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Public Health

Public health involves promoting health and preventing disease for all people in a community. The mission of public health is to promote health and mental health and prevent disease, injury, and disability for all the inhabitants of a community or other jurisdiction. Society has an interest in protecting its population and making assurances to that population that the society will endeavor to create conditions for all people to be healthy. Public health practitioners carry out the mission of public health through assessment, policy development, and the application of the essential public health services. The vision of public health is to promote a healthy people in healthy communities agenda. At a scientific level, this means that research and practice will be oriented to preventing disease before it occurs (primary prevention), finding ways to prolong life, encouraging healthy lifestyles with individual responsibility for maintaining these lifestyles, and developing a public health system that promotes health for all its population through organized community efforts and collaboration. This latter point is tied to a major concern about health equity for all. At a practice level, this agenda would also be pursued by preventing epidemics and the spread of disease, protecting people from environmental hazards, prevention of injuries, responding to disasters and helping people and communities in the recovery period, and assuring accessibility of health services for everyone. Public health is thus population based and not generally a provider of clinical services. Public health agencies work with other community health partners to carry out the mission of public health and a vision for a healthier future.

Major Functions and Essential Services

Public health has 3 major functions and 10 essential services that will successfully impact a local public health system. The first function is assessment, which involves the identification of health problems in a community and a determination of all quantitative and qualitative considerations of that problem. The function of policy development involves the creation of solutions and action steps with appropriate rules, regulations, statutes, and laws, and protocols related to these solutions. The final function involves assurance, which relates to the implementation of the solutions in the area of action.

A clarification of these core functions involves the public health system carrying out the 10 essential public health services:

  • Monitor health status to identify community problems.
  • Diagnose and investigate health problems and health hazards in the community.
  • Inform and educate people about health issues and empower them to deal with the issues.
  • Mobilize community partnerships to identify and solve health problems.
  • Develop policies and plans that support individual and community health efforts.
  • Enforce laws and regulations that protect health and ensure safety.
  • Link people to needed personal health services and ensure the provision of healthcare when otherwise unavailable.
  • Ensure a competent public health and personal healthcare work force.
  • Evaluate effectiveness, accessibility, and quality of personal and population-based services.
  • Conduct research for new insights and innovative solutions to health problems.

Structure of the American Public Health Service System

Most public health agencies in the United States are found at the state and local levels. Although the American public health system tends to be decentralized, with different structures between states and localities, it is possible to see a public health presence at the national level. The U.S. Public Health Service includes the Office of Public Health and Science (OPHS) and eight operating agencies. These agencies are (1) the Health Resources and Services Administration (HRSA), (2) Indian Health Service (IHS), (3) Centers for Disease Control and Prevention (CDC), (4) National Institutes of Health (NIH), (5) Food and Drug Administration (FDA), (6) Substance Abuse and Mental Health Services Administration (SAMHSA), (7) Agency for Toxic Substances and Disease Registry (ATSDR), and (8) the Agency for Healthcare Research and Quality (AHRQ).

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