The “new” public health

Most doctors in practice today graduated at a time when there were few universities, fewer medical schools and only one School of Public Health. I was looking forward to reading what academics at the “newer” Deakin University in Victoria were going to say about public health, and I was delighted to discover that their views confirmed my own. Gone is the stuffy epidemiology of defined disease, to be replaced by discussion (and analysis) of the social and health issues that trouble our community and give angst to politicians. There are case studies of individuals and populations, which challenge the intellect and ethics and which, in turn, become the wellspring for wanting to know and understand more.

Good health results from intersecting systems involving individuals and populations, and their beliefs and values. So while health status has to be measured objectively, there are perspectives from other disciplines such as anthropology, psychology and sociology that can be brought together with the clinical disciplines, to understand the many predicaments in health. These range from physical illness and disablement and the effects of ageing, to the massive burdens of substance use, mental illness and suicide risk, and the evolving threats from the environment — all of which can be better understood if the data and information are up-to-date.

How this is all put together and evaluated is the next challenge. The framework used in this book is health promotion, an approach that could be easily dismissed as mere health education. But the authors show that this is the only way to construct a reasoned public health response in modern societies. This demands new forms of evidence and evaluation, which must span education, criminal justice and social policy as well as care — evidence not so readily found in the application of evidence-based medicine.

The authors have done an excellent job of encapsulating these issues and more within contemporary Australian and international data. This book is only a first step for exploration, and throughout there are pointers to websites and current data sources for the reader and student to follow-up.

If this is the “new public health”, it makes a lot of sense to me.

Ian W WebsterEmeritus Professor of Public Health and Community Medicine Sydney, NSW