National Public Health Week kicks off today!
Let’s start with the basics: what is public health?
Ultimately, public health is about prevention at the population level.
As the Johns Hopkins Bloomberg School of Public Health’s motto so fittingly states, public health is “protecting health, saving lives – millions at a time.” We design neighborhoods more conducive to exercise; we strive for improvements in hospital systems so as to reduce mistakes; we pursue policy changes to ban false marketing by cigarette companies – all these things affect not one or two people, but hundreds, thousands, and millions.
Public health is also largely about prevention – keeping bad things from happening in the first place, as opposed to solving or managing already-present problems (although public health does a fair bit of that too). We clean environments to prevent asthma, we don’t provide inhalers; we teach you to cough into your elbow to prevent the spread of flu, we don’t prescribe antiviral medicine; and we redesign cars and roads to prevent injury, we don’t perform surgery.
Focusing on just this kind of population-level prevention, National Public Health Week offers us the following daily themes:
- Active Living and Healthy Eating – Promote healthy choices in your communities, such as bike lanes and farmer’s markets.
- Alcohol, Tobacco and Other Drugs – Identify alcohol and drug use disorders early to reduce high-risk alcohol and drug consumption.
- Communicable Diseases – Encourage proper hand-washing and food preparation habits.
- Reproductive and Sexual Health – Practice safe sex, encourage responsible contraception behavior and promote access to preventive health services.
- Mental and Emotional Well-Being – Refer people with signs of depression and suicidal thinking to appropriate resources and help centers.
In addition to the above topics, National Public Health Week provides us a time and space to delve into the idea of integrating primary care and public health, an idea that was the focus of a recent IOM report, as explained on the occupy healthcare site just a couple days ago.
In addition to the case studies mentioned in that post, the operation of community health centers back when they originated provides a phenomenal example of true integration of primary care and public health.
The community health center movement started about 45 years ago, with roots in the civil rights and social justice movements of the 1960s, and with some incredible leaders at the helm. At the dawn of this movement, community health center leaders saw health as but an entry point to solving a broader range of problems, without raising the same level of opposition as more blatantly political “social change” programs. The goal was to not just to provide primary care and related outreach and patient education, but to address social determinants of health through job development, nutrition, sanitation, and social services. All while maintaining a core principle of respect for and involvement of community residents (aided by the legal requirement that governing boards of community health centers must be composed of at least 51% consumers).
While community health centers in the U.S. continue to do phenomenal work providing much-needed high-quality primary care services to largely underserved populations, most have become primarily – some entirely – deliverers of medical care. I would love to see these centers take a turn back to the roots of the community health center movement, propelled by grassroots advocacy by community members, national organizations such as the National Association of Community Health Centers, and advocates for integration of primary care and public health such as those of us here.
For more tips and action steps, visit www.nphw.org!
This post is cross-posted at http://occupyhealthcare.net