What does the public health system do?

The issue of public health has been in the spotlight since the start of the Covid-19 pandemic, but that is just the latest in a long series of challenges facing public health workers. Public health by definition is the science of protecting and improving the public’s health.

As we’ve seen lately, a large part of this involves fighting infectious diseases, of which Covid-19 is just the most recent. While it is currently in the public eye, fighting disease is only one of many aspects in meeting a society’s public health requirements. After all, how do you define health? Good health goes far deeper than just not having an infectious disease. The WHO defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. The list of public health problems also includes issues of public awareness, education and the promotion of a healthy lifestyle.

In this article, we’ll cover the difference between community health versus public health, the leading public health problems across the world and the exciting public health technology that is being used. We’ll also cover what health courses and public health qualifications are available and run through what you would study if you enrolled for a degree in public health.

The public health system focuses on preventing disease, prolonging life and ensuring the good health of the public. A country’s public health system is not just the government’s health department and its infrastructure, but also includes a complex network of private and non-governmental organisations (NGOs) that all work towards the goal of improving health and people’s wellbeing.

The public health system provides communities with access to healthcare at hospitals and clinics. There is also an incredible amount of work done behind the scenes, dealing with the logistics of keeping hospitals properly supplied with skilled staff and effective medicines. The public health system also includes all the medical laboratories and research facilities, which analyse medical samples and conduct research to improve treatment.

As the saying goes, prevention is better than cure, and much of the public health system is aimed at keeping people from needing to go to hospitals or clinics in the first place. Public service and education campaigns form a large part of this. Again, we’ve seen this very recently with all the social distancing campaigns and signs at shops and in the streets since the start of the Covid-19 pandemic. While the wearing of face masks is something new for us, you may well remember learning the importance of washing your hands in nursery or primary school. That too was part of a public health campaign to improve personal hygiene.

Another example that you’re likely to have experienced were school visits to educate learners about the dangers of smoking, drugs, alcohol abuse and HIV/Aids. Education campaigns like those are all planned and coordinated by people working in the public health system.

Public health problems

The World Health Organisation (WHO) put together a list of what it believes are the biggest dangers to public health that the planet will face soon. As you’ll see, this list is not limited to strictly medical issues and also relates to far wider societal issues and cannot be solved by smart people in white lab coats alone. These public health problems are very complex, which is why the people dealing with them require public health qualifications to gain the skills needed.

Air pollution and climate change

Amid all the diseases we face, it may come as a surprise that air pollution is considered by WHO as the greatest environmental risk to health. They note that 90% of the global population breathes polluted air and air pollution is responsible for 7 million deaths per year, making it a massive public health problem. Linked to this is the issue of climate change, which is caused by the same burning of fossil fuels that pollute our air. The WHO predicts that climate change will cause 250 000 additional deaths each year by 2030, as a result of malnutrition, malaria, diarrhoea and heat stress.

Non-communicable diseases

Also known as chronic diseases, non-communicable diseases are diseases that do not pass from one person to another. Although there are a huge number of such diseases, including very rare genetic diseases, the four biggest ones are diabetes, cancer, heart disease and respiratory illness. Together, these are responsible for more than 70% of all deaths worldwide, or 41 million people, according to the WHO’s data.

Antimicrobial resistance

Modern medicine has made great advances in the development of antibiotics, antivirals and antimalarial treatments, but unfortunately, the battle is ongoing. Bacteria, parasites and viruses are constantly evolving. For example, there are now strains of tuberculosis that have developed their resistance to the drugs used to treat patients.

Weak health care and crisis

Weak primary health care and what the WHO terms fragile and vulnerable settings were listed separately, but they are two closely interlinked societal public health problems. More than a quarter of the world’s population (1.6 billion) live in places without access to basic care, due to a combination of poor health services and ongoing crises. This includes both natural and human causes such as drought, famine, conflict and population displacement. Poverty and a lack of resources within lower-income countries are other obstacles to the WHO’s goal of universal health coverage. This public health problem affects South Africa too, where there is a shortage of skilled public health workers.

Vaccine hesitancy

Vaccines have vastly improved health across the world for more than 200 years and prevent more than 2 million deaths a year, but they can only work if they are used. Vaccine hesitancy is the reluctance or refusal to vaccinate despite vaccines being available. While this is partially a “first world problem” due to many people in poorer countries not having access in the first place, the WHO estimates that a further 1.5 million deaths could be avoided if global coverage of vaccinations improved.

Dangerous infectious diseases

Although the WHO lists each of these separately in their top 10 list, we’ll lump them together for simplicity.

The WHO warns that a global influenza pandemic is inevitable and that it is just a matter of when and where it breaks out. Ebola gets a mention together with “other high-threat pathogens”, while Denge fever and HIV/Aids also earned mentions on this list of worst offenders.

Public health vs Community health

In comparing the fields of public health versus community health, there are a lot of similarities and crossover, but they each have their specific focus. Community health deals with matters on the ground, providing healthcare to local communities, while public health is more “big picture”, dealing with issues on a broader scale.

In practice, what this means is that those involved in community health deal directly with people and include doctors and nurses working at hospitals and clinics. Public health on the other hand is often run on a national level, planning and coordinating across an entire country’s health infrastructure.

Public health tech

Public health tech is an exciting field that is rapidly moving ahead. Advancements in cutting edge technologies like artificial intelligence and virtual reality are opening up entirely new opportunities for healthcare in general. The wide use of smartphones by the population is another relatively new development that has opened up huge potential in public health tech.

As you may have read, many countries quickly developed apps to monitor and inform their citizens about the Covid-19 pandemic. Places such as Hong Kong were able to contain localised infections very efficiently through the use of a national contact tracing app. Although there have been political and privacy concerns, the ability to track population movement is an exciting development for public health tech. The wide use of smartphones also makes it much easier to keep the public informed and provide public health education.

What do you study in public health?

As we’ve seen, public health is a wide and complex field. Unsurprisingly, there are public health courses for a broad range of specialisations and many different public health qualifications that can be studied at different levels, from undergraduate through to PhD.

The five main areas in the public health field are biostatistics, environmental health, epidemiology, health policy management and social and behavioural sciences. Good public health courses and public health qualifications, such as UPOnline’s Postgraduate Diploma in Public Health give a solid grounding in all of these areas.

Environmental health science looks at factors in the environment that affect people’s health, such as air pollution mentioned earlier. Biostatistics deals with gathering and interpreting data to improve health, an area where smartphones and public health tech are opening up new possibilities. Epidemiology deals with diseases – identifying their causes, monitoring them and ultimately preventing their spread.

Health policy management entails the making and implementation of public health policy, as well as the management and administration of public health facilities. Social and behavioural science looks at how the public adopts and adapt to public health policy, dealing with education and overcoming public health problems such as vaccine hesitancy.

Degree in public health

If all the above has you interested in taking on the challenge of the many public health problems and helping meet the public health requirements of your community, then you may want to enter the field of public health. There are many public health qualifications and courses that can be studied should you choose this as your career.

A bachelor’s degree in public health is a good starting point to enter the field and gain valuable work experience, however, a postgraduate public health qualification is recommended if you want to go far in your career. To study UPOnline’s Postgraduate Diploma in Public Health you will need to already hold an Honours degree or have a bachelor’s degree in public health or a related field plus two years of work experience.

If this appeals to you, please read our article on what you can do with a public health degree and have a look at UPOnline’s Postgraduate Diploma in Public Health.