socio-economic groups
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or cultures etc so we're doing the
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surveillance and this research to
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understand the distribution and the
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magnitude of exposures and
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outcomes so that we can do two things
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firstly we want to understand the causal
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relationship between exposures and
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outcomes and secondly we want to plan
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interventions to improve public health
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and of course these two things are
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connected so the better we understand
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the causal relationship between
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exposures and outcomes the better we can
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plan interventions that we know will
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work and will have an impact on public
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health so we've talked about the first
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area where public health professionals
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work and we've shown how this all leads
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to a point where we've got a better
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understanding of how it is that we can
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intervene and plan programs that have an
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impact on public health and so this of
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course leads us to the second area that
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public health professionals work which
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is to act in other words we want to act
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on that understanding right so we
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intervene really in two ways we want to
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keep healthy people as healthy as
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possible and we want to ensure that
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people that are unwell have access to
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care and treatment so let's look at the
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first one first what do we do to prevent
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disease and disability well we do two
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things firstly we promote behavior
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change and secondly we reduce exposure
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to risk and of course as you can imagine
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there's a lot of overlap between those
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two so with respect to promoting
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behavior change there's really two
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things that we try to do we want to
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promote behavior firstly that we know
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will have a positive impact on health
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like improve diet exercise etc and of
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course we want to deter behavior that we
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know will have a deleterious effect on
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public health like smoking then with
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respect to actions that we take to
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reduce exposure to risk we do this by
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addressing two kinds of risk firstly
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there's the physical and environmental
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risk factors that people are exposed to
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things like radiation water contaminants
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and safe medicines and secondly there's
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what we call the social determinants of
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health things like human rights
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violation gender discrimination etc so
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now we've talked about what we do to
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prevent disease and disability in
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otherwise healthy people now let's talk
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about what we need to do to ensure that
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care and treatment is available for
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people who are unwell so as you can
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imagine I'm going to tell you that
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there's two things that we do the first
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thing that we're going to do is we're
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going to use best evidence we're going
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to lean on that understanding that I
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referred to in the first half of this
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talk and we're going to use that to
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advocate for policy change that ensures
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equitable access to safe and effective
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treatment in other words we want to make
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sure that all people have access to
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health services and the second thing we
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need to do and of course it's related to
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the first is
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we need to ensure that the health
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systems are in place to provide care and
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treatment for people that need it now
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health systems can be thought of as two
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things the first is capability and the
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second is capacity capability is what
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you're able to do what you're capable of
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doing and this is really a function of
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things like health service planning
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governance leadership information
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management etc and then there's the
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other side of health systems is what we
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call capacity how much you're able to do
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and this tends to be a function of
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finance products and human resources in
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other words the more money the more
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products and the more people you throw
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into the health system the more capacity
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the health system has in other words
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more people will get treated so that's
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really public health in a nutshell like
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I said at the beginning the definition
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of public health is that it's a
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discipline that addresses health at a
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population level what it is that public
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health professionals do well that's a
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slightly longer conversation what I've
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talked about here certainly not
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comprehensive I mean there's more to
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public health in what I've mentioned but
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this is perhaps a good schematic that
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you can use to place the studying or the
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work that you're doing in the context of
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a broader set of activities thank you
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for listening I hope you found this
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useful
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you