Public Health Past and Future
April 5, 2019
Public Health Past and Future
By Jeffrey Levin, MD, DrPH
Senior Vice President for Academic Affairs and Provost
Chief Academic Officer
Professor, Occupational and Environmental Health Sciences
Professor, Occupational and Environmental Medicine
Director, NIOSH Southwest Center for Agricultural Health, Injury Prevention, & Education
Jesse H. Jones Distinguished Professor of Occupational Health Sciences
Houston Endowment, Inc. Professor of Environmental Science
According to the American Public Health Association, “Public health promotes and protects the health of people and the communities where they live, learn, work, and play.” The word prevent derives from the Latin meaning ‘to come before’. As with prevention, the focus in public health is a search for those factors ‘that come before’ and that contribute to cause disease, illness, and injury. Public health then attempts to intervene with these factors and evaluate the effectiveness of these interventions. Similarly, public health practitioners promote wellness by encouraging healthy behaviors. While medical doctors treat individual people who are sick, professionals who work in public health try to prevent people from getting sick or injured. Medicine focuses on one patient at a time while public health focuses on populations and communities.
Public health is credited with 25 of the 30 years of added life expectancy from birth over the last century. Several initiatives such as vaccinations, a safer workplace, safer and healthier food, tobacco use reduction, and motor vehicle safety have been recognized among the top 10 achievements in US Public Health in the 20th Century. On the backdrop of prevention, health promotion, and health protection, the Institute of Medicine has defined three core functions of a public health framework, namely, assessment, policy development, and assurance. Divided among these core functions are 10 essential services which help monitor health, prevent injuries and the spread of disease, protect against environmental hazards, promote healthy behaviors, and assure both the quality and accessibility of health services.
The health challenges of today and the future are changing, with a combination of health disparities and a disproportionate contribution from chronic diseases compared with the last century. However, research, combined with the aforementioned framework of public health delivery, continue to offer the tools for advancing health and preserving the significant gains that have been achieved.