The health of an individual is highly determined by the health of the population in defined settings. Therefore, we should widen our vision to go beyond the individual level and incorporate the health of the population i. e. public health. Public health is more about collective actions and implies the science and the art of enabling, and organizing the community so as to prevent disease, prolong life and promote health (Detels & Breslow 2002, p. 3). The aim of public health is to provide the optimum level of health and standard of living to the population.
This involves various functions such as health needs assessment, the formulation of health policies, the provision of cost-effective health services etc (Detels & Breslow 2002). This means public health is an interdisciplinary field and requires different actors, including policy makers, researchers, medical professionals, health professionals, epidemiologists, donors, managers and community leaders, at different levels (global, national and community) to practice its core functions.
These actors practice public health through different approaches or discourses, the most prominent being disease control. From the Babylonian sewage system (Khaliq & Smego 2007) to Chadwick’s intervention of sanitation (Hamlin 2002) in 1842 to date, disease control and prevention is the most commonly used discourse in public health and is one of the eight Millennium Development Goals. Other discourses in public health include environment health, social determinants and health inequalities, health economics, health management, health promotion, evidence based health and social justice.
Which discourse is paid more attention depends on the key global actors, for instance the nation states, donors and global institutions. For example, the Gates Foundation, a philanthropic organization, aims mainly at developing and delivering vaccines, medicines and other health tools for improvement on health of developing countries (Bill ; Melinda Gates Foundation 2010). This means a middle level actor bound by a political commitment made to the Gates Foundation might give higher priority to delivery of vaccines and medicine.
Looking at the public health achievements, we can see that in last century life expectancy in USA has increased by 30 years and in the rest of the world by 22 years (Khaliq ; Smego 2007). Mortality in children under five has dramatically fallen by 41% in the last two decades (UNICEF 2012). There have been similar achievements in many other aspects of health. However, there is the growing disparities within and across the nations. When 3,365,000 children under five died in Sub-Saharan Africa in 2011, only 78,000 children from high income countries died in the same year (UNICEF 2012).
Such discrepancies are also evident between race, gender and level of education. The epidemiological transition from communicable to non-communicable diseases as leading cause of death is new problem in nations like the USA, whereas the developing nations are suffering from a double burden of diseases (Khaliq ; Smego 2007). After analyzing the current situation of public health, I can say that for good practice of public health the key global actors should work together to minimize the global inequalities.
The world requires the collaborative efforts of these actors to close the gaps between the countries and improve the health systems of developing countries. A good public health practitioner should have the appropriate knowledge and skills gained from higher level education and training. He or she should be able to assess the real needs of the particular setting by optimizing the use of local resources. A good practitioner can always identify which settings require which approach or discourse.
He or she should have the leadership qualities to attract all the stakeholders in his or her agenda. Capacity to face and resolve the challenges as they appear is equally important. Overall, in my perception, public health is the collective actions of various actors for the achievement of optimum level of health and the standard of living in the defined population. Identification of real needs, utilization of local resources and the ability to involve all the stakeholders makes a good practitioner. REFERENCES:
Bill ; Melinda Gates Foundation (2010) Global Health Program [online]. Bill ; Melinda Gates Foundation. Available from: http://www. gatesfoundation. org/global-health/Documents/global-health-program-overview. pdf [Accessed 14 October 2012] Detels, R. ; Breslow, L. (2002) Current scope and concerns in public health. In: R, Detels. B, McEwen. ; H, Tanaka. (eds. ) Oxford Textbook of Public Health. 4th ed. Oxford, Oxford University Press. pp. 3-20. Hamlin, C. (2002) The history and development of public health in developed countries.
In: R, Detels. B, McEwen. ; H, Tanaka. (eds. ) Oxford Textbook of Public Health, 4th ed. Oxford, Oxford University Press. pp. 21-38. Khaliq, AA. ; Smego, RA. (2007) Global health: past, present, and future. In: WH, Markle. MA, Fisher. ; RA, Smego. (eds. ) Understanding Global Health, New York, McGraw-Hill Professional. pp. 1-18. UNICEF (2012) Levels and Trends in Child Mortality [online]. World Bank. Available from: http://blogs. worldbank. org/opendata/files/opendata/unicef-2012-child-mortality-for-web-0904. pdf [Accessed 14 October 2012]