Today, public health is assuming greater importance than ever in view of a host of factors like changing lifestyle, environmental issues and outbreak of newer diseases. The coming days are going to be extremely challenging to the public health facilitators and society at large, warranting a significant change in the policies, strategies and attitudes towards health safety issues.
Population explosion, chronic diseases, emergency preparedness, and even the more familiar ground of infectious disease are all fraught with uncertainties to which public health community – comprising healthcare authorities, healthcare centres, doctors, NGOs and society at large – will need to respond seriously in the years to come. Such responses will often require significant changes from the kinds of responses public health agencies have employed in the past.
The future public health scenario will no doubt be more challenging than ever. Though the future is uncertain, it can be secured by using the knowledge we have today. Further, public health leaders have an opportunity to influence which future unfolds and how.
A 1988 definition of public health by the Institute of Medicine (1988) says: “Public health is what we as a society collectively do to ensure the conditions for people to be healthy.” Responsibility for many of the activities that ensure the conditions for people to be healthy is delegated to public health agencies in most of the democratic setups. These agencies have often taken on functions that no one else could or would do. For example, public health has long provided direct healthcare services to those with little or no access to healthcare. Similarly, public health has focused particularly on marginalised populations and on advancing health equity.
Public health evolved in form and scope since its formal organisation in the 18th and early 19th centuries. In form, public health in democratic nations, including developed countries as well as developing countries like India, has been primarily a government effort supported by academic and non-profit organisations. “In the future, however, this may change. Some of the gaps in healthcare that are currently filled by public health may – particularly if healthcare reform is fully implemented – largely disappear, as access to effective healthcare becomes nearly universal,” says the Institute for Alternative Futures in its report titled Public Health 2030: A Scenario Exploration.
Further, functions that public health retains in the years to come are likely to change significantly in terms of how they are done, as in the case of automating inspections and surveillance. Therefore, what public health will do in the decades ahead is an open question. In scope, public health started out with controlling and preventing infectious diseases, but has since grown to include healthcare, food safety, child and maternal health, screening for specific diseases, tobacco control, chronic disease control and prevention, emergency preparedness, environmental health, policymaking, and strategic leadership for communities.
(Read the full part of this article in the February Issue of Safety Messenger Magazine 2016)