Public Health versus Medical Care

Through my years working in the field of public health, I have encountered several individuals that do not know the distinction between public health and medical care.
These individuals include professionals or just the regular person from the street.
Often times, I hear people define public health as “it’s the health of the public” and medical care as “it only focuses on individual’s health.”

Recently, I was asked to research the distinction between public health and medical care. While conducting my research, I found in a book titled “Introduction to Public Health” by Mary Jane Schneider, the BEST comparison between medical care and public health. It not only defines the core functions of public health (assessment, policy development, assurance), but compares and contrasts them with the medical care practice.

While medicine is concerned with individual patients, public health regards the community as its patient, trying to improve the health of that population. Medicine focuses on healing patients who are ill. Public health focuses on preventing illness.

In carrying out its core functions, public health – like a doctor with his/her patient – assesses the health of a population, diagnoses its problems, seeks the causes of those problems, and devises strategies to cure them. Assessment constitutes the diagnostic function, in which a public health agency collects, assembles, analyzes, and makes available information on the health of the population. Policy development, like a doctor’s development of a treatment plan for a sick patient, involves the use of scientific knowledge to develop a strategic approach to improving the community’s health. Assurance is equivalent to the doctor’s actual treatment of the patient. Public health has the responsibility of assuring that the services needed for the protection of public health in the community are available and accessible to everyone. These include environmental, educational, and basic medical services. If public health agencies do not provide these services themselves, they must encourage others to do so or require such actions through regulation.

As you can see, the fields of public health and medical care are interconnected; while the physician focuses on the health of the individual, public health focuses on the health of the entire population, and both are working together to improve the overall health of a community.

To learn more about public health and the effort to establish a regional health department in the Lehigh Valley, visit RenewLV’s Regional Health Initiative page.

Posted on April 2, 2010, in Education, Health and tagged , , . Bookmark the permalink. 3 Comments.

  1. I think it’s important to remember that public health isn’t just about a government health department or providing health services. It’s about helping people learn what they can do to prevent health problems.

    This includes many of the same concerns that we hear when people talk about sustainability. People often focus on the environment when they address overconsumption of resources, global warming, ecosystem damage, loss of bodiversity, or waste that will not biodegrade. It isn’t their impact on ‘the environment’ that’s the problem — it’s that current unsustainable practices cause people to get sick and even to die.

    The community health departments of both hospitals and of the cities of Allentown and Bethlehem have shown a strong commitment to improving public health in our communities. Unfortunately, their efforts have generally been confined to traditional public-health issues such as obesity & smoking. These are important issues, but they are only a small part of the picture.

    Public health should be looking at things that effect the population as a whole, including both long- and short-term impacts and those where cause and effect may not be obvious. So when we talk about things being unsustainable — driving, lower energy consumption, real food instead of the poisonous outputs of the industrialized food system, reducing the greenhouse gas (GHG) emissions that contribute to global warming — we’re not talking about effects on ‘the environment’, we’re talking about public health; we’re talking about changing things that cause people to become sick and even to die.

    Let’s look at just one area as an example: the Clean Air Task Force estimates that Diesel pollution in the Lehigh Valley exceeds EPA limits by enough to cause about 50 deaths per year, not to mention thousands of acute asthma attacks and other respiratory ailments. I have yet to hear any of the public health agencies address these issues in any meaningful way. If a regional public health department ignores these issues, it won’t accomplish much.

    Peter Crownfield, internship coordinator
    Alliance for Sustainable Communities-Lehigh Valley

  2. Barbara Tornatore

    Peter: You certainly make good points. This is one of the reasons why the Lehigh Valley Board of Health is currently holding focus groups throughout the Lehigh Valley; to hear from residents as to what their concerns are. Perhaps you may want to find out when/where they are holding them to express yours. We, as public health educators, would certainly like to be able to reduce greenhouse gases, lower energy consumption, etc, etc. These are overwhelming initiatives that one public health department probably could not handle. However, part of a public health system includes joining forces with other entities that specialize in a sector of public health – including those areas mentioned in your letter. With that said, what the Lehigh Valley Department of Health would do is partner with organizations, such as RenewLV, to structure a department that can utilize the expertise of these organizations to come up with plans that directly target these issues. None of this can happen until the state officially gives the Lehigh Valley Dept. of Health the certification to open its doors. In the mean time, it would be advantageous for you to attend the monthly meetings of the Board of Health to offer your suggestions and concerns to them. As Victoria’s article stated, public health does look at treating the population as a whole, not on the individual level as medical care does. Public Health also does look at short- and long-term impacts – this is what we are trained to do as public health educators. Your concerns are valid and in-line with what the Lehigh Valley Dept. of Health would like to achieve – doing the “greatest good for the greatest number of people” (Mills, 1863).

    Barbara Tornatore, MPH, CHES

  1. Pingback: Public Health « Crossroads

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