importance of public health essay

importance of public health essay

The Importance of Public Health

1. Introduction

Through the use of many recent relevant examples, this book will solidify for the reader the understanding of the significance of public health and related policy implications. This will be useful for persons involved in policy making as well. Since one of the best ways to learn about public health is to see it in action, using the provided exercises (and recommended answers) between each chapter, and the suggested exercises and readings that follow the completion of the text, will provide a successful learning experience.

By using a consistent and comprehensive approach, this text is useful for students of public health and various other health professions. This book will be an asset for seasoned public health professionals as well. Whether you are a health service provider, public health official, health advocate, or a concerned citizen, the depth and breadth of this book will give you a much clearer sense of the societal concerns of public health.

This book is intended to help bridge the gap between the everyday and the scientific notions of public health. It is written to add depth and breadth to the understanding of public health and its impact on societal concerns. By delving into an array of explanations, examples, and cases, this book is designed to provide a comprehensive look at public health and its many facets. By examining the variety of methods and agents regarding promotion of health and wellness, risk factor identification, and illness prevention, this book takes a systematic look at how to improve the public’s health.

2. Benefits of Public Health

Public health learns from the past of various successes and failures globally. Learning from the global past, malaria, a life-threatening disease, was successfully eliminated from the United States and other developed countries using the “National Malaria Eradication Program.” Unfortunately, the same program didn’t succeed in underdeveloped countries, due to which the disease still remains rampant. The reasons for these are supported by intricate scientific studies, which have then placed the knowledge gathered by such studies to be used for future reference in the prevention of a disease. An attempt to increase the lifespan and better the health of those in every country can be seen as a transition of the health status of a person or a group, from one which had premature death, ill health, and disability to a better state characterized by a longer and healthier life. In saying this, public health has a measurable aim, which is to set objectives and use a variety of ideas to achieve the best possible solution.

It is hard to speak of any aspect of human life without discussing the benefits of public health. It is the responsibility of all individuals – themselves, communities or governments – to protect and improve the health of those who are in need. The objective of improving health for all includes several processes intended to achieve this goal: a better understanding of how to improve health, well-organized health care programs and services, and a betterment of the socio-economic environment. Essentially, it is about looking into the various factors which affect a person’s health – be it physiological, ecological, social, and behavioral – in an attempt to identify the health problems that are likely to arise.

3. Challenges in Public Health

In an earlier section of this chapter, the developing counterfactual approach to evaluating state-level policies was described. The evidence there suggested that most state-level policy interventions are endogenous to economic and social conditions and not very effective in improving health. If this is indeed the case, policy interventions to improve population health run into an immediate problem. Most policymakers are concerned with distributing the state’s resources to a targeted group or area with the intention of improving their welfare. They will be concerned to avoid ‘wasting resources’ improving health in areas or groups that are already comparatively healthy. However, policies to improve population health create a classic case of a public good. They will act on determinants of health that affect everyone in the population regardless of income or social position. In fact, it could be argued that in many countries, large public and social changes that have been engineered in the last 100 years had at least a partial intention of improving health or living conditions of the least well off. For example, the legislation to abolish child labour would not have been just welfare policy for a targeted group of child workers, rather it would be seen as a policy to improve the health of all children from working families. Such health policy can be strongly redistributive in its effect. The epidemiological evidence presented in the first section of this chapter shows that many diseases and mortality are gradient phenomena showing a strong inverse relationship with income and/or levels of education. This suggests that it is often those who are better off, who are able to press for policies to improve health and also express concern about avoiding the resource ‘waste’, who will be the least enthusiastic about redistributive health policies. These policies may encounter considerable opposition from vested interests. An obvious contemporary case would be opposition to some global measures to re-regulate the tobacco industry, a powerful sector in many economies, so as to strongly reduce smoking in all social groups.

4. Strategies for Improving Public Health

It is important to remember that control and treatment of human disease and disability has never been cheap, and requires significant investment in resources that could otherwise be used elsewhere. This is a difficult proposition for any economically-developing country, and as such resource allocation for health “competes with other equally compelling needs for scarce investment resources, such as education, safe water and sanitation, food and shelter”. There are 3 main strategies for improving public health, outlined comprehensively by the World Health Report 2002; these are “investing in sustainable health infrastructures, preventing and managing risks to health, and providing people centred care”. All of these are to be done with a strong focus on the needs of the poor. Investing in sustainable health infrastructures is crucial for any developing country. It is essentially an investment in the country’s future, with “infrastructures” including human resources, essential drugs and medicines, facilities and equipment and health information systems. Globalisation has made this even more important; for example Sub-Saharan Africa has at any one time roughly 3000 health professionals working in the west! This is a huge loss of resources for Africa. With globalisation health risks are also becoming more common, for example developing countries are now at risk from “diseases once considered of exclusive rich-country concern and from new diseases which spread more quickly due to interconnected societies and the worldwide integration of markets for goods and services”. An example of this is SARS. Developing countries require the means to prevent and manage such health risks, but often are caught short due to weak infrastructures. In order to do this they must employ the second strategy, preventing and managing risks to health. This can be done in a number of ways to provide efficient and cost-effective solutions. An example provided by the World Health Report is the increased use of “highly effective public health and prevention strategies based on allopathic as well as traditional and complementary medicine.” This is in contrast to many developing countries’ heavy reliance on costly allopathic treatments. The report also suggests that environmental health risks can be managed with greater success, offering the example of preventing pesticide exposure through integrated pest management to reduce the incidence of suicide in rural Asia. Widespread action such as this offers an indirect source of income for the poor, by preventing health risks it essentially “avoids that poor people pay a higher price for goods and services in money, health and life”.

5. Conclusion

The beginning of a new millennium is a logical time to review the achievements in the realm of global health, and the previous decade has been witness to vastly increased awareness and corresponding effort to address global health issues. The success of Health Initiatives stands as a testament to this trend. With an accumulation of evidence suggesting global health is a cause worth the effort, and the accomplishments of the past are lessons for the future. The chief aim remains clear: to improve health on a global scale, but there is much that needs to be considered on the specific direction to take and how best to utilize our resources. In the context of the varying impact of different diseases, a consideration of the strategy in resource allocation to health throughout the world is crucial. It’s an often lamented fact that there are gross inequalities in health between countries and regions, rich and poor, but yet the greatest disparity lies in the lack of resources to prevent this. The reign of the aforementioned ‘globalization diseases’ upon third world countries is a double-edged sword. They are a symptom of perpetuated poverty and hindrance to development, but in the current state, health efforts have been largely focused on these countries, diverted from the prior goal to bring health to all developed nations.

In conclusion, the health chief’s focus forms in the beginning on the diverted efforts towards communicable or infectious disease control. With the world teetering on the edge of a next catastrophic disease, the effort by Europe and now the US to throw money at ‘stockpiling’ pharmaceuticals as well as attempting to vaccinate populations may prove prudent, especially in the face of H5N1 avian flu and the rapid increase of drug-resistant tuberculosis. But it is a decidedly shortsighted strategy and does little to protect the millions of people in the world living in poor health with weakened immune systems, some of which have scarce access even to these therapies. The visible result of these efforts is largely a failure, and communicable disease remains a vast health burden. The pinnacle of this failure is epitomized most recently by the SARS epidemic and the reverberations of that event, which sparked a frantic and perhaps overzealous effort to improve international public health and safety regulations, albeit in the form of travel restrictions and quarantines, yet with little effort to address global social disparities that are root causes of health inequality.