Public Health is a well-known phrase these days, with 2020 having the unlikely honour of being the year that had the first global pandemic in 100 years. But even with that dubious privilege, the term “public health” is still not a phrase you could easily break down.
The limits of public health are often rather fuzzy. No two systems of public health around the world are entirely identical, for reasons of opinion or government policy (never usually because the science directs it down a particular path). Here in the UK, public health covers health care, social care, the voluntary sector, local government, education, housing, environment, sport, culture, and scientific research – and I have inevitably missed some. In short, public health is for all of us as it impacts all parts of our lives, and every part of our life directs an aspect of public health. Its goal is to improve health and wellbeing, focused on both the local and the national levels.
You might not realise how all the factors I’ve mentioned affect a nation’s public health. Going back to the 17th century, the 1601 Poor Law introduced various improvements to impact the wellbeing of people with disabilities, the physically ill, and the mentally ill. Vaccines were introduced in the 19th century, and our public health has been greatly improved superior as a result; the recent vogue for a small number of people arguing that vaccines are dangerous have caused some diseases – previously thought to be extinct – to reappear. Scientific ignorance is a direct threat to good public health; when people are stupid, they risk our collective health. The NHS, founded after the Second World War, is a brilliant example of a nationally-coordinated health service designed to reduce health inequalities; the fact it is led by politicians makes it something of a political football with every election cycle, and therefore not as effective as it might otherwise be as a wellbeing service.
To be healthy is to have a sense of wellbeing – to not just be free from physical illness, but also actively well emotionally, mentally, and socially. You could still have a sense of wellbeing even if you are lacking in one of those areas, and one person’s perception of wellbeing could differ from another’s. Being healthy in all parts of our life is essential to this sense of wellbeing, however, and public health services need to accentuate the positive rather than just focus entirely on getting better from illness – actively promoting good health, and preventing ill health, is the key.
People are often surprised when they are asked to consider housing or economic status or living in a “green” area as part of public health – but, of course, all three of those are natural fits. If you live in cramped, damp conditions, you can expect higher amounts of breathing difficulties. If your wages are decent, you can afford decent-quality food (and, usually, a greater variety of ingredients). If you are surrounded by parks, you can go somewhere for exercise, even if you live in a home with no garden; that has a positive impact on both your mental and physical health. During the 2020 Covid lockdown in the UK, my son and I lived in a flat with no garden; however, we lived five minutes from a large, beautiful park, which we would walk or cycle to every single day without fail to sit, have lunch, or run around. They were magical times, when we laughed, bonded, and savoured the good weather.
Public health is vital, the cornerstone to a healthy society full of potential for its citizens. We must all take responsibility for our individual and collective wellbeing, but that is made easier in a healthy society – if our city is clean, green, and a safe place to live; if we are paid well; if our children grow up free from disease; and if we have access to hobbies and health services. It’s all connected; we just need all of these things to work well for us, rather than be disconnected. With the 2020 pandemic still fresh in our memories, it’s plain to see how things aren’t always well-connected – and it’s easy to remember a time when we didn’t have access to a lot of services, and how that made us feel. We have a right to expect and demand change at a societal and individual level – and if we speak with one voice (something that is often hard to do), life can change for the better.