What is Public Health?

I see public health not as merely as a subject that studies how promote the well-being of populations, but one that has so large a scope that can make use of every piece of human knowledge to solve complex health-related problems.

As a Chinese, I’m glad to see that my motherland is now an expanding world power, but the public healthcare of its citizens is still concerning. Born with a sweet tooth, I’m a frequent visitor to the dentist’s and always suffer from the fear of the dental drill. But the hardest part was that I had to arrive at the registry as early as 6:30 in the morning and waited three hours to receive treatment. Patients crowded the waiting hall and seats are hardly available.

I’ve witnessed how trust and respects towards doctors are plagued by high costs and long waits in China. News about violent attacks against medical professionals flooded every possible web page. It’s because the public couldn’t find a way to voice their opinions to government but they had to vent their anger. The vicious cycle started as less and less undergraduate students choose to pursue a medicine major and the shortage of medical practitioners continued to drive medical expenditures up.

However, the expenses are relatively cheap compared to those of the US citizens, and it’s definitely easier to see a doctor in China since there’s no appointment needed. Why are people still unsatisfied? Is there anything wrong with the social medical insurance policy? What can the government do to increase the number of medical doctors? When I’m pondering on these questions, I realized that public health is not only about distributing condoms and giving vaccinations, but a much more complicated field in which different subjects such as economics, demography, culture studies and public policy come cross and intertwine, trying to make healthcare and well-being possible, accessible and affordable for every citizen. Yes, curative medicine is the key that can facilitate us to achieve “health”, but not “public health”. Unlike science, there are not certain, quantitative answers or even existing theories that can help me answer those three questions I raised. The field of public health is so pivotal to us since its significance is already embodied in our everyday life. For example, in the context of my previous experience, we need doctors to be reachable and we need public health leaders to address the inefficiency between the demand and supply. Even if one argues that we don’t meet with doctors on a day-to-day basis, but other than biosciences, sewage treatment, custom inspection, and nutrition all are indispensable contributors to our well-being and they are different dimensions of the field of public health. We are sometimes oblivious of them, but we cannot deny the value of their existence.

Public Health?

Most individuals would regard “good health” as a blessing because they are aware that without good health, they would not be able to function and carry out their day-to-day lives. Thus, policymakers, healthcare officials, and community leaders prioritize discussions and decisions about public health, or the collective well-being of a community.

Public health is a comprehensive topic because of the multitude of areas that could improve or damage the well-being of a community. For example, residents of third-world countries living in the most extreme forms of poverty are likely to have poor health. Poverty has shown to lead to issues like a shortage of healthcare facilities and personnel, lack of sanitation, and malnourishment. Each of these factors has the potential to impair the health of a nation’s residents and create a cycle over generations in which, the public health of that community, is threatened. Thus, the agendas and policies decision-makers create regarding the economics, infrastructure, and healthcare of their nation affect the living conditions and essentially the health of their communities.

Public health also relies on the decisions made collectively by a community. For example, genocide and other forms of war, decided upon and enacted by one group with the intention of harming another, pose implications for the public health of the community. In war-torn areas, people often lack access to essentials like clothing, food, and water, and as their lifestyle begins to deteriorate, so does their health. War weapons can also create new health issues like lead poisoning and acid burns. In some areas, certain groups have cultural views that objectively damage their health. For example, the stigma against women with fistulas in Africa and the practices of genital mutilation and breast-ironing all pose a threat to the lives of those respective populations.

Lastly, public health can also be impacted by non-human factors such as natural disasters and epidemics. Droughts, floods, and earthquakes often create conditions that prevent populations from accessing basic resources. Epidemics such as Ebola and Zika also take the lives of thousands and challenge scientists and decision-makers to create solutions that would stunt the spread of these illnesses. The decisions created at a local and global scale that affect the well-being of populations experiencing similar conditions are thus integral to maintaining public health.