What is Public Health?

Public health is the science of protecting and improving the health of communities through education,
research for disease and injury prevention, investment in healthy social conditions, and the promotion of
healthy lifestyles. Public health professionals analyze the effects of genetics, individual choice, and the
environment on individual health in order to develop strategies that protect the health of larger
populations. It is also a field that is concerned with limiting health disparities and achieving equal
opportunity to be healthy, regardless of socioeconomic status, race, gender identity, sexual identity,
disability, and more. The fight for health care equity, quality, and accessibility is an ongoing and
important part of public health.

The common goal of public health professionals is to prevent health problems from happening or
recurring, as well as to foster health promotion. From smoking cessation to nutritional education to
vaccinations to the management of pandemics and epidemics, the applications of public health
interventions in our society are endless. Although it seems that focusing on prevention could be the key
to achieving healthier populations and alleviating much of our healthcare system’s financial burden,
public health only receives a fraction of the healthcare funding in this country. Why? What obstacles
are in the way? In this section, we hope to present to you some of the challenges facing public health
and the current responses to those challenges.

Resources:
● UC Berkeley School of Public Health - http://sph.berkeley.edu
● Healthfinder - http://www.healthfinder.gov
● Centers for Disease Control & Prevention (CDC)- http://www.cdc.gov
● Office of Disease Prevention and Health Promotion - http://www.health.gov
● UNICEF - http://www.unicef.org
● World Health Organization - http://www.who.int/en
● World Federation of Public Health Associations - http://www.wfpha.org
● State Public Health Information and Analysis - http://www.statepublichealth.org
● American Public Health Association - http://www.apha.org
o This is the oldest and largest organization of public health professionals in the world
with more than 50,000 members from over 50 occupations of public health.
● Association of Schools & Programs of Public Health - https://www.aspph.org/discover/
● California Department of Public Health - http://www.cdph.ca.gov/Pages/DEFAULT.aspx
● Public Health Institute - www.phi.org
o This is an independent, nonprofit research organization aimed at promoting health,
well-being, and quality of life for people throughout California, the nation, and the
world.
● United States Department of Health and Human Services - www.hhs.gov
o Information on current health issues in the US, relevant for most topics in PH116.

Statistics:
● About one in four Americans lack access to a health center to receive regular medical services
and a primary care provider, and almost one in five Americans under age 65 years do not have
medical insurance coverage, according to the Healthy People 2020 report released by the Centers
for Disease Control and Prevention (CDC - 2020).
 ● According to the National Health Interview Survey’s Early Release Program, 28.9 million persons
under age 65 were uninsured at the time of interview (CDC - 2017).
● In 2018, among persons under age 65, 41% had been uninsured for at least part of the last year,
17% had been uninsured for more than one year, and about 25% were receiving public coverage.
(CDC - 2018)
● Over 1 in 10 Americans have diabetes and about one-quarter of those do not know they have it. 1
in 3 Americans have prediabetes, and 90% of them do not know they have it. In recent years, the
incidence of type 2 diabetes in Americans ages 10-19 increased for all groups except
non-Hispanic whites, and especially increased among non-Hispanic blacks ages 10-19. (CDC -
2020)
● 7 of the top 10 causes of death for 2017 were chronic diseases, first being heart disease and
second being cancer. Heart disease, stroke, and other cardiovascular diseases caused 1 in 3 deaths
in the United States (CDC - 2017).
● According to the CDC, 6 in 10 U.S. adults live with at least one chronic disease and 1 in 4 adults
have two or more chronic diseases (CDC - 2019).
● According to the Pregnancy Mortality Surveillance System, pregnancy-related mortality in the
United States increased from 7.2 deaths per 100,000 live births in 1987 to 16.9 deaths per
100,000 live births in 2016. During 2011–2016, the pregnancy-related mortality ratio for Black
non-Hispanic women was 42.4 deaths per 100,000 live births (CDC - 2020).

General Terminology:
● Public Health: “Public health promotes and protects the health of people and the communities
where they live, learn, work and play. While a doctor treats people who are sick, those of us
working in public health try to prevent people from getting sick or injured in the first place. We
also promote wellness by encouraging healthy behaviors.” (APHA)
● Health care: Efforts made to maintain or restore health by trained and licensed professionals.
● Epidemiology: A central aspect of public health that deals not only with the spread of the disease
but also with the multiple causes and effects of societal problems.
● Social Determinants of Health: Conditions in the places where people live, learn, work, and play
which affect a wide range of health risks and outcomes (CDC).

The Ten Essential Public Health Services:

1. Monitor health status to identify and solve community health problems
2. Diagnose and investigate health problems and health hazards in the community
3. Inform, educate, and empower people about health issues
4. Mobilize community partnerships and action to identify and solve health problems
5. Develop policies and plans that support individual and community health efforts
6. Enforce laws and regulations that protect health and ensure safety
7. Link people to needed personal health services and assure the provision of health care when
otherwise unavailable
8. Assure competent public and personal health care workforce
9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services
10. Research for new insights and innovative solutions to health problems
—Centers for Disease Control & Prevention (CDC)
What is public health and why is it important?
phoenix.edu/blog/what-is-public-health.html

By Cooper Nelson

At a glance

Public health includes any organized effort to protect and promote the health of
populations at a local, state or national level.
Public health works to ensure the equitable distribution of health promotion and
disease prevention efforts across and within populations (e.g., race, gender, ethnicity,
identity, community).
Public health services include health communication campaigns, disease monitoring
and investigation, mobilization of communities around health issues, development of
health policy and plans, and enforcement of laws to create healthy environments.
At University of Phoenix, the Master of Public Health degree program can prepare
students to assess and advocate for the health needs of communities.

Whether it’s clean water or access to healthcare, members of society frequently work together
to promote group health. This collective goal to prevent illness and promote wellness for all is
known as public health.

Here, we provide information about public health — the research, programs and careers that
help protect health on a large scale.

What is public health?

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Public health is any effort to protect the health of a community or country. This includes
organized efforts to identify and address disease, promote healthy lifestyles, prevent injuries
and illness, improve nutrition and emphasize meaningful hygiene. Public health efforts are
enacted at local, state and national levels through organizations such as health departments,
clinics, public health foundations and community centers.

Public health also plays an important role in implementing health policy, enforcing public
health laws, ensuring equitable development of and access to public health efforts, and
creating a public health workforce that continually assesses and improves upon public health
programs.

Public health can promote simple wellness strategies, such as hydration and adequate sleep.
More frequently, however, it represents a coordinated effort to protect health for an entire
group of people. For example, an organization might distribute safe drinking water to a
community recovering from a natural disaster.

Healthcare experts play a particularly important role in helping to further public health
efforts in a variety of ways, including research, education, medicine and vaccine distribution.
Students also play an important role in public health, often contributing to research efforts
while completing healthcare degree programs.

Healthcare students may also choose to pursue healthcare administration degrees, given the
subsequent career possibilities in fields like health administration, nursing home
management, healthcare administration and health information systems. No matter the
healthcare field, though, it’s important that students understand the role public health plays
in society.

Healthcare professionals might also enhance their education through a master’s degree in
nursing (MSN). After polishing skills in informatics and gaining a practical nursing
education, licensed registered nurses can pursue an MSN or MSN bridge program to prepare
for new opportunities in their career, such as leveraging nurse roles across a variety of
healthcare operations — many focused on protecting public health.

The importance of public health

Public health professionals fulfill many roles. Among other important duties, healthcare
experts work to protect communal health. This means keeping a society healthy and
informed regarding any physical or mental health threats.

Sometimes, public health officials can help prevent disease outbreaks. In other cases, public
health efforts can assist rural communities, implement education programs and complete
preparatory research projects. No matter the type of outreach, it contributes directly to the
greater good of societies around the world.

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Officials in the public health sector, in other words, provide advice and direction that drive
health forward, reducing pressure on medical facilities and the cost of medical care to society.
Public health officials also ensure we are equipped to react appropriately in the face of a
health crisis.

Public health research

One of the main responsibilities of public health is to keep society apprised of the latest
health developments. To inform both the public and healthcare decision-making, healthcare
professionals such as healthcare researchers routinely undertake research projects.

This research takes many forms, but the underlying goal remains the same: to understand
health challenges, predict future developments and prevent health crises.

Research is one of the main pillars of public health. Unlike many other health sectors, it is
largely preventive — professionals use ongoing research to identify and prevent health
challenges before they escalate.

Without research, professionals and officials lose valuable time in responding to issues. In
addition, a lack of research can mean that officials don’t know which biological,
environmental or social influences to target.

Working in healthcare requires a strong ethical foundation. Learn about the

four principles of ethics in nursing.

Public health communication

Public health professionals frequently need to communicate with society. When it’s time for
health experts to share research findings with people, they use a variety of communication
channels.

At times, health experts might communicate with the public through the following channels:

Journals and other digital or print publications featuring public health research
Community events
Announcements or bulletins distributed in public locations
Phone or email messaging
Social media
Local news channels
Digital advertisements

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Health professionals have a few priorities when communicating with society. First, they must
ensure that they deliver accurate information to the general public. This information must
also be timely; if the information takes too long to reach people, it might already be outdated.
Lastly, it needs to provide instructions about how to act on the message. Effective health
communication draws on decades of health communication theory.

Public health programs and organizations

Public health organizations fulfill a wide variety of responsibilities. These organizations exist
to protect society from disease, illness and other health-related challenges, and many make
sizable research contributions in individual fields.

The following organizations are dedicated to public health:

National Institutes of Health (NIH): A U.S. government agency that maintains

biomedical research on several diseases with a global focus.
Centers for Disease Control and Prevention (CDC): The official health agency of
the U.S. government, which works to prevent disease and illness.
Substance Abuse and Mental Health Services Administration (SAMHSA):
An agency within the U.S. Department of Health and Human Services dedicated to
advancing behavioral health.
World Health Organization (WHO): A United Nations agency that sets
parameters for controlling disease, developing and distributing medicine, and serving
vulnerable populations.
The Carter Center: A nonprofit organization started by former President Jimmy
Carter and his wife, Rosalynn, which is dedicated to promoting international peace and
health efforts.
American Public Health Association (APHA): An organization that works to
shape public policy pertaining to public health. Areas of concern include funding and
access to care.

These and other public health organizations work to improve the lives of people around the
world. They frequently partner with public health professionals to relay research findings,
messages and health updates to the public.

Pursuing a career in public health

When you complete a degree in healthcare, you take the first step toward impacting the
health of your community. Students interested in public health can obtain a degree in several
different healthcare fields, and embark upon careers such as:

Health educator
Health information management director

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 Health manager
Nursing director

A Master of Public Health is the degree program that most aligns with these job outcomes.
However, an undergraduate degree is needed to pursue a master’s. Many students often
begin their journey to an MPH with a healthcare-related degree, like a bachelor’s degree in
health administration. In the program, you’ll learn many of the basics that inform a
professional health career, including skills in health administration and quality management.

For those who want to remain in the healthcare field but not necessarily pursue a career in
public health, an option is a master’s degree in health administration. In addition to polished
healthcare skills, you’ll learn strategies that can help you assume a leadership role in a public
health setting.

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Genetic Code Vs. Zip Code: The Social Determinants Of
Health
forbes.com/sites/forbestechcouncil/2022/06/13/genetic-code-vs-zip-code-the-social-determinants-of-health

June 13, 2022

Tom Lawry
Forbes Councils Member

Forbes Technology Council

Jun 13, 2022,10:15am EDT

Tom Lawry is the National Director for Artificial Intelligence, Health and Life Sciences at
Microsoft.

“The future is already here. It’s just not evenly distributed.” - William Gibson, Futurist.

With so many types of data available today to help monitor and manage health, here’s a
question: Which is a better predictor of health status: your genetic code or your zip code?

Where you live affects how you live. It impacts whether you have access to healthy food,
places to exercise or health services when needed. Your “living location” also affects your
personal and family’s economic prosperity based on the availability of jobs, unemployment
rates, education and training opportunities. These “social” factors shape and determine
health and longevity across your lifespan.

Social determinants of health (SDOH) matter when it comes to addressing how we improve
the health status of individuals, communities and nations. SDOH are conditions where
people live, learn and work that affect a wide range of health and quality-of life-risks.

Here’s an example from a MedCity News article: “Two 60-year-old women live 10 miles apart
in the Washington DC area. They’ve both been prescribed beta-blockers for high blood
pressure, both have family histories of Type 2 diabetes, and have missed their last few annual
check-ups. What should their care plans look like? Should they be different?”

“Clinically, they’re spitting images of each other. However, one piece of data — their zip code
— can dramatically tilt the equation. Turns out, they face radically different life expectancies
(63 versus 96 years), just based on the difference in their geographic locations. This 33-year
life expectancy gap can be chalked up to differences in income level, education level, and
access to grocery stores with fresh food.”

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Traditional health systems have historically used data to understand the physiologic aspects
of a health or medical condition. Such data is important in making diagnoses and managing
health, but this only shows part of the picture. Social and environmental factors are much
more indicative of a patient’s health outcome than once thought. One study suggests that
60% of a patient’s healthcare outcome is driven by their behavior and social and economic
factors, 10% by their clinical care, and 30% by their genetics.

The Color Of Coronavirus

According to an article from The Conversation, “Neighborhoods with large black populations
tend to have lower life expectancies than communities that are majority white, Hispanic or
Asian. Such racial differences reflect the places in which different races live, not the
individual characteristics of people themselves.”

Covid-19 gave voice to these issues. For example, at the beginning of the pandemic, Black
Americans were twice as likely to die from Covid-19 even though they were a smaller
percentage of the overall population. In taking a closer look, two things became self-evident:
First, higher death rates related to where people lived. Second, the “twice as likely to die” was
a statistical average. Underneath this average was the true story. In reality, if you were Black
and living in Washington D.C., you were six times more likely to die of Covid at that time.
Living in Michigan meant that you were four times more likely to die of Covid.

The Conversation article also notes that “Research shows that black communities are less
likely to have access to resources that promote health, like grocery stores with fresh foods,
places to exercise and quality health care facilities. This is true even in middle-class
neighborhoods.”

Artificial Intelligence (AI) As A Turning Point

AI gives us the ability to better understand and proactively address social determinants
impacting health.

To factor SDOH into health planning, health organizations must first be able to identify
consumers facing adverse SDOH. Once identified, such factors can be incorporated into
personal health management and population health strategies.

AI can help automate the identification of people whose health is likely impacted by their
living situation. Opportunities include adding intelligent features to EMRs and proactive
assessments of patient populations. Such activities help to identify and triage at-risk
populations and enable organizations to build intelligent workflows for referrals and follow-
up.

One study found that AI accurately predicted inpatient and emergency department
utilization using only publicly available SDOH data such as gender, age, race and address.

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AI promises to make it more practical to incorporate SDOH into care management and
population health strategies. AI can identify consumers whose health issues are related to
SDOH and then help clinicians with targeted interventions to help them better manage their
health while maximizing the use of resources.

Understanding and incorporating social determinants of health in health planning is at the

heart of moving toward healthier citizens and communities.

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Homelessness is a Public Health Crisis | Opinion
newsweek.com/homelessness-public-health-crisis-opinion-1581743

Jason Nichols April 8, 2021

Opinion
Erin Kelly , public health expert

On 4/8/21 at 6:00 AM EDT

Opinion
Homelessness
Coronavirus
NYC
New York City
More than a year into the COVID-19 pandemic, our country is still grappling with numerous
crises. With the vaccine rollout underway, conversations are starting to shift from
management to recovery. Nowhere is this truer than in the health and housing sectors, where
a vaccine won't magically fix one's ability to pay for long-term health issues or rent. Given the
breadth of the recovery, policymakers must be strategic, but also identify opportunities to
promote long-term stability. That begins with treating housing instability, including
homelessness, as a public health crisis.

As policymakers and professionals in the health and housing sectors embark on a post-
pandemic recovery process, they must work together to deliver solutions that simultaneously
promote a person's health and housing stability. This will help speed up the recovery by
allowing experts to share resources, align efforts and more purposefully address systemic
root causes of illness and housing instability.

Any financial, time, or resource investment in housing stability is an investment in health

and vice versa. By promoting collaboration between these fields, there's an opportunity to
facilitate knowledge sharing, communication and collaboration to more effectively and
efficiently reach goals of promoting health and housing, while also advancing each other's
outcomes in the process.

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The COVID-19 pandemic highlighted the interdependence between a person's housing
stability and their health. The stress of experiencing housing instability and living on the
street or in a shelter make people exponentially more likely to contract and die from COVID-
19. Having the coronavirus can cause housing instability through financial disruption or job
loss—with the financial downturn increasing joblessness and housing instability nationwide.
This is truer for Black and brown communities, who are bearing the brunt of the pandemic
and financial crisis and experience homelessness at much higher rates than other
demographics.

The significance of the relationship between an individual's housing and health status cannot
be overstated. Housing instability harms health both directly—by moving people away from
their doctors and into unsafe housing—and indirectly—by causing stress and eliminating

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resources that could otherwise keep people healthy. In other words, housing impacts health
not just in terms of a home's physical conditions, like chemicals or pests, but also in the
social context and consistency of the housing itself.

Being healthy helps people remain stably housed. This promotes financial stability and
ensures they're able to maintain their homes. Given the deep connection between health and
housing, experts in both fields can't just cheer each other on, they must work together to
enact policies and programs that jointly benefit people's health and housing stability.

Notably, there is already collaboration between the two sectors to tackle the most extreme
cases—people experiencing long-term homelessness with serious mental illness, substance
use conditions and/or chronic health conditions. Using the principle of "housing first," many
communities operate supportive housing programs, principally providing homes along with
clinical services, recognizing that ongoing health care promotes housing stability.

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A man experiencing homelessness sits in the rain on April 24, 2020, in New York City.
Pablo Monsalve /
VIEWpress via Getty Images

Research shows supportive housing programs keep people in permanent homes, off the
streets, out of shelters and also self-report better health outcomes. While there is room for
improvement, these programs demonstrate the effectiveness of policies and programs

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designed to simultaneously promote health and housing stability.

The health sector already has a history of using housing stability as a means to prevent health
crises—providing insight into what's possible if services were more frequently integrated.
Some health departments implement "hotspotting" programs that connect chronically ill
patients to health and social services in an effort to reduce costs. When these programs only
provide more health care or support without any tangible community resources, they're less
effective at improving health. When "hotspotting" techniques deliver housing support for
chronically ill patients, health status improves.

In both of these examples we see that the most successful collaborations between the health
and housing sectors are designed using a public health lens that strives to prevent crisis and
illness. By asking how housing can prevent illness and how to use health services to prevent
housing instability, policymakers can achieve broader success than either sector could
achieve alone. Collaboration between the sectors only for the most vulnerable isn't enough.
Health and housing professionals must also work together to develop policies and processes
with shared goals of improving health and increasing housing stability.

Just as doctors prescribe groceries to promote health, housing too must be seen as a
prescription to prevent illness—especially in a post-COVID world. The recovery will be a
massive undertaking and despite substantial promised government investment, resources are
always limited.

In order to most efficiently and effectively use COVID recovery funding, policymakers should
work to jointly promote housing stability and health, and encourage professionals in both
fields to collaborate. Doing so will speed up the recovery and lay the foundation for a more
effective system going forward, one that works together to prevent health and housing issues
for all.

Erin Kelly, MPH, is a public health expert and one of the founders of RxHome, an
organization working to end homelessness in New York City that was founded on the belief
that homelessness is a public health crisis. Follow RxHome on Twitter and Instagram to
learn more.

The views expressed in this article are the writer's own.

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