What is public health?

The goal of public health is to provide the conditions and services for people to be as healthy as possible. It is different from the clinical disciplines because it sees the “patient” as being a community or population rather than an individual. It has different diagnostic tools and management strategies and also asks different questions about its “patients”.

Public health asks the following questions about the health of communities and populations:

  1. What are the problems?
  2. What are the causes?
  3. What are the solutions?
  4. How well are the solutions working and can we do better?

The terms “community health” and “population health” are used interchangeably with “public health”. A closely related field is “global health”. Global health is slightly different because it compares health and health care between countries rather than between different populations and communities in the same country. However, it uses the same approaches and tools. In this book, the term public health is used throughout.

Why do clinicians need to know about public health?

Public health provides the language and tools used by managers and administrators to plan and monitor services. When clinicians understand the language and tools of public health, they can share knowledge and take a meaningful part in planning discussions. This means that they can better collaborate with public health professionals and managers to improve services for their patients. Many of the public health tools in this book can also be used within individual clinical units and can empower clinicians to make improvements in their own working environments.

An understanding of public health can also help clinicians to make sense of the caseload presenting to their facility. Knowing why people present with particular problems can reduce frustration and feelings of helplessness when apparently preventable issues happen again and again. Although many of the “determinants of health” are beyond the control of individual practitioners and require changes in legislation, regulation or policy outside the health service, health professionals can be important voices for the communities they serve. As a first step, they need to know where risks to health come from and what can be done about them.

This book is divided into four parts that cover the four big questions in public health listed above. Each chapter uses a self-learning method and is accompanied by a set of multiple choice questions. We hope it will be useful.

Note on the self-study materials

Several chapters include examples of public health challenges. Some are real, particularly those that describe international events. There is also a cast of fictional South African characters that appear from time to time. Sr Dlamini, Dr Prudence, their colleagues and their patients, have been made up and are not intended to resemble any person living or dead. However, the problems they have to tackle in their working lives are very real.

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