What in the World is Public Health?

What is public health? Public health is all around you, yet can be so difficult to categorize because its scope is so broad. The American Public Health Association states, “Public health promotes and protects the health of people and the communities where they live, learn, work and play.” But even with that simple definition, people are often still left wondering, what does public health mean? What do you study? Where do you work? What do you really do? Am I already interested in public health?

Those who work in public health may have very different roles, but are all trying to improve the health and well-being of a community. The field of public health works across disciplines and fields to promote and to accomplish lifesaving public health initiatives from polio vaccines to hand-washing to wearing seat belts. It’s also about making sure people are prepared for and have access to stable jobs, safe neighborhoods and quality education.

Whatever angle of public health you’re looking at, you can break down the key roles and how they interact to promote a healthier community. To give an example, let’s look at the USDA Food and Nutrition Guidelines, which very clearly relates to health, but has many less obvious contributors who all make the Guidelines useful. Some of these contributing areas include: Research, Community Outreach, Clinical and Policy.

Research

In this Guidelines example, research is not typically conducted as a wet lab experiment. Those who study food and nutrition focus on how peoples’ dietary habits correlate to their health outcomes. People working in this field may ask participants to complete food diaries, call in once a week to list all of the foods they have eaten or even change their diet for an extended period.  In these examples, public health researchers are interested in identifying major dietary patterns and understanding how that pattern related to a specific health outcome or disease.

Another form a of research is in food security and food access. Researchers in this field look at whether people have enough food for the week? What do people in this community consider as enough food for the week and what types of food are they eating? What grocery stores are around? How far away are these stores? What are the transportation options to get to there? These researchers may use policy and mapping software as tools to advance their research.

While some researchers work with people, others are working with the food. Those who research farm science try to answer questions like: What crops grow best in various environments? Do the nutrients in the same crop change when it is grown in different environments? How can we improve the growth of a crop in a certain area? What nutrients can we add to a crop? The research in this field contributes to the market of food supplies, crop sustainability, and overall availability in order to enhance the health of a community.

The Guidelines’ purpose is to promote healthy food and dietary options to the United States public. The research generated from those working in food and nutrition shape the behaviors and food sources that make up the Guidelines. The growth and sustainability of these crops weigh in the decision of determining the Guidelines. Though these are only three examples of research, there are many other fields and topic areas of food and nutrition that play a role in determining the Guidelines.

Sample Job Titles

  • Research assistant
  • Nutritional epidemiologist
  • Clinical dietician
  • Sustainability advisor
  • Farmer
  • Spacial Expert
  • Civic Engineer
  • Biostatistian

Community outreach

Though research shape the Guidelines, community outreach is the backbone of how people learn and eventually incorporate Guidelines into their daily lives. Those who work in community outreach understand the values and norms of the community, and design programs around those to best serve the population.

For example, after assessing a community’s needs, public health professionals continue to work with members of a religious group to educate them on ways they can start community gardens for their constituents. These gardens in turn provide communities with access to fresh produce that may be lacking in their diet to help meet the national Guidelines of consuming five to seven servings of fruits and vegetables a day. These professionals train leaders to be able to educate others on the nutrition Guidelines and steps making healthier choices.

Public health professionals can also use their community network to better understand the food availability of a community, such as how people access food and what can be purchased. Then, they can team up with community leaders and political advocates to improve access, like working to build grocery stores in their towns. Those working in community outreach have an important role to play in guiding policy and creating community initiatives that lead to healthier communities.

Sample Job Titles

  • Development advisor
  • Outreach and communications manager
  • Grant writer
  • Policy Advocate
  • Community educator

Clinical

Another way that the community is educated about the Guidelines is through their primary care physicians or other clinicians. Many healthcare workers discuss dietary habits with their patients. Through this interaction, clinicians can provide the patient with information about the Guidelines as a healthier nutrition option. Many providers even us the Guidelines as a prescription program. When food is used as a prescription, the goal is to motivate behavior to change the diet of a patient, to improve health or prevent disease. This type of prescription is commonly used for patients with non-communicable and chronic diseases like diabetes, high blood pressure, and obesity.

The Guidelines may also be used for preventative health through schools. By measuring elementary and high school students’ height and weight annually, nurses can assess if a child’s growth is on par with the average, and then suggest recommendations around the nutritional Guidelines to help get a student on track.

Nutrition plays a very important role in that even at a young age. Within the first 1,000 days of life, breastfeeding and proper nutrition determine your growth curve for your life. The Guidelines promote healthy dietary behavior to support women breastfeeding newborn children and provide nutritious options for those children as they grow into school age.

Sample Job Titles

  • Promotora
  • Nutritional dietician
  • Clinical doctor
  • Registered nurse
  • Community educator

Policy

Every few years the nutrition Guidelines are reviewed and updated. As you can see, this process involves public health professionals, clinical healthcare workers, and many others in the nutritional world. They collaborate to determine which dietary behaviors are most beneficial to the public’s health. Though the Guidelines are hosted by the United State Department of Agriculture and talked about as a policy, there is no public regulation for folks to adhere to them.

However, indirectly the Guidelines influence other policies and the economy. Based on the recommendations, farmers may change the crops they propose to grow to meet the needs of the market. In turn, policy makers who work on the Farm Bill are highly alert to the publication of the guidelines with each edition. Not only do they want to make sure that their own farm markets are being protected, but that other markets can thrive. Farms that produce corn and soybeans provide crops to grocery stores but also to meat and dairy farms for animal feed. If meat and dairy is cut out of the dietary Guidelines it could change the market for certain farms. A farm that only grows corn feed for cows may no longer have a place to sell their crops if meat consumption decreases. Policies including SNAP and WIC are also related to the nutrition Guidelines determining which products are eligible for supplemental funds – both of those programs are public health programs. These programs help individuals battling with food insecurity provide for themselves and their families by aiding them with temporary financial assistance for food purchases. When SNAP and WIC benefits were expanded to be accepted at local farmers markets and similar venues there was an increase in purchasing of fruits and vegetables. Thus local farms had to grow and provide markets with more fresh fruits and vegetable crops. Indirectly these two policies now affect the farming industry and will play a role in shaping future nutrition Guidelines.

Sample Job Titles

  • Policy advocate
  • Grant writer
  • Clinic director
  • Outreach and communications manager
  • Policy analyst

Public health and nutrition are at the root of all the previous examples. Professions in each example may not consider themselves public health advocates but in fact they are! Though it may not be in the title or job description there are professionals working in research, in the field, with the community, in clinical settings, and even on Capitol Hill. Public health encompasses a variety of topics and a variety of fields but through a collaborative effort those working in the healthcare field can promote strategies that improve the health of a large group of individuals.

Public health expands far beyond nutrition. While this is one insight into public health, you can find examples of other focuses all around you.  This includes the food you eat at every meal is a symbol of public health and the “clear” running water that is flowing out of your faucet. Just your interest in the health professions can be declared as public health since you are in some way dedicating your career to improving life for others.  When you think about it, anyone who is working to minimize health disparities, prevent disease, and improve the wellness of the community is working in public health. Much of which does not happen in a clinical setting. While medical professionals are public health, so much of public health incorporates policy, history, community outreach, and science. Almost any interest and area of study can be related to public health in some way. It is a great compliment to any degree providing you with insight and perspective on health and allowing you to make a positive impact on many peoples’ lives. More importantly, you can use a public health degree to incorporate health and well-being into your daily work. If you are interested in working to help others, improving health and social policies, and being an advocate for communities, public health is a great match for you.

Thank you to the Association of Schools and Programs of Public Health‘s Emily C. Gordon, MPH, CPH, for submitting this guest post. 

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