Structure and Responsibility of Public Health

Public health as a discipline is really both the science and art of preventing disease, improving health, and prolonging the quality of life within a given society by use of public and private organizations. Overall, it is concerned with threats that are the type that may hurt society as a whole -- epidemics, dangers, social and mental well-being, etc. Modern public health is a multi-disciplinary field that includes medical professionals, statisticians, biologists, ecological and environmental professionals, dental professionals, nutritional experts, veterinarians, engineers, lawyers, sociologists, anthropologists, academics, and the political process itself (Rosen, 1993).

Historically, disease vectors, polluted water and pathogens, and lack of sewage without any scientific basis for control or actual understanding of pathogens created public health problems. In the modern world, public health focuses on several levels of health: local/regional, state, national and global -- typically based upon population statistics, demographics and the analysis of disease. Even in modern times, the most predominant issue is communicable diseases that may result epidemic or pandemic proportions, particularly within areas that are unprepared for such outbreaks. In this, the two basic paradigms of public health are: 1) dealing with the preventative side of human health as opposed to focusing on the curative side (prevention and control rather than reaction), and; 2) looking at health from a population level rather than an individual level basis to understand how communities react to health issues overall and what the best means of control might be given the technological and environmental issues at hand (Schneider, 2006).

Overall, public health has historical ties to cultural and religious law, which often attempted to regulate certain behaviors that kept individuals from getting sick (dietary restrictions, modifying behaviors, waste disposal, finding clean water, and even sequestering people away from the group if they were sick). At times, these laws may have seemed primitive, but were in place prior to the formal study of epidemiology, which was not typical for society until after 1854 when the water from certain wells was linked to cholera, and the germ theory of disease began to glean acceptance (Breslow, 2002).

Public Health at the Local Level- Essentially, the local/regional level of public health is the tactical rather than strategic level of data collection, planning and enforcement of public health needs. Local medical professionals are, by law, required to report certain diseases (hepatitis, STDs, etc.) and that data is used to follow up and report to higher levels to gauge the level of seriousness. At the local level, professionals use educational programs, legal inspections, and integration with the medical community to ensure compliance and prevention. For instance, the inspection and monitoring of local restaurants for cleanliness and adherance to ordinance is the responsibility of local public health officials. Many describe the local health departments as the arms and legs of state and federal agencies -- and most especially to monitor and respond to outbreaks of health related issues (flu, higher than average occurance of disease, etc.). In recent years, this has expanded to the role of helping to prevent pandemic diseases like Type-II diabetes, obesity and chronic hert issues. Many of these issues arise from diet, lifestyle, smoking, alcohol consumption, and behavior, and can be best addressed at the local level on an ongoing preventative means through educational programs and partnerships with schools and the medical community (National Association of County and City Health Officials, 2011).

The local level of public health is also sometimes called Community Health -- particularly as the tactical arm of agencies like the Centers for Disease Control and the State Public Health Services. In general, there are ten critical services that local departments perform on a regular level: 1) The monitoring of the health status of the local community based on statistical averages and community health hazards; 2) Assisting in the diagnosis and investigation of both health problems and hazards within the community; 3) To provide critical information that educates and empowers the community to prevent and solve health issues; 4) To act as a central agency to mobilize community partnerships that will solve health issues; 5) Assisting local governments and institutions in developing policies and plans that support the overall health directives from the federal and state government; 6) Enforcement of laws and regulations that help protect the community in both the health and safety realms; 7) Providing services that help link individuals to particular helath services and health care, particularly for at risk populations; 8) To continually evaluate the effectivness and accessibility of all community health services; 9) To ensure that there is a competent and expert level of public health workers to support the individual community; and 10) To assist in research that provides new and innovative health-based solutions for a wide-range of health concerns (Centers for Disease Control, 2012).

Because of the enormity of issues on a state and national level, local public health agencies are key in their roles to aid and respond to epidemiological concerns. For instance, almost every year communities are hit with a new form of influenza. A recent study actually found that at the local community level the performance of health workers tends to be extraordinary and vital for the survival of that community. Local public health workers are ofen willing to adapt to challenges, unknown risks, to respond to crises, and to form the very basis of the modern publoic health system (Barnett, D., et al., 2011).