When we think about public health, we often start with governmental public health. The agencies that provide services such as vaccinations and monitor for disease outbreaks. But the field extends beyond public health departments. Public health includes community-based organizations, research institutes, and policy advocates.
How can public health professionals continue to expand their thinking about health?
Public Health 3.0: A Call to Action to Create a 21st Century Public Health Infrastructure, urges public health professionals to think about health differently. The report focuses on the social determinants of health. Think education, income, housing, and the physical environment -- all of the things that make your zip code a stronger determinant of health than your genetic code.1
Early public health wins include sanitation services and widespread access to effective vaccines. As chronic diseases became more prevalent, the field shifted to address that new burden. Efforts focused on ensuring access to health care and on behavior change.
Today, the field continues to evolve. The issues being faced today are complex. Changemakers are thinking about overall wellbeing. This means considering:
- Vital conditions like stable housing, quality education and access to healthy food;
- Urgent services like providing services for people experiencing homelessness, in need of mental health or acute care, or involved with the criminal justice system.
No one sector can solve these issues on their own. They require partnering across sectors.
For some public health professionals, this focus on social determinants feels intuitive. For others, it is new territory.
Our collaborative action must ensure, for the first time in history, that every person in America has a truly equal opportunity to enjoy a long and healthy life.Karen B. DeSalvo, MD, MPH, MSc
Social Determinants of Health
The World Health Organization defines social determinants of health as the conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels, which are themselves influenced by policy choices. The social determinants of health are mostly responsible for health inequities -- the unfair and avoidable differences in health status seen within and between countries.
Put more simply, we’re talking about the things that make your zip code a stronger determinant of health than your genetic code.
What can public health professionals do to build healthy communities?
Public health professionals are focused on protecting the health of entire populations. They often talk about this as population health. To do this, they serve a broad role in communities ranging from recommending policies to implementing educational programs and administering services and conducting research.
Use data to drive action to address community needs
Public health changemakers work to address key issues facing their communities. In many communities, Community Health Assessments and Community Health Implementation Plans guide the work of local public health. (You might hear public health folks refer to these as CHAs and CHIPs.)
In recent years, the public health field has focused on issues like obesity and tobacco use. Today, the field has a growing focus on things like education, income, housing, the physical environment, and community safety.
Focus on equity
Along with a focus on social determinants of health comes a focus on equity.
In 2017, the Robert Wood Johnson Foundation introduced its definition of health equity: “Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care. For the purposes of measurement, health equity means reducing and ultimately eliminating disparities in health and its determinants that adversely affect excluded or marginalized groups.”2
HealthEquityGuide.org, from Human Impact Partners, shows how health departments across the nation have taken a lead role in addressing equity. The site provides guidance, case studies, and resources to help local public health move equity work forward.
Serve as a convener
Public Health 3.0 calls on leaders in the field to bring together multi-sector partners to take action for healthier communities. Going Beyond Clinical Walls: Hats Matter, a 2.5 minute video, illustrates the power of partnership across sectors and how it is critical to improve health outcomes.
Start at home
As employers, public health organizations and departments set internal policies that impact the health of the people they employ. For example, these agencies can set internal policies to ensure:
- Their employees earn a living wage.
- Their employees have access to quality health care.
- The work environment supports healthy choices.
Learn more about what employers can do to impact the health of their workforce in What Works for Health.
Population health is defined as the health outcomes of a group of individuals, including the distribution of such outcomes within the group.3
How do I connect with public health?
Do your research
First, find out who leads public health work in your local community. (Note: Public health jurisdictions and resources differ from state to state.) Then start with their website and look for the organization’s priorities and information about existing partnerships.
We mentioned Community Health Assessments and Community Health Implementation Plans above. Public health agency CHAs and CHIPs are a great way to understand the community's priorities and to begin to identify where your interests align.
Public health also often serves as a convener for or is a member of local coalitions. An existing coalition is an ideal place to explore partnerships.
Once you’ve got some organizational context, look for a way to connect with a person. Ideally, you’ve identified one or more key changemakers in the organization. This could be the agency director or the person who heads up community outreach or chronic disease prevention.
If you have a mutual partner, ask for a warm introduction. If not, introduce yourself. Public health is often eager to connect with other changemakers. As with anyone, it’s helpful to start by asking about their efforts and priorities. Look for areas where your interests align.
What’s in it for them?
Focus on healthy communities. Public health professionals and advocates are leading efforts to improve health in their communities.
Public health can’t do it alone.They know they must focus on the social determinants of health -- the things that make your zip code a stronger determinant of health than your genetic code. Leaders are eager to partner with others to address education, income, housing, community safety, and the physical environment.
Outside forces. Accreditation standards and many funding requirements are also pushing public health changemakers to engage in multi-sector partnerships. Learn more about Specific Assessment Requirements that impact public health and health care.
Not sure where to start?
Three key national public health networks may help you connect with local or state organizations. Look for member directories to find contacts near you.
- Association of State and Territorial Health Officials -- represents state public health agencies in the United States, the U.S. Territories, and the District of Columbia.
- National Association of County and City Health Officials -- comprised of nearly 3,000 local health departments across the United States.
- National Network of Public Health Institutes serves as a central hub for 40 public health institutes, 10 university-based regional training centers, and 40 affiliates.
- Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services. Public Health 3.0: A Call to Action to Create a 21st Century Public Health Infrastructure. Washington: U.S. Dept of Health and Human Services; 2016.
- Braveman P, Arkin E, Orleans T, Proctor D, and Plough A. What Is Health Equity? And What Difference Does a Definition Make? Princeton, NJ: Robert Wood Johnson Foundation, 2017.
- Kindig D, Stoddart G. What is population health? Am J Public Health. 2003;93(3):380-383. doi:10.2105/AJPH.93.3.380.