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Health and public health

  • Page updated onMarch 10, 2025
Health and public health
Photo: Bruno Abarca
"Health" is possibly the most frequently repeated word on this website. However, each time it has different nuances: understanding it from an individual perspective is not the same as understanding it from a collective perspective.from a public health perspective.

What is health?

Health is well-being, with all that this entails

Health is physical, mental and social well-being. This wonderful four-word definition will soon be 80 years old. It was thus reflected in the 1946 Constitution of the World Health Organization, closely accompanied by the equally necessary sentence "The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political ideology, economic or social condition.".

It is possible that the definition of health proposed by the WHO, seen so long afterwards, falls short in many aspects - as many authors say - but it also continues to be highly inspiring. This definition does not limit health to the biomedical, and also elevates it to the aspirational. This brings with it, however, some additional problems: how to measure something so utopian and so dependent on the subjective wellbeing of each person? How to transfer something so individual to the collective?

Health as a public good

To overcome the limitations of this definition, others add that well-being provides the ability to function or perform. This new variable can lead to a (mis)understanding of health as a mere market good or an instrument for production. However, it also opens the door to placing health at the service of what each person wishes to do with his or her life. Moreover, it encourages us to think of health as a public and global good. Suddenly a person's health can contribute to the health of others in his or her environment and community through care, interpersonal relationships or participation in collective efforts.

By understanding health from the biopsychosocial, more questions arise: What then determines the state of health, what are these determinants of health?

What is public health?

Public health as a collective effort

The concept of public health was born in the middle of the 19th century. Today we can understand it as an organized effort to prevent disease and to protect and promote the health of the population.

This definition is only a simplification of other more complete and advanced definitions for the purpose of dissemination. However, it helps us to focus on some key characteristics of public health as an art or science: coordination among actors in a health system, emphasis on prevention, a population-based approach with a goal of social justice and equity, and a series of essential functions.

Essential public health functions

There are many models of essential public health functions or services that explain what public health is about.

They all have in common some aspects such as the use of data for decision making. This includes population health surveillance, equity monitoring, or the evaluation of the social determinants of health. It also involves research and analysis of the capacity and performance of health systems and their services. These are all functions that allow the use of the knowledge of the available scientific evidence to be able to manage health risks and public health emergencies.

Another group of public health functions is related to ensuring access to quality preventive and curative health services. This may require guiding resource allocation, developing the potential of the health workforce, ensuring the availability of medical products and technologies, and ensuring equity through proper financing.

All this is highly related to the development and implementation of policies, plans and laws related to health care, the social determinants of health, the right to health and equity, and the promotion and protection of health, ensuring social participation, transparency and accountability.

Public health governance

The exercise of public health - and therefore its governance - must be carried out under the leadership of the authorities (duty bearers). These must be supported by other organizations and institutions (responsibility holders) and with the participation of the population (rights holders). Although when referring to population it is intuitive to think of groups of inhabitants of administrative areas such as municipalities, districts, regions or countries, it is also possible to think of communities, collectives or territories, for example.

Health fundamentals

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