We're 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 to 1999 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. 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 on the mental and social aspects, as well as public health, is the science and art of preventing disease prolonging life and promoting health through the organized efforts of society. let's take a look at an example, let's say someone has an accident and has a broken leg a clinicians 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 poor knowledge of driving skills or bad attitudes towards driving was he under the influence of alcohol or drugs. when he was driving are their 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. what the road he was driving on 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 a 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 lifestyle and behaviors and also the physical social and economic environments the social determinants of health in order to make a difference in health. There's 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's 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 and 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 work. The World Federation of Public Health Association 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. 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 behaviors over 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. That's a quick introduction to the fascinating field of public health we've had a look at what it is how it's different from clinical medicine who's responsible for doing it and how it's done.
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