Various Definitions of Public Health

The Institute of Medicine defines public health as the fulfillment of "society's interest in
assuring conditions in which people can be healthy." This is achieved through community
effort "to address the public interest in health by applying scientific and technical knowledge
to prevent disease and promote health.

Essentials of public health:

Public health "is a broad social enterprise, if not a movement, that seeks to extend the
benefits of current knowledge in ways that will have the maximum impact on the health
status of a population. It does so by identifying problems that call for collective action to
protect, promote, and improve health, primarily through preventative strategies."

ASPPH:
Public Health is the science and art of protecting and improving the health of communities
through education, promotion of healthy lifestyles, and research for disease and injury
prevention.

APHA:
Public health is the practice of preventing disease and promoting good health within groups
of people, from small communities to entire countries.
Public health is defined as what we do collectively to assure conditions in which people can
be healthy.

WHO:
Health is a state of complete physical, mental, and social well-being and not merely the
absence of disease or infirmity.

When we think about public health, it might be helpful to think about a story, "The Parable of
the Clinician and the Epidemiologist":
The brown river flows lazily through town. It's usually lovely. One day, two doctors are
walking along its banks, ready to have lunch -- when horrified, they looked to the side and
they see a torrent of human bodies floating down the river. Some thrashing, some eyes
glazed. They jump into the water to try to pull the bodies out. More bodies are coming. They
can't possibly save everyone.
And as one of the doctors is laying down an older gentleman, she turns and runs up the
river. Her colleague yells at her, 'What are you doing? Help me save these people! I can't
pull them out of the water by myself!' She turns to her colleague and says, "I'm going up the
river to find out why they're falling in.'
Now this parable, colleagues, exemplifies the difference between public health -- that which
is concerned with upstream factors, prevention, understanding cause -- and perhaps, access
to health care, clinical care, symptoms. We all want to pull the bodies out of the water, but in
public health, we go upstream.

Assessment:
Core Functions:

Public health agencies and professionals regularly and systematically collect,

assemble, analyze, and make available information on the health of the community,
including statistics on health status, community health needs, and epidemiologic and
other studies of health problems.

Essential Services:

Monitor health status to identify community health problems

Diagnose and investigate health problems and health hazards in the community

Policy Development:
Core Functions:

Public health agencies and professionals exercise responsibility to serve the public
interest in the development of comprehensive public health policies by promoting use
of the scientific knowledge base in decision-making about public health and by leading
in developing public health policy.

Essential Services:

Inform, educate, and empower people about health issues

Mobilize community partnerships and action to identify and solve health problems

Develop policies and plans that support individual and community environmental
health efforts

Assurance:
Core Functions:

Public health agencies and professionals assure their constituents that services
necessary to achieve agreed-upon goals are provided, either by encouraging actions
by other entities (private or public sector), by requiring such action through regulation,
or by providing services directly.

Essential Services:

Enforce laws and regulations that protect environmental health and ensure safety

Link people to needed environmental health services and ensure the provision of
environmental health services when otherwise unavailable

Ensure a competent environmental health workforce

Evaluate effectiveness, accessibility, and quality of personal and population-based
environmental health services
Research for new insights and innovative solutions to environmental health problems

Age:

Under 5 years

5 to 17 years

18 to 44 years

45 to 64 years

65 years and over

Race:

Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the
Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia,
Pakistan, the Philippine Islands, Thailand, and Vietnam.

Black/African American: A person having origins in any of the black racial groups of Africa.

Native American/Alaska Native: A person having origins in any of the original peoples of North and
South America (including Central America) and who maintains tribal affiliation or community
attachment.

Native Hawaiian/Pacific Islander: A person having origins in any of the original peoples of Hawaii,
Guam, Samoa, or other Pacific Islands.

Mixed Race: A person having origins in multiple geographic areas.

White: A person having origins in any of the original peoples of Europe, the Middle East, or North
Africa.

Ethnicity:

Hispanic or Latino

Not Hispanic or Latino

Gender:

Male

Female

Geographic Location:

Town/City

County

State

Region

Country

International

Place of Birth

Social Class:

Education

Occupation

Income

HealthStatusIndicators:
In the public health field, health status indicators are measures of important health

determinants for communities and populations. Health status indicators help

professionals and organizations determine the health of a population. The U.S.
Department of Health and Human Services identifies 205 indicators, which can be
broken down into several main groups.

1. Demographic Information
This indicator captures characteristics of a population that have a potential effect on the
amount and type of services used, health status, and resources available. These include a
populations size, general poverty level, age, and race/ethnicity.

2. Summary Measures of Health

This indicator is comprised of four measurements that provide a broad view of a communitys
health. These include average life expectancy, all causes of death, self-rated health status,
and average number of unhealthy days lived per year.

. National Leading Causes of Death

Created by the National Center for Health Statistics, these indicators are reported in order of
magnitude. The main causes of death are complications of pregnancy/birth, birth defects,
injuries (unintentional, motor vehicle, etc.), homicide, cancer (breast, colon, lung, and
prostate), suicide, heart disease, stroke, and HIV/AIDS.

4. Measures of Birth
These measures apply both to the baby and the mother. The indicators include low birth
weight, premature birth, births to women under 18, births to women ages 40 to 54, births to
unmarried women, and no care in first trimester.

5. Infant Mortality
These indicators apply to the baby only and include neonatal mortality and post-neonatal
mortality.

6. Vulnerable Populations
These indicators are focused on populations that typically have poor health outcomes. These
populations include people with no high school diploma, no employment, service work
disabilities, major depression, or recent drug use, among others.

7. Environmental Health
Measurement of these indicators is vital as they have a significant impact on large
populations and can lead to national leading causes of death. Environmental health
indicators include infectious diseases, toxic chemicals, and air quality.

8. Adult Preventative Services Use

Preventative services are vital to the general health of society as they can identify national
leading causes of death early (like cancer), which can lead to better health outcomes.
Assessments include pap tests, mammograms, sigmoidoscopy (and colonoscopy), and
vaccines.

9. Risk Factors for Premature Death

The indicators listed here are based on three personal behaviors that contribute significantly
to poor health: little or no physical activity, eating too few fruits/vegetables, and smoking.
These three individual behaviors are linked to obesity, high blood pressure, and diabetes, all
of which lead to health complications and premature death.

10. Access to Care

The ability to get preventative care and treatment is a major health indicator. For obvious
reasons, people who have access to care have better health outcomes. These indicators are
measured by reviewing the number of uninsured individuals and Medicare beneficiaries; use
of primary care physicians, dentists, and community health centers; and shortages of health
professionals in certain areas.