So What is Public Health?
What keeps us healthy as a population?
I started this article when there was no pandemic or emergency health crisis. Somehow, with everything shutting down, I put this article aside to take care of more pressing issues, such as the health and safety of my family.
We have all restricted our lives to essential activities so that our medical care clinics, emergency rooms, human resources, and equipment do not go short if needed by a larger population than can handle the crisis.
Here is a clear address to meet the challenge of a global pandemic head on. We all have to participate for it to work. Acute care at its finest requires support from so many essential services, and we are all impacted in some way. Today’s measures are unprecedented, and I am not the first to say so.
When the world changes
Now that things have settled down in my life, and a new sense of routine is being established, I have begun to think again about that question “what is public health?”.
In our current level of societal crisis, it’s easy to think of public health as emergency medicine, hospitals, clinics, and government responses to health threats. We tend to equate public health with all those essential activities like quarantine, hospital beds, and “flattening the curve.”
Of course we also think about the availability of masks and hand sanitizer. Everyone wants our front line health care to operate effectively during a pandemic crisis, but how do we ensure the health of our populations when there is no emergency?
I sit at one of the only coffee shops which is still open in Nelson BC, during a pandemic where people are asked to socially isolate. The coffee shop is sparse – less than half the tables are present, and with many less walk-through customers than I would usually expect (at the time of publication, all sit-down restaurants have closed).
As I contemplate this current crisis, I can appreciate how those of our society who are most vulnerable are the ones that will have the hardest time coping with these health directives we have all been given.
How can we all stay healthy?
Those with easy access to income at a crisis can stay afloat. Living pay-check to pay-check means less capacity to weather the storm. It also helps to have a strong base of health to begin with.
The social determinants of health are compelling, as stable housing, safe neighbourhoods, adequate income, and a healthy diet support disease prevention – some which are underlying risk factors to infection in an epidemic.
Improving medical care works great for acute emergency responses to pathogens and injuries. Chronic, long term health problems, that are best solved in community settings, can clog up our hospitals and clinics which are better designed to treat acute problems. Preventing disease can be accomplished at the population level.
Risk factors vs. social determinants
In the mainstream popular media, I hear a lot about risk factors that make an individual more susceptible to complications from an epidemic viral infection. I hear repeatedly to wash hands frequently, practice social-distancing.
I also hear how some people are more at risk who have high blood pressure, diabetes, or cancer. These underlying factors are wide spread in our society. According to the government of Canada, “heart disease is the second leading cause of death after cancer, and a leading cause of hospitalization” (1).
Excellent medical facilities and services are only one part of what keeps us healthy, as chronic care for these risk factors cannot happen in an acute care facility indefinitely.
There are other social advantages that can contribute to a population’s health which may lower the overall incidence of new disease diagnosis, perhaps making us more resistant. Once this current crisis is over, we have an opportunity to address those social determinants which make parts of our population more vulnerable or more at risk.
- Government Of Canada (2020). Heart disease in Canada: Highlights from the Canadian Chronic Disease Surveillance System. Retrieved from: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/heart-disease-canada-fact-sheet.html