Public Health

Definition: Public health is defined as “the science and art of preventing disease, prolonging life, and promoting health through the organized efforts and informed choices of society, organizations, public and private communities, and individuals”.¹ Health determinants (the personal, economic, social and environmental factors that affect health) can play a role in public health due to certain populations potentially being more predisposed to particular conditions due to genetics, health behaviors, social or societal characteristics, and availability and quality of health services or medical care.² The aims of public health are prevention and health promotion. Prevention is aimed at reducing the risk of disease, such as modifying risk factors, using screenings to find disease in its early stages, and immunizations, while health promotion is directed at modifying behaviors of individuals at risk.

Public health is assessed through different sciences (mainly epidemiology, laboratory, informatics, and surveillance), prevention effectiveness to monitor health trends, and outcomes to prevent disease and maintain healthy communities. There are 10 essential services that help define the role and purpose of public health.^2-4

Assess and monitor population health status, factors that influence health, and community needs and assets  Investigate, diagnose, and address health problems and hazards affecting the population Communicate effectively to inform and educate people about health, factors that influence it, and how to improve it Strengthen, support, and mobilize communities and partnerships to improve health Create, champion, and implement policies, plans, and laws that impact health Utilize legal and regulatory actions designed to improve and protect public health Assure an effective system that enables equitable access to the individual services and care needed to be healthy Build and support a diverse and skilled public health workforce Improve and innovate public health functions through ongoing evaluation, research, and quality improvement Build and maintain a strong organizational infrastructure for public health

How it relates to ACO/PCMH: There are many ways in which public health agencies and departments can collaborate with ACOs and PCMHs, including assisting with needs assessment, performance measurement and improvement, health promotion, and patient engagement.⁵ Public health agencies can also collaborate with ACOs and PCMHs to target and contact vulnerable and hard-to-reach patients. In addition, when ACOs partner with public health agencies, this can broaden the resources, community programs, and services available to patients. Through collaboration and providing efficient and effective services to patients in ACOs, shared cost savings can occur through improved care management.⁶

Involved organizations/oversight: Monitoring and surveillance of public health trends occurs at the local, state, regional, and national level by the different agencies within HHS and USPHS, as well as partnerships with academic and private institutions. There are also international organizations who monitor these trends with WHO being the most notable.³

Resources:

1. Winslow C-E A. The untilled field of public health. Science. 1920;51:30.
2. CDC. NCHHSTP social determinants of health. Available at: cdc.gov/nchhstp/socialdeterminants/faq.html
3. WHO. WHO definition of public health. Available at: publichealth.com.ng/who-definition-of-public-health/
4. CDC. 10 essential public health services. Available at: cdc.gov/publichealthgateway/publichealthservices/essentialhealthservices.html
5. Association of State and Territorial Health Officials. Accountable care organizations and public health. Available at: astho.org/Programs/Access/Primary-Care/_Materials/ACO-and-Public-Health-Fact-Sheet/
6. Ingram R, Scutchfield FD, Costich JF. Public health departments and accountable care organizations: Finding common ground in population health. Am J Public Health. 2015;105(5):840–6.

Contributing authors:

Medical Home/ACO and Public Health SIG Collaboration

Ashley L. Adams, PharmD, MS, BCACP
Lieutenant U.S. Public Health Service Clinical Pharmacist, Sells Hospital

Morgan P. Stewart, PharmD, BCACP
Clinical Assistant Professor, University of Texas at Austin College of Pharmacy
Clinical Pharmacist, CommUnityCare Federally Qualified Health Centers

Last Updated 11/13/2020