As soon as I entered the field of Public Health I got used to the question: What exactly are you doing? What does Public Health mean? And let me tell you, the answer is not always that simple and easy.
Therefore, I decided to define key terms of Public Health on my blog, for you & me.
A helpful factsheet from the American Public Health Association brings it to the point: Public Health focuses on actions that promote health and prevent disease, injury and disability on a population level. Goal is to increase the quality of life of a targeted group of people, but also to save money and increase productivity.
The quality of life depends on multiple factors and Public Health is a complex field that includes interdisciplinary professions such as medicine, environmental sciences, politics, economics, behavioral and social sciences, architecture, urban planning, design, statistics, research and others.
Successful Public Health activities are often not recognized because disease outbreaks and a decline in the quality of life of a population receives more media attention than the effective prevention of that conditions. Good Idea Public Health is a little approach changing that…
Health Promotion is according to the Ottawa Charter for Health Promotion the process of enabling people to increase control over, and to improve, their health. Health Promotion aims to influence behaviors on multiple levels, using theories and evidence, with the goal to increase the quality of life of a targeted population.
Multiple levels include the individual level (person at risk), interpersonal level (e.g. partner, parents), organizational level (e.g. hospital staff member, school staff member), community level (e.g. community center staff member, church member), and societal level (e.g. policy maker, journalist).
Health Promotion develops, implements, and evaluates health interventions considering socio-economic factors and cultural needs.
Health Communication is the effort to catch and hold the attention of the target population and transfer health literate messages that influence the health behavior of the target audience. Health Communication uses human, mass and multimedia approaches to educate & inform, to increase self-efficacy, and to change beliefs, attitudes & norms.
Health Literacy describes the ability of a person to find, comprehend, evaluate and use health-related information. The information can be verbal exchange, written content, numbers, a picture or graph.
Health Literacy considers four basic areas: fundamental literacy (reading, writing, speaking, numeracy), cultural literacy (cultural norms of sender and receiver), scientific literacy (ability to understand and use science and technology), and civic literacy (know civic and governmental processes, hierarchical relationships).
I like the book by Zarcadoolas & Co about Health Literacy.
Social Marketing is one of many theoretical approaches in health promotion. Social Marketing applies commercial marketing techniques for a social cause campaign. The marketing mix of social marketing focuses on the 8 P’s: product (e.g. service, health behavior), price (time, habit change), promotion (ways to receive attention of the audience), place (used channels to reach audience), people (program producer and receiver), policy (policy change through advocacy), purse strings (requirements of program funder), and partnership (collaborate to respond to complex health issues).
Individual vs. Structural Interventions
Individual interventions aim to change health behaviors through influencing knowledge, attitudes, self-efficacy… of the target audience, e.g. through educational actions. Targeted are people with a high-risk profile and it is in the control of an individual to make a behavior change.
Structural Interventions aim to change the environment of the target audience, which can lead directly to a behavior change. Four different structural approaches include: (1) Availability: Making protective factors (e.g. fruits & veggies) more available and harmful factors less available (e.g. smoking bans); (2) Physical Structures: Physical characteristics increase a healthy behavior (e.g. bright, inviting stairs); Social Structures: Laws and policies (e.g. bar owner needs to control ID’s and will be punished if serving alcohol to adolescents); (4) Cultural and Media Messages: Communicating through media and cultural practices (e.g. PSA, entertainment-education).
Affected are all people living in the area of the structural intervention, which makes the approach cost-effective especially for large-scale health issues, e.g. obesity. It can also increase the quality of life of a whole population and not only the high-risk target audience.
If you are interested to dig deeper in the topic I recommend the book Prescription for a Healthy Nation by Tom Farley and Deborah Cohen.