College of Health, Education and Human Development

Changing Faces of Public Health Care

by Ralph S. Welsh, M.S.

The mission of public health is “to fulfill society’s interest in assuring conditions in which people can be healthy”As students begin and end their “Introduction to Public Health” course experience each semester, they are asked to answer the question, “What is public health?” While this question may seem simple at first, students soon realize it is much more than just educating people on how to live healthy or providing community health clinics or immunization programs. They realize that, like many Americans, they don’t fully understand what public health really involves.

While students may be concerned when I tell them I won’t give them the specific answer to this test question, I assure them that they will gain the knowledge and skills necessary to effectively answer the question by the end of the semester and their collegiate career. As students begin to refocus their attention from grades to knowledge and skills, they discover that while being able to effectively communicate the answer to this question is the ultimate challenge to keeping the public healthy, it will also increase their likelihood of receiving the grades they seek while enhancing their ability to become highly effective and valued professionals within our evolving world and U.S. health care system.

So what is public health? The mission of public health is “to fulfill society’s interest in assuring conditions in which people can be healthy” (The Future of Public Health, Institute of Medicine). Public health care is the “preventive” arm of our U.S. health care system, and it works synergistically with our more recognizable “curative” medical care system. It is the associated activities of governments, private and voluntary organizations, and individual citizens working together to bring about improvements in the quality and years of healthy living for approximately 300 million Americans.

Public health care is unique from medical care in that its primary focus is on the holistic health (e.g., physical, mental, social and economic health status) of populations, as opposed to individuals, utilizing a science-based systematic process of population health improvement.Public health care is unique from medical care in that its primary focus is on the holistic health (e.g., physical, mental, social and economic health status) of populations, as opposed to individuals, utilizing a science-based systematic process of population health improvement. Due to the large multidisciplinary organizational nature of our health care system, public health professionals must possess a level of understanding in each of the core public health science disciplines: biomedical sciences, epidemiology and biostatistics, environmental health science, behavioral health science and health services research. In addition, they must possess the skills necessary to work collaboratively with diverse professions and cultures while also being able to effectively deal with the inherent economic, political and ethical controversies that influence the effectiveness of our nation’s health care system.

It is through this multidimensional integrated training that our future health care professionals will be better prepared to take on the broad range of health threats facing our nation. These threats include skyrocketing health care costs, a significant percentage of adults and children lacking health insurance, medical mistakes ranking among the top 10 modifiable causes of death, obesity and physical inactivity-related diseases, emerging drug-resistant strains of infectious diseases, food-borne illnesses, childhood diseases, an aging population, violence, substance abuse, climate change, poverty and the numerous health disparities that exist within our nation.

It is through this multidimensional integrated training that our future health care professionals will be better prepared to take on the broad range of health threats facing our nation. These threats include skyrocketing health care costs, a significant percentage of adults and children lacking health insurance, medical mistakes ranking among the top 10 modifiable causes of death, obesity and physical inactivity-related diseases, emerging drug-resistant strains of infectious diseases, food-borne illnesses, childhood diseases, an aging population, violence, substance abuse, climate change, poverty and the numerous health disparities that exist within our nation. During students’ participation in “Introduction to Public Health,” they are challenged to show they can learn through independent reading assignments, lectures and discussions, short perspective papers called mini-assignments and a term paper in which they form a position on how to improve the U.S. health care system’s ability to protect and promote the health of the U.S. population. They are introduced to the interactive role that genetics, biology, behaviors, the environment and access to health care have on individuals’ overall health status. In addition, they learn the dynamic role that psychological, social, cultural, organizational and economic determinants play in the health behaviors of individuals, groups and populations.

Through historic and current examples, students begin to discover the important role that sound epidemiological research methods play in the early detection, treatment and prevention of disease outbreaks and how studying the effectiveness, efficiency and equity of our U.S. health care system has the potential to reduce health care costs and ultimately increase Americans’ access to quality health care.

Through their mini-assignments, students must think independently, apply facts and concepts from the course to the world around them and show that they can effectively present their perspectives in written form. These perspective papers encourage students to identify public health care concepts in the media; identify current sciencebased information using information technology; critically analyze research studies for their strengths, weaknesses and uncertainties; describe ethical dilemmas in health care and a personal framework by which they can make ethical decisions; and describe the process by which governmental activities are designed to empower individuals, communities and populations to be healthier while taking into account individual liberties, economic impacts and potential value conflicts.

These skills and knowledge are so beneficial for our future health care providers that the Centers for Disease Control and Prevention and the Institute of Medicine have recently recommended that anyone pursuing medical school acceptance or careers in the U.S. health care system receive introductory training in public health as a part of the academic curriculum. As our health science students take on the challenges of their course work and upper-level service-learning opportunities offered through the HEHD Department of Public Health Sciences (DPHS), it is encouraging to know they will not only be better prepared to seek medical school education but also many of the numerous professions within our broad U.S. health care system.

As a lecturer in the DPHS, I feel privileged to be able to provide skillbased education while incorporating my broad-based experiences in public health to such a well-prepared and inspired group of students who achieve so much during their Clemson experience. I am also glad to have known all the students who have come through my classroom in the past seven years as they have challenged me to enhance the education I provide by helping me better understand the changing culture, learning styles, interests and skills of our future health care professionals. I am truly honored and encouraged to have seen the changing faces and abilities of our new generation of health care professionals.

clemson.edu/publichealth