January 2, 2012

Public health measures make for a healthy community

Happy New Year to you all! May 2012 bring you joy, love and peace.

Today I was surprised by an article I was reading that confused public health with health services received at a public facility. In fact, to me, this was quite astonishing, for having worked in the administration of public health programs now for a very long time, had never come across this delicate inference ever. Perhaps this perception of public health should not be taken too lightly for I now believe this thinking may indeed be more pervasive than I thought it to be. So here I am putting this on blog in an attempt to make the concept of public health a bit clearer.

From a health promotion point of view, clarity on this is absolutely necessary. Public health is about health related actions that address the public’s health as a whole, as contrasted with health service or care received that usually benefits one person at a time. This is called individual health care. For example, if we provide clean water to the masses, or dispose of solid wastes that our cities produce every day as a mass effort, or individual efforts that contribute to a mass effort, then these activities are termed public health related actions as these contribute the making a whole lot of people healthy in one go so to say. If we all have clean and safe water to drink, a lot of people will be kept from getting all kinds of stomach bugs, and if our garbage is removed from our homes and our cities, we will not have the flies and roaches, and smells that make us sick. Remember that flies and roaches and rodents carry the germs into our homes and on to our food that will make us sick. Actions such as these will make us all experience good health. But even if our streets are filthy and water contaminated, we can still go to the doctor and get well for a while from the medicines we can take. But of course this cure would be a very temporary measure. We will soon get sick again, and we have to make another trip to the doctor. This type of service is called private or individual heath service.

To call a place healthy or health promoting, both these types of health services must be available. The services of doctors in our clinics and hospitals must be available for the individual care we seek such as getting the medications we need for a disease we contract. Let’s not forget, they also provide public health services such as immunizations, and health advice that can benefit a whole community’s wellbeing. While these public health services available at the doctor’s clinic may not amount to too much as compared to the individualized services they provide, to be healthy as a community, we truly need to keep our neighborhoods clean of the garbage and sewage we produce, have safe drinking water and safe food (from the markets and restaurants) available. And of course we ourselves must practice good hygiene and safe practices such as washing our hands regularly, using our household chemicals in a safe way, not spitting about on our streets, covering our mouth and nose when sneezing and coughing in public, refraining from risky life-style behavior, and not smoking.

So, public health is about the type of actions and services that keep the whole community healthy; not about whether we get our health care from a public or private service outlet.


Robert said...

Thank you for pointing out the difference between public health and individual health care. We often focus solely on health care, but as you write, public health interventions can greatly improve the lives of people in an entire community. I would like to see more funding for public health efforts in Boston!

Abdul Sattar Yoosuf said...

Yes Robert, i tend to think that in our industrialized countries, disease prevention (classical public health measures) is perhaps taken more or less for granted as these are a part of daily functions of health departments. But preventive measures on NCDs need much more work even in the developed countries. Promotion of healthy living, eating, and socializiing all determine NCD outcomes. So is the need for the public health measures as you say.

Surinder Aggarwal said...

The state and its beneficial private sector partner donot want public health action to materialize as capitalization of heal;th will be affected. Health sector is an industry for them which is like a milking cow. That is why we donot have that many pulic health schools as they will keep the government and their capitalists friends away from medical related business and profits. Whole drug( pharmaceautical) industry,medical equipment industry, health related soft infrastruture will lose billions of dollars business, if principles of public health are promoted and implemented.This is where we need to make dent and turn the wishes/ideas into a public movement like anti-corruption movement in India to raise public consciousness to this need of the day. Sattar, I really welcome your stirring notion of public health vs individual health embedded in health care