Public health: The approach to medicine that is concerned with the health of the community as a whole. Public health is community health. It has been said that: "Health care is vital to all of us some of the time, but public health is vital to all of us all of the time."
The mission of public health is to "fulfill society's interest in assuring conditions in which people can be healthy." The three core public health functions are:
- The assessment and monitoring of the health of communities and populations at risk to identify health problems and priorities;
- The formulation of public policies designed to solve identified local and national health problems and priorities;
- To assure that all populations have access to appropriate and cost-effective care, including health promotion and disease prevention services, and evaluation of the effectiveness of that care.
There are many distinctions that can be made between public health and the clinical health professions. While public health is comprised of many professional disciplines such as medicine, dentistry, nursing, optometry, nutrition, social work, environmental sciences, health education, health services administration, and the behavioral sciences, its activities focus on entire populations rather than on individual patients.
Doctors usually treat individual patients one-on-one for a specific disease or injury. Public health professionals monitor and diagnose the health concerns of entire communities and promote healthy practices and behaviors to assure our populations stay healthy.
One way to illustrate some of the breadth of public health is to look at some of the notable public health achievements in the 20th century. The following were selected as the "Ten Great Public Health Achievements -- United States, 1900-1999" by the U.S. Centers for Disease Control and Prevention (CDC).
Vaccination Vaccination has resulted in the eradication of smallpox; elimination of poliomyelitis in the Americas; and control of measles, rubella, tetanus, diphtheria, Haemophilus influenzae type b, and other infectious diseases in the United States and other parts of the world.
Motor-vehicle safety Improvements in motor-vehicle safety have resulted from engineering efforts to make both vehicles and highways safer and from successful efforts to change personal behavior (e.g., increased use of safety belts, child safety seats, and motorcycle helmets and decreased drinking and driving). These efforts have contributed to large reductions in motor-vehicle-related deaths.
Safer workplaces Work-related health problems, such as coal workers' pneumoconiosis (black lung), and silicosis -- common at the beginning of the century -- have come under better control. Severe injuries and deaths related to mining, manufacturing, construction, and transportation also have decreased; since 1980, safer workplaces have resulted in a reduction of approximately 40% in the rate of fatal occupational injuries.
Control of infectious diseases Control of infectious diseases has resulted from clean water and improved sanitation. Infections such as typhoid and cholera transmitted by contaminated water, a major cause of illness and death early in the 20th century, have been reduced dramatically by improved sanitation. In addition, the discovery of antimicrobial therapy has been critical to successful public health efforts to control infections such as tuberculosis and sexually transmitted diseases (STDs).
Decline in deaths from coronary heart disease and stroke Decline in deaths from coronary heart disease and stroke have resulted from risk-factor modification, such as smoking cessation and blood pressure control coupled with improved access to early detection and better treatment. Since 1972, death rates for coronary heart disease have decreased 51%.
Safer and healthier foods Since 1900, safer and healthier foods have resulted from decreases in microbial contamination and increases in nutritional content. Identifying essential micronutrients and establishing food-fortification programs have almost eliminated major nutritional deficiency diseases such as rickets, goiter, and pellagra in the United States.
Healthier mothers and babies Healthier mothers and babies have resulted from better hygiene and nutrition, availability of antibiotics, greater access to health care, and technologic advances in maternal and neonatal medicine. Since 1900, infant mortality has decreased 90%, and maternal mortality has decreased 99%.
Family planning Access to family planning and contraceptive services has altered social and economic roles of women. Family planning has provided health benefits such as smaller family size and longer interval between the birth of children; increased opportunities for preconceptional counseling and screening; fewer infant, child, and maternal deaths; and the use of barrier contraceptives to prevent pregnancy and transmission of human immunodeficiency virus and other STDs.
Fluoridation of drinking water Fluoridation of drinking water began in 1945 and in 1999 reaches an estimated 144 million persons in the United States. Fluoridation safely and inexpensively benefits both children and adults by effectively preventing tooth decay, regardless of socioeconomic status or access to care. Fluoridation has played an important role in the reductions in tooth decay (40%- 70% in children) and of tooth loss in adults (40%-60%).
Recognition of tobacco use as a health hazard Recognition of tobacco use as a health hazard and subsequent public health anti- smoking campaigns have resulted in changes in social norms to prevent initiation of tobacco use, promote cessation of use, and reduce exposure to environmental tobacco smoke. Since the 1964 Surgeon General's report on the health risks of smoking, the prevalence of smoking among adults has decreased, and millions of smoking-related deaths have been prevented.