Chapter 1
Introduction to public health

What is public health? Why do I need to study it? We hear this question a lot from medical students just starting out on their medical careers. There is, of course, the standard definition:

Public health is the science and art of preventing disease, promoting health and well-being and prolonging life through the organised efforts of society (Faculty of Public Health)

…but what does this really mean?

The difference between the clinical and public health roles of doctors (and health services) is often illustrated by the image of people pulling others out of a river (Figure 1a). So busy are these people with saving those who are drowning that nobody has thought to go back upstream to find out why people are falling in to begin with. Public health aims to go upstream to find out why people are drowning. Besides understanding the problem, public health also tries to prevent it or reduce the harm resulting from it. Such action may involve persuading decision-makers to put up effective barriers to stop people falling into the river, repairing damaged river banks or controlling flooding, as well as providing information in the right way to prevent risky behaviour near the river. It may also be appropriate to make sure that the people saving those who are drowning are well trained and at the right place on the river bank to save as many lives as possible effectively and efficiently.

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