What exactly is public health?
It is important first of all to unravel what the term ‘public health’ means as it is a complex concept with a range of different meanings and it is a term that is often taken for granted.
In other words, it is easy to assume that there is a ‘common sense’ understanding that public health is concerned with the health of the population, the lifespan of individuals and the extent to which individuals are free from disease. While this is true, some people might find this approach too ‘simplistic’, as it may imply that public health is medically orientated and only concerned with the control and prevention of epidemics and infectious disease, for example through immunisation and screening.
A broader and more preferred perspective is one in which public health is viewed holistically, encompassing a concern for well-being, and recognises that health and well-being are influenced by the rich interplay of a wide range of factors. Debates about the meaning of public health therefore can be focused on how narrow or all-encompassing and broad a term it is.
What about the meaning of the ‘public’? Well, this can be as small as a group of people, or could refer to a community, region, nation or continent but importantly the definition highlights that improving public health requires collective action. In other words, everyone has a role to play and can play their part.
There are multiple definitions of public health but the one used by the World Health Organization defines public health as:
‘The science and art of preventing disease, prolonging life and promoting health, through the organised efforts and informed choices of society, organizations, public and private, communities and individuals’ (Acheson 1988: 1).
Although it is dated, this definition gives us some insight into the role of public health in society.
The main feature of public health is that it focuses on populations rather than on individuals. In other words, public health is concerned with preventing disease and promoting health and well-being at a population level. This view holds that population health is not simply the sum of its parts, meaning that by treating enough individuals the health of the public will improve, but greater than the sum of its parts (Arah 2009).
Drilling further down, Acheson describes public health as a ’science and art’. This not only tells us what public health is but how improved health and well-being can be achieved through the ‘organised efforts … of society’.
This highlights the multidisciplinary nature of public health as it brings together people with a whole range of knowledge and skills, from clinical and non-clinical backgrounds and a range of organisations and sectors, to work collaboratively to benefit population-level health and well-being.
Public health, therefore, is a broad term. Its meaning is complex because protecting health, preventing illness and improving quality of life is a complex process. While it may be difficult for most nurses to see how they can become involved in public health, it is nevertheless expected that public health will become part of their role.
Nursing is often described as a science and art, but what do you understand by the science and art of public health?
Using Acheson’s definition of public health above, think about your own Strengths (talents, skills, knowledge); your Weaknesses (areas for development); the Opportunities and Threats or barriers for personal and professional development to being more public health-focused in your nursing practice.
In the comments below, post two or three bullet points for each of these four categories.
You may have come across this kind of activity before, and know it as a SWOT analysis. A SWOT analysis (Strengths, Weaknesses, Opportunities, Threats) is a method of planning, assessment or measurement used to determine the components, attributes and relationships that need to be considered in order to accomplish an objective, in a specific context.
Acheson, D. (1988) Acheson Report: Independent Inquiry into Inequalities in Health Report. London: The Stationery Office
Arah, O. A. (2009) ‘On the Relationship Between Individual and Population Health’. Medicine, Health Care and Philosophy. [online] 12 (3), 235-244. available from https://doi.org/10.1007/s11019-008-9173-8 [18 June 2018]
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