Academic journal article Perspectives in Public Health

The Definition of Public Health - Where to Shift the Focus: Prevention or Population?

Academic journal article Perspectives in Public Health

The Definition of Public Health - Where to Shift the Focus: Prevention or Population?

Article excerpt

In 1920, the American microbiologist and public health pioneer Charles-Edward Amory Winslow1 famously described public health as 'the science and art of preventing disease'. Influenced by those words, public health is today commonly defined as the science of preventing diseases, as opposed to medicine, defined as the science of curing diseases. But public health is also frequently defined as the science of improving the health of populations, as opposed to medicine, defined as the science of improving the health of individuals. Unfortunately, these two criteria are not identical and using them as though they are as only serves to create confusion and inaccuracy.

According to the individual-versus-population criterion, the relationship between a physician and her patient, with the former aiming at maximising the health of the latter, is the quintessential representation of medicine. However, according to the cure-versus-prevention criterion, the same relationship would not be suitable to represent medicine since a good physician aspiring to optimise patient health will also need to call into play preventive strategies. The foregoing is only one of the many cases of ambiguity. For instance, according to the individual-versus-population criterion, the study of the drug development process would be part of public health; yet, according to the cure-versus-prevention criterion, it would be part of medicine. …

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