The Impact of Public Health

Effective public health practice often goes overlooked at first. The reason for this is that public health is preventative in nature, resolving issues before a problem occurs. It has been said that if public health entities are functioning, they will be mostly unnoticed. However, there is a value to public health that many don’t always realize at times.

Life expectancy in developed countries has increased from less than 50 years in 1900 to nearly 80 years now. The greatest progress occurred in the first half of the 20th century, when life expectancy in the United States increased by an average of 20 years, largely because of universal availability of clean water and rapid declines in infectious disease, as well as broad economic growth, rising living standards, and improved nutritional status. Other gains in the latter half of the 20th century came about largely from advances in the treatment of cardiovascular disease and control of its risk factors (i.e., smoking, high blood pressure, and high cholesterol).

Public health policies and allocation of public health resources can significantly improve public health. The difference between traditional health care and population-level methods for improving health is that public health interventions often happen at numerous levels. Upstream interventions involve policy approaches that can affect large numbers of people through regulation, increased access to healthcare, or economic incentives. For example, increasing tobacco taxes is an effective method for controlling tobacco-related diseases. Midstream interventions occur within organizations. For example, worksite-based programs that increase employee access to facilities for physical activity show promise in improving health. Downstream interventions involve individual-level behavioral approaches for prevention or disease management.

It is vital to the health of any community to have an effective public health workforce ensuring all three approaches above. This includes all ten of the core functions of public health: 

Assessment

• Monitor health status to identify community health problems
• Diagnose and investigate health problems and health hazards in the community
• Evaluate effectiveness, accessibility, and quality of personal and population-based health services

Policy Development

• Develop policies and plans that support individual and community health efforts
• Enforce laws and regulations that protect health and ensure safety.
• Research for new insights and innovative solutions to health problems 

Assurance

• Link people to needed personal health services and assure the provision of health care when otherwise unavailable -
• Assure a competent public health and personal health care workforce
• Inform, educate, and empower people about health issues
• Mobilize community partnerships to identify and solve health problems

Public health is essential to any community, regardless of status or geography.  However, it is most important in communities that suffer a disproportionate burden of disease or mortality. It is crucial that public health has the resources needed to perform their core functions.