public health awareness essay

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Public Health Essays (Examples)

1000+ documents containing “public health” .

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Public health betrayals a fascinating reality of.

Public Health Betrayals A fascinating reality of public health is that when it is working, nothing is happening. People are healthy, they participate in their community's welfare, and they themselves are likely to want to be more engaged in the culture's economic and pleasurable activities. But the problem with a negative reality like this suggests Laurie Garrett in Betrayal of Trust, is that there is a tendency for governments of all types -- democratic or authoritarian, and one might guess, even those in the news today that are in the midst of disarray -- to cut back on whatever services they have. With the end result being that people don't get to live or die right (2000:7). Garrett shows why the underlying issue of organizing a community for health is not just a matter of medical, cultural or technological advancement. She goes through a variety of stories of how different countries have….

REFERENCES:

CBSNews, (2011), The Cost of Dying: End of Life Care. Viewable at  http://www.cbsnews.com/2100-18560_162-6747002.html?pageNum=3&tag=contentMain;contentBody .

Garret, L (2000). Betrayal of Trust: The Collapse of Global Public Health, Hyperiod, NY.

Gawande, A. (2010). Letting Go: What should medicine do when it can't save your life? The New Yorker. Viewable at  http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gawande?currentPage=all#ixzz0uuAGwOwQ .

Wikipedia, Fred Phelps (2011). Viewable at  http://en.wikipedia.org/wiki/Fred_Phelps .

Public Health Practice

Health Care There are many things that have led to the renaissance of public health in the past 20 years. However, the most important ones include eradication of infectious diseases through vaccination, increased awareness, better hygiene control, better primary care facilities and more stress on epidemiology. It has been stated that humans have a right to public health (Principles of the Ethical Practice of Public Health, 2002) Keeping this in mind, public health authorities have been quite vigilant in reducing the burden of disease. Infectious disease were the major cause of morbidity and mortality. Due to the presence of vaccines and antibiotics, these diseases have been controlled to a very decent extent. Vaccination programs that go on to protect the person against diseases like TB, Diphtheria, Pertusis, Mumps, Measles and ubella have been successful in countries all over the world. Furthermore, antibiotics have been made available to cure infectious diseases like diarrhea….

Principles of the Ethical Practice of Public Health. (2002). [e-book] Available through: Public Health Leadership Society  http://www.apha.org/ NR/rdonlyres/1CED3CEA-287E-4185-9CBD-BD405FC60856/0/ethicsbrochure.pdf [Accessed: 15 Mar 2014].

Schwarzenberger, G. (1943). The three types of law. Ethics, 53 (2), pp. 89 -- 97.

Scutchfield, F.D. & Keck, C.W. (1997). Principles of public health practice. Albany: Delmar Publishers.

Sharpe, P.A., Greaney, M.L., Lee, P.R. & Royce, S.W. (2000). Assets-oriented community assessment.Public Health Reports, 115 (2-3), p. 205.

Public Health Emergency Preparedness and Response

Public health emergency preparedness and response. Public health: Emergency preparedness and responses While all areas of the nation should periodically engage in risk assessment, not all locations are equally vulnerable to different types of attacks. Public health emergencies can originate in natural causes, such as hurricanes or pandemics. Emergencies also include disasters caused by human error and emergencies due to conscious, malicious intent, such as terrorism. New York City is vulnerable to such emergencies because of its high population density as well as its political, economic, and symbolic significance. In general, two departments coordinate emergency responses. The New York Department of Health and Mental Hygiene deals with health-related issues such as the H1N1 pandemic; the Office of Emergency Management deals with catastrophic disasters such as terrorist attacks and tornadoes. The NYC Medical eserve Corps, a trained group of health professionals schooled in emergency responses in a wide variety of disciplines can also respond….

Johnson, Morgan. (2011). Public Health Preparedness. Office of Emergency Preparedness & Response. NYC Dept. Of Health & Mental Hygiene. PowerPoint.

NYC will launch national emergency response system. (2011, May 11). The Washington Post.

Retrieved May 20, 2011 at  http://www.washingtonpost.com/national/national_emergency_alert_system_tied_to_cell_phones_to_be_announced_in_nyc/2011/05/10/AFIiZ9gG_story.html?wprss=rss_national 

Qureshi, K., Gershon, R., Sherman, M. (2005). Health care workers' ability and willingness to report to duty during catastrophic disasters. Journal of Urban Health, 82, 378 -- 388

Public Health Systems the Value

One of the most fascinating problems associated with the information age, is not the lack of information but the overabundance of information one can find on any given topic. The internet drives this phenomena of abundance and can offer the individual to many choices and conflicting opinions. There is really no issue, besides health that more effectively resembles the above statement. Many people then seek information from recognized public sources. Of the nine websites listed in the assignment brief, the three that stand out, for various reasons are: American ublic Health Association - http://www.apha.org/,National Association of County and City Health Officials http://www.naccho.org / & U.S. Department of Health and Human Services http://www.hhs.gov/. Each of these websites has a user friendly format with easy links to information that a health consumer might be looking for, but these three offer significant benefits. The first website contains the most effective answer tot the question….

Public Health Foundation  http://www.phf.org/ 

U.S. Department of Health and Human Services  http://www.hhs.gov/ 

U.S. Environmental Protection Agency  http://www.epa.gov/State  health departments, available through ASTHO  http://www.astho.org/ Local health departments, available through NACCHO  http://www.naccho.org/ Association of Schools of Public Health, available through ASPH http://www.asph.org

Public Health Resources 1& 8226 Information About Country

Public Health esources 1• Information about country, state, and national public health resources Public health is the bigger science of protecting and improving the health of communities by providing services based on education, healthy lifestyles, and other forms of medical and paramedical services. Public health professionals tend to analyze the health issues of individuals, family and community. However public health also involves the control of epidemics, causalities and calamity reactions. Thus public health professionals try to prevent problems from happening or re-occurring. The basis of the delivery of public health services is on the "Public Health Laboratory Practice, Public Health Policy and Practice." ("What is Public health," 2011) These practices are however very costly and is not adapted by private agencies. ("What is Public health," 2011) However the evolution of public health concept was made from very early times but the U.S.A. is a capitalist country with private participation in almost all fields….

Fox, Daniel M; Ludden, John M. (1998) "Living but Not Dying by the Market: Recent

Changes in Health Care." Daedalus, vol. 127, no. 4, pp: 137-141.

Goh, Yethun; Pritula, Mike. (1996) "Current Research: The New Value Creators in Healthcare." The McKinsey Quarterly, vol. 1, no. 2, pp: 192-205.

Institute of Medicine (IOM). (1988) "The Future of Public Health"

Public Health Is a Science

Therefore environmental studies are of great importance to public health .the air we breathe, water that we drink, and the interaction which is complex between humans and the surrounding. Environmental studies help us understand how the build as well as the natural environment can influence the health of people in a community. It also helps us understand how the risk factors that cause certain diseases can be reduced. The environmental; risk factors can lead to development of diseases such as cancer, asthma and food poisoning. Due to incorporation of chemistry, engineering and toxicology in environmental studies there can be combined expertise that will help in answering public health related questions. Environmental health which is a discipline of both public health and environmental studies can be divided into various aspects like water quality, noise control, air quality, food protection, management of solid waste and so on. All these are important….

CDC., (2013). Core Functions of Public Health and How They Relate to the 10 Essential Service. Retrieved aril 4, 2013 from  

Public Health Systems Public Health

This is particularly so for traditionally disadvantaged communities. The involvement of academic institutions would mean a larger among of revenue in order to provide these communities with the best in health care. This will reduce not only the rate of illness, but also of death in these communities, as better equipment is available and students are better prepared for their workforce duties. Preparation alone is however not enough, and the health worker should ensure that he or she regularly engage in learning opportunities in order to remain the best in their field. There are many agencies throughout the United States that focus not only on workforce preparation, but also on continued learning. One of these is the American Public Health Association (APHA, 2008). This institution serves its associates by providing regular training opportunities via meetings and training sessions. These serve the core activity of the Association by focusing on continuing….

Bibliography

APHA (2008). Continuing professional education.  http://www.apha.org/ programs/education/

Fauchald, Sally K. (2004, Winter). Using academic-community partnerships to improve health care services for underserved populations. Journal of Multicultural Nursing & Health.

Public Health How Is Public Health Financed

Public Health How is public health financed in you state, povince, o county? How does the cuent budget cisis impact Public Health and Community sevices in you aea? The issue of public health and its subsequent impact on society as a whole is becoming a vey contentious issues fo govenment. In the midst of an election yea, public health issues such as Medicae, social secuity, and disease pevention ae all becoming moe pevalent. In the state of New Jesey, public health is no diffeent in this egad. Accoding to U.S. Public Health Sevice, ove the last centuy, the aveage life span of an Ameica gew by 30 yeas. 25 of those yeas ae attibuted to an incease in public health sevices. As such, decisions make by govenments on the fedeal, state, and local level will have a pofound impact on the community. One conundum facing the state of New Jesey in paticula….

references)

Journal Articles used

1) Charles Maynard and Michael K. Chapko Data Resources in the Department of Veterans Affairs Diabetes Care May 2004 27:b22-b26; doi:10.2337/diacare.27.suppl_2.B22

2) Charles Maynard, Michael K. Chapko. Diabetes Care. May 2004 v27 i5 pB22(5).

3) Journal of Clinical Epidemiology Volume 54, Issue 12, December 2001, Pages 1195-1203

Public Health Strategies and Interventions

These included natural disasters such as fires and sanitation related problems such as infant mortality rates. Over the years however, health services and technology have improved to the point where many health problems may be anticipated. This is the result of experiential learning over the years from the 19th to the 20th centuries. Accordingly, the functions of health services have gradually changed their focus from response to prevention and preparedness through education. These functions manifest themselves in the strategies currently utilized by the public health care service. Rather than therefore responding to epidemics, citizens are educated to prevent illnesses by for example practicing adequate sanitation habits. In terms of disaster, technology can help citizens to be prepared for disasters, or to respond more adequately in a case where health services are disabled or difficult to access. The newly established functions of the health care system therefore directly influences its….

Public Health strategies and interventions changed considerably over the years from 1834-1999. The changes occurring range from vaccinations and institutions to issues such as welfare and general sanitation. Vaccinations for example increased as these were developed in response to outbreaks of serious illnesses, often resulting in large-scale death. Furthermore humanitarian and moral issues such as poverty and sex behavior increased responses to welfare sanitation difficulties as well as education relating to sexually transmitted diseases.

The greatest influences on changes in strategies and interventions may be summarized as the rise in population, urbanization, the economy, natural disasters and large-scale outbreaks of diseases resulting from sanitation issues. Strategies and interventions were then tailored to the particular needs identified by the above factors.

During the early years of the 18th century the function of the health care system was to identify needs and respond to these, as well as to cope with unforeseen disaster and disease. These included natural disasters such as fires and sanitation related problems such as infant mortality rates. Over the years however, health services and technology have improved to the point where many health problems may be anticipated. This is the result of experiential learning over the years from the 19th to the 20th centuries. Accordingly, the functions of health services have gradually changed their focus from response to prevention and preparedness through education. These functions manifest themselves in the strategies currently utilized by the public health care service. Rather than therefore responding to epidemics, citizens are educated to prevent illnesses by for example practicing adequate sanitation habits. In terms of disaster, technology can help citizens to be prepared for disasters, or to respond more adequately in a case where health services are disabled or difficult to access. The newly established functions of the health care system therefore directly influences its specific strategies.

Public Health Gwinnett County in

The two most important functions include the community Helpline and a five-year strategic plan for children and families. These functions culminate in assurance paradigms for the community, including five major councils and multiple committees. These support planning processes with regard to community health and the assessment and fulfillment of the citizens' needs. This provides the community members with the assurance that their best interest and health are at the core of the Coalition's functions. ources The Gwinnett Coalition for Health and Human ervices. (2005). http://www.gwinnettcoalition.org/ The Gwinnett Coalition for Health and Human ervices (2005b). http://www.google.com/search?q=cache:zMg3gj8oZIoJ:www.gwinnettcoalition.org/pdf/finaldatareport.pdf+gwinnett+county+core+functions&hl=en The Gwinnett Coalition for Health and Human ervices (2004). Mission and Vision. http://www.gwinnettcoalition.org/about.asp Gwinnett County Health Department. (2005). Centers for Disease Control. GA Dept. Of Human Resources. Gwinnett County Health Department (2005b). Gwinneth County Health tatus Report. GA Dept. Of Human Resources. Gwinnett County Public chools (2005). Health Issues. http://www.gwinnett.k12.ga.us/gcps-edprogweb01.nsf/0/d261df1d6778feb4852567d00054c3f8?OpenDocument.

The Gwinnett Coalition for Health and Human Services. (2005).  http://www.gwinnettcoalition.org/ 

The Gwinnett Coalition for Health and Human Services (2005b).  http://www.google.com/search?q=cache:zMg3gj8oZIoJ:www.gwinnettcoalition.org/pdf/finaldatareport.pdf+gwinnett+county+core+functions&hl=en 

The Gwinnett Coalition for Health and Human Services (2004). Mission and Vision.

Public Health Reform The Affordable

" (Federal egister, 2010) Incentive Payments Section 401(c) of the HITECH Act is reported to add an incentive for payments to specific Medicare Advantage (MA) organizations for their affiliated EPs who meaningfully use certified HE technology and meet other certain requirements." (Federal egister, 2010) for MA organizations in which services provided by affiliated EPs who are not meaningful users of certified EH, technology a downward adjustments of payments is stated beginning in 2015. Also required by the Act is a process to be established that ensures that no duplicate payments are made to MA organizations. In addition, hospitals that do not meaningfully use a certified EH technology will receive a reduction in their annual payment for inpatient hospital services. Critical access hospitals who meaningfully use certified EH technology will receive reasonable costs for the purchase of a certified EH technology beginning in fiscal year 2011. It is reported that meaningful use will….

Federal Register (2010) Part II Department of Health and Human Services, Centers for Medicare & Medicaid Services 42 CFR Parts 412, 413, 422 et al. Medicare and Medicaid Programs; Electronic Health Record Incentive Program; Final Rule Vol. 75 No. 144. 28 Jul 2010. Retrieved from:  http://www.gpo.gov/fdsys/pkg/FR-2010-07-28/pdf/2010-17207.pdf 

Standards and Certification Rules (2010) Final Rules and Regulations. HealthIT.gov. Retrieved from:  http://www.healthit.gov/policy-researchers-implementers/standards-certification-rules

Public Healthcare Legislation the Public

As the president works to pass what is most assuredly his most important legislative package to date, he is struggling against a great wall of opposition which appears to be driven by a philosophical aversion to public funding of a deeply privatized industry. The result is a tremendous amount of pressure on the president and a reigning fear in the public that he will be forced to capitulate. There are indications from the Obama Administration that the crucial nature of this issue has produced a distinct urgency in terms of passing some system overhaul. Indeed, this discussion generally supports this idea that there is an imperative to act in intervention of a wildly undesirable healthcare scenario. Thus, the nature of this legislation remains uncertain, and those who have desired the establishment of a public option and its promotion of social welfare goals may yet be bitterly disappointed. (MSNBC News Service,….

Works Cited:

Creer, T.L. (2009). Will Healthcare Reform Actually Occur in the U.S. Chronic Illness, 5(2), 134-141.

Cummings, J. (2006). About Half of U.S. Adults Lack Confidence inboth Democrats and Republicans to Do a Better Job of Addressing Healthcare

System Concerns. The Wall Street Journal. Online at .

Public Health There Are a

e can train our people, communicate with them, and ensure that they are performing correctly. There has to be an understanding that there are severe consequences for failing to ensure proper sterilization. This issue is one where I would want to guarantee 100% elimination of the problem at my facility. HIV and teenage pregnancy are relatively straightforward issues. e need to make sure our young people are equipped with knowledge and have access to contraceptives (Kirby, Laris & Rolleri, 2007). There is no point in putting them at risk to satisfy some busybody's need to tell others how to live. e need to combine our efforts with a massive education program, because these are lessons that young people need to know -- you cannot just turn back from either of these things. They are life-changing, and young people need to be aware of this. Lastly, automobiles are a real challenge. People….

Kirby, D, Laris, B., Rolleri, L. (2007). Sex and HIV education programs: Their impact on sexual behaviors of young people throughout the world. Journal of Adolescent Health. Vol. 40 (2007) 206-217.

Shils, M., Olson, J. & Shike, M. (1994). Modern nutrition in health and disease. Lea & Febiger: Philadelphia.

Public Health and Safety Effectiveness of Emergency

Public Health and Safety Effectiveness of Emergency Management and the eadiness of Trauma Centers Since massive terrorist attacks of September 11, 2001 and the anthrax scares in Washington, D.C. shortly thereafter, the effectiveness of emergency management responders and the readiness of emergency trauma centers have become national security issues. Unfortunately, the system is overburdened and may not be up to the challenge, possibly compromising the original mission for emergency rooms to provide adequate trauma care to local communities. The nation's emergency room system is inadequate to deal with a WMD or other massive attack in terms of both funding and equipment. In this research proposal, we will examine the need for examining why this is and what the federal government can do to remedy the need. Additionally, we need to find out to what extent federal efforts are succeeding and how and/or deficits with the federal efforts. Analysis/Literature eview-Crisis for Emergency Management in the Emergency….

Becker, S.M., & Middleton, S.A. (2008). Research improving hospital preparedness for radiological terrorism: Perspectives from emergency department physicians and nurses. Disaster Medicine and Public Health Preparedness, 2(3), 174-184.

Cherry, R.A., & Trainer, M. (2008). The current crisis in emergency care and the impact on disaster preparedness. BMC Emergency Medicine, 8(7), 1-7.

Reilly, M.J., Markenson, D., & DiMaggio, C. (2007). Comfort level of emergency medical service providers in responding to weapons of mass destruction events: Impact of training and equipment. Prehospital and Disaster Medicine, 22(4), 297-303.

Public Health in Tennessee in

Fact Sheet. Number of Deaths for Leading Cause of Death. December 31, 2009). For Tennessee the data indicate heart disease 14,636, cancer 13, 161, and stroke 3,450 (CDC. Tennessee Fact Sheet. November 9, 2010), yet it is heart disease which strikes the Tennessee population most egregiously. Coronary heart disease is caused by "the narrowing of the coronary arteries due to fatty build- ups of plaque" (American Heart Association. January 17, 2011) invariably leading to chest pain or heart attack (American Heart Association. January 17, 2011). Aside from the harsh statistical realities of deaths and disabilities caused by heart disease mentioned previously; the financial cost of coronary heart disease in "prevention and treatment is higher than for cancer or any other diagnostic group, an estimated $286 billion in 2007, according to the annual update from the American Heart Association" (ArticlesBase. December 24, 2010). Tennessee had "total charges associated with diseases….

Can you help me with essay topics related to public health and physical activity?

Physical activity plays such an important role in public health . It is especially important when a society has become sedentary, which applies to many of the industrialized societies around the globe.  It is not surprise, then, that public health efforts often focus on increasing daily movement as a way to help improve community health .

Possible research topics include:

• The relationship between green spaces like parks and walking trails with community levels of physical activity.
• The relationship between afterschool sports programs and physical activity for youth, and whether that relationship remains as people transition from youth into adulthood.

Need ideas for a Health Care Informatics Risk Assessment program.

A Health Care Informatics Risk Assessment is one of the tools used in healthcare management.  They examine workflow issues that have the ability of positively or negatively impacting several important factors, such as the quality of care, overhead costs, and overall efficiency.  One of the areas of health care that can benefit from a Health Care Informatics Risk Assessment program is telemedicine .   Another area of health care that could benefit from a Health Care Informatics Risk Assessment program is vaccine administration in large groups.

If the COVID-19 pandemic has any lasting impact on the provision of....

I need help with a topic sentence for my research paper on how would monitoring teens and their social media / device used decrease the rate and prevent teen suicide?

Teen suicide is a one of the biggest health threats to teens.  This may be due to many factors, such as the fact that teenage brains are not fully developed, hormone changes from puberty, teen vulnerability to child abuse or dating violence, or the fact that many mental illnesses begin to emerge in the teenage or young adult years.  Reducing the suicide rate among teens is a consistent public health goal, though there is no guaranteed intervention that will always lead to success.  With social media usage among teens changing the way that teens socialize, there is little....

I was looking for help in writing my learning outcomes for population health nursing clinical using bloom taxonomy.

Bloom’s taxonomy is a way of using three hierarchical models to classify learning objectives.  Bloom’s taxonomy breaks learning down into three broad models based on learning styles: cognitive, affective, and sensory.  It then further divides each of these three larger categories into smaller areas. The cognitive domain is divided into knowledge, comprehension, application, analysis, synthesis, and evaluation.  The affective domain is divided into receiving, responding, valuing, organizing, and characterizing.  The sensory domain is divided into perception, set, guided response, mechanism, complex overt response, adaptation, and origination. It can be helpful to keep these various....

Public Health Betrayals A fascinating reality of public health is that when it is working, nothing is happening. People are healthy, they participate in their community's welfare, and they themselves…

Research Paper

Health Care There are many things that have led to the renaissance of public health in the past 20 years. However, the most important ones include eradication of infectious diseases…

Public health emergency preparedness and response. Public health: Emergency preparedness and responses While all areas of the nation should periodically engage in risk assessment, not all locations are equally vulnerable to…

One of the most fascinating problems associated with the information age, is not the lack of information but the overabundance of information one can find on any given topic.…

Public Health esources 1• Information about country, state, and national public health resources Public health is the bigger science of protecting and improving the health of communities by providing services based…

Therefore environmental studies are of great importance to public health .the air we breathe, water that we drink, and the interaction which is complex between humans and the…

This is particularly so for traditionally disadvantaged communities. The involvement of academic institutions would mean a larger among of revenue in order to provide these communities with the…

Public Health How is public health financed in you state, povince, o county? How does the cuent budget cisis impact Public Health and Community sevices in you aea? The issue of…

These included natural disasters such as fires and sanitation related problems such as infant mortality rates. Over the years however, health services and technology have improved to the…

The two most important functions include the community Helpline and a five-year strategic plan for children and families. These functions culminate in assurance paradigms for the community, including five…

" (Federal egister, 2010) Incentive Payments Section 401(c) of the HITECH Act is reported to add an incentive for payments to specific Medicare Advantage (MA) organizations for their affiliated EPs who…

As the president works to pass what is most assuredly his most important legislative package to date, he is struggling against a great wall of opposition which appears to…

e can train our people, communicate with them, and ensure that they are performing correctly. There has to be an understanding that there are severe consequences for failing…

Public Health and Safety Effectiveness of Emergency Management and the eadiness of Trauma Centers Since massive terrorist attacks of September 11, 2001 and the anthrax scares in Washington, D.C. shortly thereafter,…

Fact Sheet. Number of Deaths for Leading Cause of Death. December 31, 2009). For Tennessee the data indicate heart disease 14,636, cancer 13, 161, and stroke 3,450 (CDC.…

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Strengthening the basics: public health responses to prevent the next pandemic

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• Peer review
• Victoria Haldane , researcher 1 ,
• Anne-Sophie Jung , research fellow 2 ,
• Chuan De Foo , research associate 3 ,
• Mathias Bonk , secretariat member 6 ,
• Margaret Jamieson , researcher 1 ,
• Shishi Wu , research fellow 5 ,
• Monica Verma , research associate 3 ,
• Salma M Abdalla , research fellow 6 7 ,
• Sudhvir Singh , adviser, honorary academic 6 8 ,
• Anders Nordström , head of the secretariat 6 ,
• Helena Legido-Quigley , associate professor 2 3 6
• 1 Institute of Health Policy, Management and Evaluation, University of Toronto, Canada
• 2 London School of Hygiene and Tropical Medicine, UK
• 3 Saw Swee Hock School of Public Health, Singapore
• 4 Johns Hopkins Bloomberg School of Public Health, USA
• 5 Dalla Lana School of Public Health, University of Toronto, Canada
• 6 Independent Panel for Pandemic Preparedness and Response Secretariat
• 7 School of Public Health, Boston University, USA
• 8 Faculty of Medical and Health Sciences, University of Auckland, New Zealand
• Correspondence to: V Haldane v.haldane{at}mail.utoronto.ca

Victoria Haldane and colleagues argue that to make covid-19 the last pandemic, public health responses to outbreaks must be strengthened, starting with their most basic functions

The covid-19 pandemic has challenged countries to mount and sustain comprehensive public health responses that identify and control an emerging infectious hazard. These challenges have persisted into 2021 and likely well beyond. Countries continue to grapple with the intersecting impact of ongoing outbreaks, inequitable vaccination, weak public health systems, inadequate social support, and variable political leadership. The unprecedented scale and duration of the pandemic have rightly raised questions as to what makes a robust and sustainable public health response. The answers to these questions become ever more pressing and complex as we enter the third year of the pandemic. Here, we reflect on three key questions: What are the basics of a public health response? How can these be strengthened for better pandemic preparedness and response? What is the way forward?

What are the basics of a public health response?

The basics of public health during infectious disease outbreaks aim to identify the pathogen and those exposed to it, monitor spread in the community, break chains of transmission, and communicate risk to the public. 1 Public health activities, particularly those embedded within routine health service delivery, are crucial to identifying signals, such as unusual disease, that indicate an emerging outbreak. 2 Once an unusual disease is detected and an outbreak confirmed, core public health functions operate to identify individuals and their contacts and break chains of transmission in communities.

Ongoing surveillance is foundational to understanding disease transmission and guide decision making. Comprehensive surveillance, including genomic surveillance, is reliant on accurate and timely testing to identify whether a person is, or has been, infected and to shed light on changes in the pathogen, drivers of infections, and their distribution across different populations. 3 4 Contact tracing, both forwards to identify exposures and backwards to identify sources, is equally important in breaking chains of transmission. 5 6 Once individuals are identified, quarantine restricts the movement of their close contacts and separates them from non-contacts to prevent new cases. Supporting contact quarantine and case isolation is often a weak link in public health functions, and social and financial supports should be in place to ensure people are able to complete their quarantine or isolation period.

These functions are interrelated and dependent on systems and infrastructures to ensure their maintenance and sustainability. For example, surveillance systems rely on laboratory systems to process diagnostic tests, the necessary skilled laboratory workforce, supplies and equipment to process tests, and mechanisms to communicate timely results. 7 Core to such systems is a trained and protected health workforce able to reach even the most marginalised communities. Public health functions and systems are underpinned by public health and social measures, such as mask wearing, limits on gathering, and school or workplace closures, as well as social and financial support, such as paid sick days and debt relief, that encourage adherence. 8 9

The public health response to an emerging outbreak should be grounded in a protection of human rights with proactive and ongoing community engagement and risk communication. Individuals and community groups should be proactively involved in shared decision making to develop and sustain effective public health responses and accountability. 10 Equally important is to recognise that public health —from response financing to the laboratories on the ground—is underpinned by geopolitics and global and local political decision making. These are crucial to the successes and failures of public health.

How can we strengthen public health responses?

Effective public health systems are those that strengthen the basics to be localised, responsive, integrated, and equitable ( fig 1 ).

Strengthening public health responses to infectious hazards

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Localised: engaging communities to develop and sustain responses

Community engagement and local capacity building must be central to developing and implementing public health responses to outbreaks. 11 Yet when considering the responses to covid-19, national efforts have often been disconnected from local needs, for both logistical and political reasons. Additionally, local public health efforts have failed many communities, hindered by inadequate financial and material support for pandemic preparedness. 12 Countries can strengthen and tailor risk communication by building on existing community engaged programmes, such as community health workers or youth led programmes, and by monitoring and acting on public opinion and feedback. 13 Yet deliberative spaces for community and civil society engagement must be sustainably incorporated through structures allowing for regular and routine consultation about the development, implementation, and evaluation of public health activities during emergencies. 11

Creating spaces for community representation and civil society engagement is an essential basis for accountability in public health responses. Consideration must be given to equitable representation, whereby those who are often silenced or not given a voice because of their political status (eg, unregistered migrants) or societal status (eg, women, LGBTQ+) must be included and represented in debates. Consultation must take place without fear of stigmatisation or prosecution, which might prove challenging in many countries. Importantly, these spaces must be accessible, and governments must ensure communication channels are available. This includes, for example, counteracting language barriers when communicating with migrant groups. While involving the most marginalised in every aspect of pandemic response is key, representation is highly political and sensitive to misuse. Questions must be asked around how specific groups can be safely reached and represented.

Responsive: supporting the public health workforce

Localised capacity building must extend to the public health workforce to ensure a system is responsive to the evolving epidemiological situation. Frontline public health workers must be trained and retained before, during, and after emergencies. 14 During the covid-19 pandemic, several countries, including the UK and US, have relied on insufficiently trained contract staff for contact tracing. Expanding health workforce capacities should be coupled with training to ensure high quality public health activities. Importantly, the public health workforce should reflect the communities in which they work, including a diversity of ethnic, linguistic, class, and gender representation. Longstanding challenges, including tokenisation, barriers to training, and limited mentorship, must be dealt with to capacity build emerging public health workers. 15 The public health workforce must also collaborate to achieve response goals and reach all communities by leveraging on “task shifting,” which has increased during the pandemic as those best placed to complete a task are the ones who do it. 16

The public health workforce must be supported by systems that span healthcare, laboratory, surveillance, and social functions. Systems must be responsive enough to scale up and meet the demands of outbreaks while linking across sub-national regions and feeding national and global monitoring systems. Public health authorities and governments should conduct routine evaluations of their capacities. Many countries, however, missed the opportunity to prepare for public health emergencies, as highlighted by the lack of country engagement in the joint external evaluation as called for by the International Health Regulations (2005). 17 18 Concerningly, in many countries recommendations for pandemic preparedness were not implemented before 2020 and remain inadequately responsive. 19 20

Integrated: supporting sustained responses

Covid-19 has also highlighted the lack of integration between systems, which ultimately limits our ability to prevent cases from becoming outbreaks. Systems equipped to process diagnostic tests—laboratory networks staffed by a skilled laboratory workforce, supplied with reagents and equipment to process tests, and with mechanisms to communicate timely resultsare key to an integrated outbreak response and provide crucial information to understand the epidemiological situation. 7 In response to covid-19, countries expanded surveillance through active approaches, leveraging existing systems for influenza or other pathogens, and legislated mandatory covid-19 case reporting to a national level health agency. Covid-19 has also seen digital technology used on an unprecedented scale for timely gathering and sharing of surveillance data to detect outbreaks, identify changes in epidemiological trends, and plan public health responses. 21 Although in most countries covid-19 surveillance has largely been managed by the public health sector, intersectoral collaboration has spurred the use of data collected outside healthcare settings—for example, through apps or mobility data. Surveillance and health data collection are not unproblematic: ethical considerations must be given to understand what is being measured, who is rendered visible and invisible, and to what effect or consequence. 22

Public health must also be supported by functioning and equitable supply chains and delivery systems. The first year of the pandemic highlighted how resource constraints, inequitable access to supplies, and corruption hinder crucial public health activities. 23 24 Supply shortages disproportionately impacted low and middle income countries, which were further challenged by insufficient technical and digital infrastructures requiring rapid scale-up. 25 In 2020, and now, countries of the Global South have been left unable to access supplies, including vaccines, relative to countries of the Global North. COVAX was hailed as the first step in the right direction to counteract some of these inequalities. However, instead of systematic change to tackle longstanding inequitable global distribution of medical technologies, COVAX has become a charitable project or even a smokescreen to distract from more substantial reform. 26 Systems integration that overcomes inequities in word and deed must make a concerted effort to prioritise local needs, even in the most marginalised communities.

Equitable: centring on human rights and community engagement

Deepening inequities are a hallmark of the covid-19 pandemic, with public health functions and public policy efforts disproportionately impacting those most vulnerable. 27 Public health responses must uphold privacy, equity, and human rights. National and global covid-19 responses have exposed the fault line between health interventions and health and wellbeing for all. 28 29 Public health programmes have historically underserved, and in some cases harmed, those most vulnerable, and they continue to do so with little reparation. 30 Covid-19 is a case in point, where the burden has fallen most heavily on already disadvantaged and vulnerable populations. Public health measures bear challenges within but also between countries: with the rapid scale-up of responses, especially digital health technologies and border closures, the human rights aspect that must be an integral part of all public health measures has often been an afterthought. 31 Consequently, public health measures should prioritise both stopping transmission and mitigating the effects of the policies.

What is the way forward?

The challenges amplified by covid-19 have persisted into 2021 and will continue. New questions are being raised as a variety of vaccines, used in different regimens across populations, and unclear guidance on what public health measures apply to whom and in what circumstances converge to accelerate the need for effective public health. The recommendations we offer are based on our analysis of national responses during the first year of the pandemic, but are equally important as countries transition to endemicity and in countries that have lower vaccination rates or natural immunity ( box 1 ). 32

Recommendations towards comprehensive public health systems

Invest in the frontline public health workforce to be able to detect and rapidly respond to emerging outbreaks.

Strengthen public health systems at the local level that can be rapidly scaled up when needed and are integrated with the health system and social services.

Prioritise rapid deployment of core public health functions—surveillance, testing, contact tracing, and quarantine—and ensure equitable access to supplies.

Ensure all public health efforts are developed, implemented, and evaluated in partnership with communities, including oppressed and marginalised groups.

Uphold privacy, equity, and human rights in all public health activities.

We must invest in fast acting and scalable public health systems in communities. This requires a frontline public health workforce capable of rapid response to emerging outbreaks and able to scale up and integrate with health and social systems. To prevent emerging outbreaks from becoming pandemics, core public health functions must be prioritised for rapid deployment, able to surge and with adequate and equitable access to resources and supplies necessary to safely conduct public health work. Public health must actively engage with communities, including the most marginalised, to develop, implement, and evaluate interventions. For these actions to be meaningful, public health must acknowledge its carceral history and uphold privacy, equity, and human rights in all response efforts.

These recommendations are not new, and since its emergence SARS-CoV-2 has consistently laid bare our broken and underfunded public health systems. Widespread community transmission, strained healthcare systems, depleted health workforces, and the devastating global loss of life are the consequences of public health systems not able to fully execute core functions in detecting and responding to outbreaks. Longstanding political and financial neglect to build local public health capacity and meet local needs has left the world vulnerable to infectious hazards both known and unknown.

As we enter the third year of the pandemic, we know that leaders must strengthen the basics of public health. The work ahead is to ensure that political will supports the basics and realises localised, responsive, integrated, and equitable public health systems. Crucial to this is to understand how countries can be encouraged to commit to the set of recommendations necessary to safeguard health and wellbeing in communities before, during, and after pandemics.

Key messages

The covid-19 response has been dominated by public policies to reduce transmission, underpinned by crucial public health functions including surveillance, testing, contact tracing, and quarantine.

Public health responses to pandemics must be people centred, include core public health functions with effective systems, and have complementary public policies and social supports able to rapidly scale up.

Public health must strengthen the basics and acknowledge that current failures are the result of broken and underfunded public health systems. We must redefine public health to be more than public policies, but a robust community led effort to detect and suppress emerging outbreaks.

Contributors and sources:This analysis was part of the work commissioned by the Independent Panel for Pandemic Preparedness and Response, which reviewed the national responses of 28 countries. Data used for the analysis were collected through literature review of peer reviewed papers, policy documents, public reports, and articles that examined national and sub-national policy response; semi-structured interviews with country experts; national government written submissions of selected countries about measures implemented to contain covid-19; and validation of country specific data by experts through written consultation and roundtable discussion The analysis is separate from the independent panel’s final report and has been facilitated by the independent panel secretariat. The views expressed are those of the authors and do not represent the views of the Independent Panel for Pandemic Preparedness and Response. VH, A-SJ, and HL-Q conceived and designed the paper. VH, A-SJ, CDF, RN, SA, MJ, MMJT, SW, AC, MV, PS, SMT, and HL-Q collected the data. VH, A-SJ, CDF, SW, and HL-Q analysed the data and drafted the manuscript with input from all authors. All authors contributed to revising the manuscript.

Competing interests: We have read and understood BMJ policy on declaration of interests and have no interests to declare. The secretariat of the Independent Panel for Pandemic Preparedness and Response is independent.

Provenance and peer review: Commissioned; externally peer reviewed.

This collection of articles was proposed by The Independent Panel for Pandemic Preparedness and Response. Open access fees were funded by WHO and Singapore's National Medical Research Council (NMRC/CG/C026/2017_NUHS).  The BMJ  commissioned, peer reviewed, edited, and made the decision to publish these articles. Kamran Abbasi was the lead editor for  The BMJ

This is an Open Access article distributed under the terms of the Creative Commons Attribution IGO License (https://creativecommons.org/licenses/by-nc/3.0/igo/), which permits use, distribution, and reproduction for non-commercial purposes in any medium, provided the original work is properly cited.

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Eyes wide open: an essay on developing an engaged awareness in global medicine and public health

William b ventres.

1 Institute for Studies in History, Anthropology, and Archeology, University of El Salvador, Urbanización Buenos Aires III, Block H, Calle Los Maquilishuat N° 3-A, San Salvador, El Salvador

2 Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA

Meredith P Fort

3 Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala

Associated Data

There is a growing understanding of the role social determinants such as poverty, gender discrimination, racial prejudice, and economic inequality play on health and illness. While these determinants and effects may be challenging to identify in parts of high-income countries, they are patently obvious in many other areas of the world. How we react to these determinants and effects depends on what historical, cultural, ideological, and psychological characteristics we bring to our encounters with inequity, as well as how our feelings and thoughts inform our values and actions.

To address these issues, we share a series of questions we have asked ourselves¿United States¿ citizens with experience living and working in Central America¿in relation to our encounters with inequity. We offer a conceptual framework for contemplating responses in hopes of promoting among educators and practitioners in medicine and public health an engaged awareness of how our every day work either perpetuates or breaks down barriers of social difference. We review key moments in our own experiences as global health practitioners to provide context for these questions.

Introspective reflection can help professionals in global medicine and public health recognize the dynamic roles that they play in the world. Such reflection can bring us closer to appreciating the forces that have worked both for and in opposition to global health, human rights, and well-being. It can help us recognize how place, time, environment, and context form the social determination of health. It is from this holistic perspective of social relations that we can work to effect fair, equitable, and protective environments as they relate to global medicine and public health.

The influence of social determinants on global health has been well documented [ 1 ],[ 2 ]. Poverty, gender discrimination, racial prejudice, and economic inequality are four of many determinants that put people at risk for poor health-related outcomes [ 3 ]. Throughout the world, the ¿have nots¿ struggle to acquire and benefit from the same things that keep the ¿haves¿ healthier, including access to potable water, opportunities for dignified work, and the right to decent education and reasonable medical care [ 1 ],[ 4 ]. For some, this situation reflects structural violence: a normalized albeit almost invisible state of social injustice inherent in the organization and governance of both public and private institutions [ 5 ]. For others, it is business as usual: there have been winners and losers for centuries all around the world [ 6 ],[ 7 ].

What is new, at least in the collective consciousness of medicine and public health, is an emergent understanding of both the roles these determinants play and the dimensions of their effects [ 8 ],[ 9 ]. This understanding is in part due to a mounting sense of shared vulnerability [ 10 ]; infectious diseases such as HIV/AIDS, SARS, Ebola, and dengue fever cross international borders and threaten people in low- and high-income countries alike [ 11 ]. It is due to a growing attention given to the cross-national migration of capital, people, and products (as well as their means of production) [ 12 ]¿[ 14 ]. It is due to a conviction that the world is an ever-smaller place because of increasing population density, rising rates of international migration, and the rapidly accelerating pace of information transfer [ 4 ].

Social determinants of health and their effects are patently evident in places such as El Salvador and Guatemala, where we¿the authors, both United States¿ citizens¿live and work. In these two countries, as in many other low- and middle-income countries, vast wealth and miserable poverty literally collide: high-class condominiums and boutique shops face newly renovated roads while corrugated tin shacks fill in the neglected areas that line their backyards. One cannot help but see the stark consequences of these troubling realities.

However, what seems not so evident is the process by which we as medical and public health professionals from high-income countries incorporate such observations into our consciousnesses [ 15 ].

How do we comprehend differences between what we are accustomed to in our countries of origin and what we see in other places around the world?

What do we make of the immense divisions that exist between and within societies?

How is it that we open ourselves to hear the stories born of these divisions, and how do we integrate them into our daily lives and personal histories?

Why is it that some can see, reflect on, and address the causes and consequences of social determinants, while others cannot or choose not to do so?

How each of us perceives, explores, and acts upon social determinants and health disparities depends on many factors, including historical, cultural, ideological, and psychological characteristics, along with other influences such as ethnic heritages, professional socializations, and families of origin [ 16 ]¿[ 18 ]. Our cultural and social baggage shapes how we view and understand the problems we see; it also guides whether and how we choose to address them. Regardless of whether we are new to the field of global health or old hands in its study, teaching, and practice, our willingness to witness and attend to issues of social determinants and health disparities depends on our ability to ask deep and thought-provoking questions.

In this article, we share questions we have asked ourselves in the face of obvious inequity, and review, in two short vignettes, key moments in the development of our self-awarenesses. We share these questions and vignettes to model our own processes of reflection. We do so hoping that global health professionals might become more conscious of the burdensome realities of social determinants and their consequences. We do so, as well, hoping that global health professionals, especially those from high-income countries, might begin to examine thoughtfully how their every day work either perpetuates or breaks down barriers of social difference. We believe such examination can enhance capacities to work toward ameliorating inequities in ways that are supportive, sustainable, and satisfying.

Asking questions in global health education and practice

Common questions can be asked of all those engaging in the work of global medicine and public health.

What are our interests in and motivations for exploring beyond the relatively comfortable boundaries of training and practice at home?

What are our preconceptions built from personal and professional history, previous socialization, and sense of self in relationship to others?

How do we recognize our preconceptions when confronting that which is new and different?

How do we manage these preconceptions when working with peers in low-resource settings?

Do our cultural upbringings enable or inhibit us from seeing underlying social factors that contribute to poor health?

Both at work and in our home communities, how can we productively contribute to minimize community-level health disparities?

Much, too, depends on how we experience our responses in the face of social determinants and social inequities.

Do we sense fear or anxiety in ourselves?

Are we profoundly shocked, indignantly outraged, merely uncomfortable, or at ease with it all?

Is anger mixed in, or pity, or rejection, or any one of numerous other possible feelings?

Are we even aware of our emotional responses? How do we balance the clinical detachment of our professional socializations and the profound need for empathy in times of suffering?

Alternatively, are we simply overwhelmed by encounters with social problems and thus not able to absorb the cognitive and emotional confusion that often accompanies witnessing them?

If we see work in global health as a reciprocal undertaking, one in which we both give and receive, teach and learn, nurture and grow¿and we acknowledge that not all share our view in this regard¿can we sense our interconnectedness with the workings of the world around us?

Cultivating a personal consciousness

Our responses in turn depend on how feelings and thoughts inform our values. Each of us enters into global health work holding ingrained values based on previous experiences. It would be unusual were we not to challenge our values in the face of new wisdom gained from the voices, words, and actions we hear, read, and see in our ventures domestically and abroad. It would be surprising to see people living in situations vastly different than those which we are accustomed to and not expect some change in these values. It would be an opportunity missed were such experiences not to enhance our capacities to act with authenticity and integrity.

We believe that understanding and addressing the social determinants of health and health disparities starts by contemplating questions such as those above. We encourage practitioners, educators, and learners in public health and medicine to ask these questions of themselves and reflect on them before, during, and after global work experiences. Only by opening ourselves to such self-dialogue can we develop abilities to see others from positions of equity and solidarity, rather than from dominance and exploitation. Only by probing deeply into our own personal consciousnesses can we know others as real people living in real situations, rather than as intellectualized variables in uncontrolled environments. Only by examining individual presences relative to the much larger political, economic, ideological, and social forces (many of which have created environments that frame the very problems we aim to eliminate) can we effectively address pressing issues of disease management [ 19 ]. Even if we enter into our global health endeavors with good intentions¿and we are inclined to believe that few in the healing professions do not¿by avoiding such introspection we limit our capacity to see and understand, with eyes and minds wide open, the reality and meaning of life concerns as they are seen from perspectives of those who are foreign to us.

Developing an introspective gaze in global health

What new understandings might such an introspective gaze offer us? First, we believe such a gaze helps us assume postures of inquiry rather than expertise. Regardless of what knowledge we might already possess, we also have much to learn by asking, questioning, and wondering. Such a gaze allows us to begin by scratching our heads, with interest in discovery and intention to comprehend, before contemplating physical diagnosis or program implementation [ 20 ]. Demonstrating a humble curiosity¿defining humble as respectfulness not subservience, and curiosity as genuine concern not academic nosiness¿broadens our outlooks beyond comfort zones based on professional status or sphere of knowledge [ 21 ],[ 22 ]. It improves our skills in crossing borders of culture and class. It enhances our abilities to learn from the lived experiences of colleagues, friends, and scholars (Additional file 1 : Personal Vignette 1).

Second, an introspective gaze helps us see our place as participants in systems that extend across dimensions of time, ethos, politics, and geography [ 23 ]. As global health professionals, our work inevitably touches on contextual issues such as culture, history, power, and ideology [ 24 ]. This does not mean we are complicit in the wrongs of the world or support the collateral damage that results in the wake of many policies. It does mean we are all actors on the set, whether with speaking roles or simply standing by as extras. The recognition of our presence in these complex systems can help us judge our capacities for innovation, collaboration, and action accurately and reliably. Specifically, the work we choose and the way we choose to do it helps us either break or recreate historically produced patterns of inequity.

Third, this gaze helps us perceive how we bring to our interactions something uniquely ours, and how each of us reciprocally shares our unique nature with others. Through this process, our relationships with others become less ¿us and them¿ and more ¿we¿ [ 25 ]. We see how interdependent our lives are. We share common wounds and resiliencies, even as their depths and extents may vary. We share similar hopes and dreams, even as their expressions may be remarkably different. We share capacities for growth and intimacy, as well as the reality that both joy and tragedy will assuredly touch all our lives (Additional file 1 : Personal Vignette 2).

Fourth, it helps us keep aware of where we have been, literally and figuratively, in our personal and professional journeys. Working as professionals in global health, we become increasingly cognizant that concepts like core and periphery, dominant and subservient discourses, and oppression and marginalization are not just matters that exist elsewhere [ 24 ],[ 26 ]. They exist everywhere [ 27 ]¿[ 29 ]. With this awareness comes the conceptual realization that local and global are not so far apart: there is work to be done in both locales [ 30 ],[ 31 ].

Fifth, an introspective gaze helps us appreciate our potential to act as change agents. It helps us hear and cultivate our own voices as advocates at the same time we hear and cultivate the voices of others. At a time when many are calling for reform in the delivery of medical care around the world [ 32 ],[ 33 ], it helps us develop resiliency in the face of political resistance to innovation [ 34 ]¿[ 37 ]. It helps us balance empathy, understanding, and action in our work as global health professionals.

Finally, such a gaze helps us recognize the dynamic role that each of us plays in the world. This role is not simply about examining and attending to social determinants or their end results; it is about understanding forces that work both for and against health and well-being, molding conceptions of place, time, nature, and people¿including ourselves¿into an integral notion of the social determination of health. Social determination of health is a framework, born of Latin American scholarship, that has shaped how we approach our work in global health [ 38 ],[ 39 ]. In particular, it has informed our belief that the establishment of fair, equitable, and protective health environments comes through a collective construction of profound social awareness, one in which each of us recognizes that our everyday actions can either promote or inhibit social equity.

As we work to ameliorate inequities and improve health outcomes, we as educators and practitioners in global medicine and public health confront many challenges. Among them are unconscious assumptions that can blind us to the realities of others¿ suffering and limit the breadth of our personal visions. Among them are learned convictions that may hinder our abilities to perceive those things that bind us together rather than rip us apart. Among them, as well, is the ordeal of staying motivated so as not to become indifferent in the face of ongoing daily frustrations.

Wherever we may be, amidst these challenges, lies a place between self, others, and the larger geopolitical world where differences are recognized and commonalities explored. This is the terrain¿between individual and community, between particularized ego and collective consciousness, between local and global¿upon which we can learn to grow in a wisdom co-created from shared experience. This is the fertile ground on which we can nurture an engaged awareness in global health, one that promotes personal reflection, social consciousness, and communal action in efforts to acknowledge the effects of social determinants and improve health outcomes around the world.

Competing interests

The authors declare that they have no competing interests.

Authors¿ contributions

WBV and MPF jointly conceived of this essay, participated in its design, and contributed to its writing. Both authors read and approved the final manuscript.

Authors¿ information

WBV is a family physician and medical anthropologist. He is a Research Associate at the Institute for Studies in History, Anthropology, and Archeology at the University of El Salvador. Besides qualitative research in public health and bioethics, his interests lie in physician-patient communication and the global development of primary care. MPF is a public health practitioner and researcher with over fifteen years experience in Central America. She is an Affiliate Researcher at the Institute of Nutrition of Central America and Panama in Guatemala City, where she recently completed a post-doctoral fellowship on the evaluation of chronic disease interventions. She is an advocate for just development policies including the promotion of primary health care and access to essential services.

Additional file

Supplementary material.

Personal Vignettes. Personal Vignette 1: Connected in El Salvador. Personal Vignette 2: Inequity at a Guatemalan intersection.

Acknowledgements

The authors thank Robert Taylor, MD, and Christopher Morley, PhD, for their helpful comments on previous drafts of this essay. During the writing of this essay, WBV was a Senior Fulbright Scholar and received funding from the Fulbright Commission of the United States Department of State; MPF was a Post-Doctoral Fogarty/NIH International Clinical Research Fellow and received funding from the Fogarty International Center of the National Institutes of Health. The authors very much appreciate this financial support. None of the funding institutions had any role in the preparation, review, or approval of the manuscript. The views expressed in this commentary are those of the authors and do not reflect those of any institution.

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Eyes wide open: an essay on developing an engaged awareness in global medicine and public health

Affiliations.

• 1 Institute for Studies in History, Anthropology, and Archeology, University of El Salvador, Urbanización Buenos Aires III, Block H, Calle Los Maquilishuat N° 3-A, San Salvador, El Salvador. [email protected].
• 2 Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA. [email protected].
• 3 Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala. [email protected].
• PMID: 25346040
• PMCID: PMC4422227
• DOI: 10.1186/s12914-014-0029-4

Background: There is a growing understanding of the role social determinants such as poverty, gender discrimination, racial prejudice, and economic inequality play on health and illness. While these determinants and effects may be challenging to identify in parts of high-income countries, they are patently obvious in many other areas of the world. How we react to these determinants and effects depends on what historical, cultural, ideological, and psychological characteristics we bring to our encounters with inequity, as well as how our feelings and thoughts inform our values and actions.

Discussion: To address these issues, we share a series of questions we have asked ourselves-United States' citizens with experience living and working in Central America-in relation to our encounters with inequity. We offer a conceptual framework for contemplating responses in hopes of promoting among educators and practitioners in medicine and public health an engaged awareness of how our every day work either perpetuates or breaks down barriers of social difference. We review key moments in our own experiences as global health practitioners to provide context for these questions. Introspective reflection can help professionals in global medicine and public health recognize the dynamic roles that they play in the world. Such reflection can bring us closer to appreciating the forces that have worked both for and in opposition to global health, human rights, and well-being. It can help us recognize how place, time, environment, and context form the social determination of health. It is from this holistic perspective of social relations that we can work to effect fair, equitable, and protective environments as they relate to global medicine and public health.

Publication types

• Research Support, N.I.H., Extramural
• Research Support, U.S. Gov't, Non-P.H.S.
• Central America
• Education, Medical
• General Practice*
• Global Health*
• International Cooperation*
• Public Health*
• Social Determinants of Health*
• Social Responsibility*
• Socioeconomic Factors
• United States

Home Essay Examples Health Health Promotion

Health Promotion & Public Health

• Category Health
• Subcategory Health Care
• Topic Health Promotion

Introduction

The aim of this essay is to discuss the public health issue of adverse childhood experiences and mental health in adults which affects individuals/communities in the author’s field of practice. The Mental Health Foundation (2016), states that around £600 million is invested in mental health services a year in Wales, which is more than any other service in the NHS. It is crucial to help minimise these figures by ensuring that proactive interventions are accessible to children to help prevent mental health issues from occurring before they develop during adulthood. It is important to remember, however, that preventive measures can be used to help encourage people to remain healthy with and without mental health concerns.

A survey conducted by Karen Hughes et al. (2016) comparing the relationship between adverse childhood experiences (ACEs) and mental health shows solid, increasing correlations between the number of ACE participants identified and mental disease, with the proportions reporting each result growing with ACE counts. A Welsh ACE study conducted by Mark Bellis et al. (2016), suggests that children who experience traumatic and low-quality childhoods are more likely to take up long-term health habits during puberty and adulthood, which can lead to mental health disorders.

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According to Thornbory, G. (2013) “Public Health aims at preventing health problems before they occur and focuses on populations rather than individuals.” For example, an age group or social class. Furthermore, health promotion and public health are closely linked as health promotion is seen as giving people the information they need or tools to enhance their health. As well as developing the skills and capacities of the individuals, it can also include changing the social and environmental surroundings and health impact structures (National Institute for Health and Care Excellence NICE, (2020). The Royal College of Nursing ( RCN, 2020) believes that the emphasis should be on nursing to alleviate the impact of the illness, encourage well-being and help patients succeed at home, at work, and at leisure. There are resources for improving mental health and building resilience as clinicians care for patients and families at life-changing events or with chronic health problems (Steve Thomas et al. 2016).

This essay will address an overview of the public health issue chosen using supporting epidemiological data such as the identification of people at risk and the most effective intervention methods to help promote health and well-being. Furthermore, at least two identified environmental and socioeconomic factors will be discussed in detail followed by two supporting policies that are being used to help prevent the public health issue. Lastly, consider the particular role of the nurse both in the use of relevant public health / health promotion initiatives and in working relationships where relevant.

Epidemiology

This topic was chosen because it is an important public health issue that needs to be challenged in order to diminish the number of people experiencing mental health issues during adulthood. This is due to the lack of support during childhood to deal with ACE events. The higher exposure someone has from ACE; the worse their health and well-being as an adult is affected. If children were provided with the resources through health promotion to help reduce the effects of toxic stress connected to ACE’s for example, sexual abuse or domestic violence within the family environment, they may be able to build resilience for later on in life (Karen Hughes et al. 2018). Actions to avoid and reduce ACEs and their long-term side effects are necessary to enhance population health for present and future generations (Bethell et al 2017). According to a Welsh ACE study from 2016, 47% of adults in Wales suffered at least one ACE during their childhood and 14% suffered 4 or more (Kathryn et al.2018). The most common ACE for maltreatment was verbal abuse at 23% and the most common childhood household was parental separation at 20%. The prevalence of individuals participating in health-harming behaviours and reporting low mental well-being as adults increased with the number of ACEs experienced. Additionally, individuals living in the most deprived areas of Wales were also more likely to encounter poor mental well-being relative to those residing in more prosperous areas after accounting for conflicting demographic and other variables, for example, ACE count.

A second study that shows the estimate of health and financial burden of ACEs in England and Wales calculated that the greatest ACE-attributable costs were for mental illness (anxiety, depression and other mental illness; England and Wales, £11.2 billion) and cancer (£7.9 billion) (Karen Hughes et al. (2020). In order to lower these statistics, there needs to be health promotion approaches put in place to promote protective factors and increase resilience. In addition, chronic ACE exposure can influence the development of the neurological, immunological, and hormonal systems. As a result, individuals who are subjected to such experiences during childhood can develop emotional control, cognitive reaction, attachment, memory, and learning difficulties that can persist throughout adult life (Hughes K et al. (2020).

Market al. 2015 believes that experiencing ACEs means that people are more likely to perform poorly at school, are more likely to participate in crime and consequently are less likely to be productive member of society. Such a cycle of childhood deprivation will force generations of successive family members into poor health and anti-social behaviour. However, avoiding ACEs in a single generation or that their impacts will help these children as well as future generations in Wales too.

Contributing factors

Though there are a number of different factors underlying how ACEs affect mental health in adult life, the main causes are socioeconomic and environmental. According to Mark Bellis et al. 2015, children who experience stressful and poor quality childhoods are more likely to adopt health-harming behaviours during adolescence which can themselves lead to mental health illnesses and diseases such as cancer, heart disease, and diabetes later in life. This could involve a child being exposed to domestic violence within the household and as a result, engage in substance misuse as a coping mechanism. Poole, Dobson & Pusch (2017) describe ACEs useful from a public health perspective to explain the need to act on diverse social structures to avoid population-level health inequalities.

Evans and Schamberg 2011 (as cited in Braveman & Gottlieb 2014) it has been shown that the correlation between childhood poverty period and adult cognitive function tends to be explained not only by poverty-related material deficiencies but also by persistent childhood stress. Children growing up in socio-economic deprived communities face greater direct physical barriers to health status and health-promoting behaviours; they often encounter social and psychological stressors, such as family tension and uncertainty resulting from chronically insufficient services. Another public health problem is the so-called ‘lifestyle drift,’ i.e. the propensity for policy proposals to tackle health disparities to start with a wide awareness of the need to take action on the larger (upstream) social determinants of health, but then drift downstream to concentrate solely on individual lifestyle factors during their implementation (Hunter et al. 2009).

Children’s Commissioner for Wales (2018) discovered that many children who have experienced ACEs will feel particularly powerless. Children need to experience their rights (e.g. being cared for, listened to, kept safe) in order to be able to take them up. Therefore, empowerment means ensuring that children are equipped with the skills and experience to be able to confidently take up their rights.

Supporting policies

The Well-being of Future Generations Act requires public bodies in Wales to think about the long-term impact of their decisions, to work better with people, communities, and each other, and to prevent persistent problems such as poverty, health inequalities, and climate change.

‘A Children’s Rights Approach’ can give coherence and strength to Wales’ approach to ACEs.

Action to tackle health inequalities is therefore embedded into policies and initiatives across the whole of Welsh Government through a ‘Health in All Policies approach. Tackling the link between poverty and poor health is a key feature of a range of commitments including employment programmes, fair work, quality housing, and access to childcare.

Role of the Nurse

Partnership working is well embedded in health policy and guidelines. The RCN (2020) believes that nursing skills are rightly valued as being able to provide meaningful public health interventions across all health and social care settings as part of holistic patient-centred care. From a professional perspective, the Code requires registered nurses to ‘prioritise people’ setting out that nurses must ‘listen to people and respond to their preferences and concerns and to achieve this you must: ‘work in partnership with people to make sure you deliver care effectively’ (Nursing and Midwifery Council [NMC] 2018). Overall, partnership working is a clear expectation for nurses but the meaning of partnership in the context of nursing practice is less explored.

The term ‘partnership’ is commonly used in healthcare, often in relation to interprofessional working or collaborations between different organisations. Health visitors in Wales collaborate with family members to achieve these targets, measure resilience, and offer resources to meet their needs. While no neighbourhoods should be considered free of ACEs, there is a greater likelihood that those living in areas of deprivation will experience multiple ACEs.

Health visitors in Wales work in partnership with families to meet these goals, assess resilience and provide support to meet their needs. While no communities should be considered free from ACEs, those living in areas of deprivation are at greater risk of experiencing multiple ACEs. In Wales, this is being addressed through Tackling Poverty Programmes such as Flying Start; Families First and Communities. These programmes are targeted at the most deprived communities in Wales. To be competent in delivering all aspects of the nursing process, nurses must have the core skill of effective communication in order to communicate directly and consistently with the service user and their families to meet their care needs.

According to the NMC (2015), a nurse must use a range of communication skills and technologies to support person-centred care and enhance quality and safety. A study to support this is one conducted by Vahdat, Hamzehgardeshi, Hessam, & Hamzehgardeshi, (2014) found that patient participation in health care decisions is a sign of valuing humanity and individuality of the patient. Therefore, planning and providing patient-oriented healthcare, based on the needs and preferences of patients are recommended.

The strong relationships between ACEs and mental illness indicate how important preventing ACEs and supporting those affected by them is in improving population mental health. Despite this, studies also suggest that most people who access mental health services are never asked about child abuse or neglect (Read et al, 2017). Using the ACEs may be prevented through enhanced public and professional awareness, evidence-informed universal service specifications, effective pathways into additional support, monitoring of intervention coverage and content and, routine audit of fidelity to intervention specifications. Although public health may have a leadership role in these innovations, collaborations and investment from healthcare providers, local authorities, and more broadly across the public sector are needed. The results from these ACE policies mentioned above will help inform and enhance developments in this area to increase the focus on preventing ACEs in the future.

Reference List

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• Mental Health Organisation (2016) Mental Health in Wales: Fundamental Facts 2016. Retrieved from: https://www.mentalhealth.org.uk/sites/default/files/FF16%20Wales.pdf
• Baillie, L. J. (2016). Working in partnership with patients and carers. Nursing Standard, 31(15), 42-45.
• Braveman, P., & Gottlieb, L. (2014). The social determinants of health: it’s time to consider the causes of the causes. Public health reports, 129(1_suppl2), 19-31.
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• Health Careers NHS UK. (2020). What is Public Health? Retrieved from https://www.healthcareers.nhs.uk/working-health/working-public-health/what-public-health
• Holt, S., Buckley, H., & Whelan, S. (2008). The impact of exposure to domestic violence on children and young people: A review of the literature. Child abuse & neglect, 32(8), 797-810.
• Hughes, K., Ford, K., Kadel, R., Sharp, C. A., & Bellis, M. A. (2020). Health and financial burden of adverse childhood experiences in England and Wales: a combined primary data study of five surveys. BMJ Open, 10(6), e036374.
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• Katie Hardcastle and Mark A. Bellis (2019) Asking about adverse childhood experiences (ACEs) in health visiting Findings from a pilot study. Public Health NHS Trust Wales. Retrieved from http://www.wales.nhs.uk/sitesplus/documents/888/Asking%20about%20ACEs%20in%20Health%20Visiting%20-%20Pilot%20Evaluation%20Report.pdf
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Writing Guide

Writing serves as a useful skill for anyone in the field of public health — students and professionals alike. Public health students must enroll in writing-intensive courses that require essays and research papers. Once students graduate, they put their skills to use writing reports on community health. They may compose presentations, research studies, or press releases, depending on their jobs. Those who stay in academia continue to write research papers throughout their careers.

Students should begin cultivating a clear and concise writing style long before they graduate.

They should also learn how to use standardized citations. Understanding how to properly cite sources will help students as they conduct research and publish their findings. Citations also help students and researchers avoid plagiarism.

This guide explains how to write a public health report, a research paper, and an exam essay. The page also advises students on how to conduct research online and find trustworthy sources. Students can review citation style guides and public health writing samples.

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Types of writing public health students will do in school, personal statements.

When applying to a public health program, schools often require students to submit personal statements. Schools may either ask students to write a general personal essay answer a certain prompt. Usually, prompts center around applicants’ interest in public health or about the public health field in general. Students might come across a prompt similar to this one: “Identify a public health issue in the U.S., and how you would work to rectify it as a public health professional.” Alternately, students may encounter this common topic: “What drove you to pursue a career in public health?”

Schools look for essays that are honest, well-written, and well-organized. Students should get the reader’s attention with an anecdote illustrating their commitment to public health. Was it an experience with adversity or discrimination that prompted you to pursue this career? Did you learn about the importance of public health while volunteering or traveling? Include those details in the story.

Students should also demonstrate their current knowledge of public health. They may write about their career goals as well. However, students should avoid writing exaggerations, falsehoods, or superlatives. People who read admissions essays can typically sense when applicants are stretching the truth. If the school makes the personal statement optional, students should still consider writing one. A personal statement demonstrates commitment and hard work, and may help make up for flawed or weak admissions materials.

In some public health courses, professors require students to answer essay questions during exams. This can be intimidating since students do not usually know the prompt until they actually start the exam. Students have a limited amount of time to write the essay, typically one or two hours. Students should allot their time accordingly. Some students do not plan their work before they begin writing; this can lead to sloppy essays with weak supporting points, disorganized information, and tangents unrelated to the prompt.

For a 60-minute time frame, students may give themselves 10 minutes to brainstorm, plan, and outline.

During the brainstorming process, students should write their thesis statement.

Then they should jot down three points that support the thesis. These ideas will serve as the three body paragraphs. Students may give themselves five minutes to write the introduction, 30 minutes to write the body, and then five minutes to write the conclusion. They then have 10 minutes to proofread. Students often inadvertently miss this step, but proofreading may make or break the essay.

Students should begin planning long before the day of the essay. Students ought to review the material well enough to be prepared for any prompt. They should carefully look over their lecture notes to determine which points the professor emphasized during classes. These points will likely prove significant when it comes time for the exam. Students should also make sure that they actually answer the prompt instead of rushing and jumping to assumptions.

Research Papers

In a research paper, students examine the existing research, theories, case studies, and ideas about a particular topic. Students have several weeks to write research papers, which may seem like a huge amount of time. However, research papers demand a lot of work, so students should start early. Professors rarely assign strict, narrow prompts for research papers. Instead, they usually give students a topic or range of topics, and students choose their focus. Public health topics may include how poverty or race affects access to healthcare; opioid abuse; the social consequences of HIV/AIDS; childhood obesity; or maternal mortality in third world countries.

Students should start by brainstorming a list of points and ideas they will investigate. Then comes the most time-intensive and significant part of a research paper: the research itself. Students ought to use multiple different resources to help them craft their arguments. Options include online databases, academic journals, and their college library. Make sure you keep track of citations and sources as you go.

Students should also make sure their essays are well-structured. A well-written thesis unites the main points of the paper. Unlike essays, research papers usually include more than five paragraphs. Students may break down their arguments into different sections. A research paper must include a works cited or bibliography that credits all sources. The exact length of the paper and number of sources depends on the professor’s expectations.

Over the course of their academic careers, public health students write many kinds of essays. Professors often assign persuasive essays, in which the student must make a convincing argument; expository essays, in which the student explores and explains an idea; narrative essays, in which the student tells a story; comparative essays, in which the students analyzes two different viewpoints; and cause and effect essays, in which the student must explain the logic behind why certain events or phenomena occur.

• Narrative: In a narrative essay, the author tells a meaningful story. Studying public health, you probably won’t write many narratives. However, narrative essays can support an argument or prove a point. For instance, if you argue that every community should have a free clinic, you might tell a personal story about your experience growing up in a low-income neighborhood with no access to healthcare. Make sure your essay demonstrates a clear plot, follows an organized structure, and includes many details.
• Expository: When professors assign expository essays, they expect students to explain or describe a concept. These essays help professors evaluate whether students have a firm grasp on a topic. Expository essay often include five paragraphs: an introduction with a thesis statement, three main points backing that thesis statement, and a conclusion. Students should do plenty of planning and research before writing to ensure they adequately address the prompt and include enough evidence.
• Persuasive: Persuasive essays appear commonly in academic assignments. Students first develop an argument as a thesis statement. Then, they generate a cogent defense of that argument by researching supporting evidence. Students should be able to anticipate arguments against their thesis statement and include counterpoints. In persuasive essays, students not only demonstrate their knowledge of the course material, but also prove their critical thinking skills by developing their case.
• Comparative: A comparative essay requires students to compare and contrast two ideas, viewpoints, or things. For example, public health students may compare two texts, theories, public health systems, or positions on an issue. First of all, students should create a list of similarities and differences between the two items. After that, they can develop a thesis statement on whether the similarities outweigh the differences or vice versa. Finally, they should organize the essay. They can either defend their thesis statement by listing each point of comparison, or they can split the essay in half by discussing subject one and then subject two.
• Cause and Effect: These essays require students to explain how one event or theory leads to a specific consequence. For instance, a public health student might argue that abstinence-only education in public schools leads to a higher rate of teenage pregnancies. Students should remember that just because one event follows another, those two events do not necessarily influence one another. In other words, correlation does not equal causation. In the analysis portion of the essay, students must explain specific reasons why they think the two events are connected using data and other evidence.

Citations Guide for Public Health Students

In public health writing, just as any other discipline, students must cite their sources. If students use ideas, theories, or research without crediting the original source — even unintentionally — then they have plagiarised. An accusation of plagiarism could follow the student throughout their education and professional career. Professors may fail students who plagiarise, sinking their GPA. Plagiarism accusations can also ruin a student’s credibility. Fortunately, students can avoid plagiarism by properly giving credit for their data and ideas. Common citation styles include those listed below.

American Psychological Association (APA) Style

Students in the social sciences use APA style when writing their essays and research papers. Business and nursing students also commonly use APA style. APA prefers active voice over passive voice, as well as concise language over flowery words. Research papers written in APA style should include a title page, abstract, and a reference page. In-text citations list the author’s name, year of publication, and page number if applicable. Below is an example of how to cite a source using APA style.

In-text citation:

In Milwaukee, poor neighbourhoods were segregated by design (Desmond, 2017, p. 249).

On the works cited page:

Desmond, M. (2017). Evicted: Poverty and profit in the American city . London: Penguin Books.

Chicago Manual of Style (CMS)

History students and students of the natural sciences typically use Chicago, or Turabian, style in their research. Papers written in Chicago style include three sections: the title page, the main body, and a references page. This style also uses footnotes to source information and provide more context. In-text citations list the author’s name, the date of publication, and the page where the student found the data. Unlike APA style, though, the in-text citation does not use a “p.” before the page number. See the example below:

In Milwaukee, poor neighbourhoods were segregated by design (Desmond 2017, 249).

Desmond, Matthew. Evicted: Poverty and Profit in the American City . London: Penguin Books, 2017.

Modern Language Association (MLA) Format

Students of the humanities — including literature, foreign languages, and cultural studies — use MLA style in their research papers. Unlike APA and Chicago style, MLA style does not require students to add a title page. MLA papers also do not include an abstract. Students only need to include the paper itself and a works cited page that corresponds with in-text citations. When adding citations in the body of the text, MLA includes the author’s last name and the page number in parentheses. This style does not list the publication year. You can find an example of MLA citation below:

In Milwaukee, poor neighbourhoods were segregated by design (Desmond 249).

Associated Press (AP) Style

Journalists use Associated Press, or AP style, in their work. AP style standardizes grammar and spelling usage across news media and mass communications. Students rarely use AP style, unless they are writing an article in their subject area for a newspaper or magazine. AP style prioritizes brevity and conciseness above all else. Therefore, it includes several rules that differ from other writing styles. For instance, AP style eliminates the last comma in a list of items (for example: “She dressed in capris, a tank top and sandals”). Since students and professors do not use AP style for academic papers, AP style does not include a reference page like other style guides. Instead, AP style simply uses non-parenthetical in-text citations.

“People who live in low-income communities lack opportunities to exercise,” said Lydia Homerton, professor of public health at Hero College.

The Best Writing Style for Public Health Majors

Professionals in the public health field use APA, the most common style in the social sciences. Professors expect students to use APA style as well. Public health research follows a standardized system of citing sources, making it easier for students and professionals in the field to conduct further research. Students should add a title page and abstract before the essay, as well as a list of references in the back.

Common Writing Mistakes Students Make

Active vs. passive voice.

When writing essays and research papers, students should use active voice and avoid passive voice. Learning the difference between passive and active constructions can be tricky. First of all, students should be able to identify the subject in a sentence. The subject is the noun performing an action. Take this sentence: “The woman catches the keys.” In this case, the woman is the subject of the sentence because she is the one performing the action, catching. The sentence “The woman catches the keys” is active because it focuses on the subject and the action. You can identify an active sentence by checking if the first noun is a subject performing an action.

By contrast, examine this sentence: “The keys were caught by the woman.” The first noun, “keys,” is not performing an action. Instead, it is being acted upon. The subject performing the action — the woman — is at the end of the sentence and not the beginning. This sentence uses passive voice instead of active voice. Some passive sentences do not include a subject at all. For example, “The keys were caught.”

Active voice makes writing more concise and easy to understand. Active sentences often include more information, especially about the subject performing an action. In research papers, students should use active voice whenever possible. However, sometimes it is clear that the author is the one performing the action, so active voice is not necessary. For instance, a researcher might write “the experiment was conducted Friday” instead of “I conducted the experiment Friday.”

Punctuation

Incorrect punctuation confuses readers. The wrong punctuation can change or obfuscate the meaning of a sentence, paragraph, or the entire essay. Publishers, professors, and other researchers often look down on papers with incorrect grammar, even if the content includes important or accurate research. Consequently, students should always use proper grammar in their essays.

The wrong punctuation can change or obfuscate the meaning of a sentence, paragraph, or the entire essay.

While students make many different errors with punctuation, most common errors revolve around colons and commas. Understand the difference between colons and semicolons. Both punctuation marks separate two parts of a sentence. Students should use colons when introducing a list. (“He ate lots of meat: pork, chicken, steak, veal, and duck.”) Colons can also introduce an appositive or new idea. (“She finally gave him the gift: a new computer.”) Semicolons, on the other hand, connect two complete, independent sentences. These sentences should be separate but related. (“He ate a lot of meat; he was ravenous.”)

Students should also take care to avoid comma splices. A comma splice occurs when writers connect two independent sentences using a comma. The following sentence includes a comma splice: “She danced with her boyfriend, he was very clumsy.” Instead, students could add an “and” to connect the two sentences. (“She danced with her boyfriend, and he was very clumsy.”) Alternately, writers could connect the sentences with a semicolon. (“She danced with her boyfriend; he was very clumsy.”) Lastly, writers could separate the two sentences with a period.

Proper grammar helps readers understand your essays. Proper grammar also gives your essay credibility. If you have a perfectly-argued essay, but your paper includes multiple grammar mistakes, the reader will likely be skeptical of the entire argument.

Understand the difference between there/their/they’re. “There” refers to a place. (“The dog is over there.”) Their shows possession. (“This is their house.”) “They’re” is a contraction for “they are.” (“They’re eating at the diner.”)

Also learn the difference between it’s and its. “It’s” is the contraction for “it is.” (“It’s hot outside.”) “Its” shows possession. (“The bird eats in its cage.”)

Make sure your sentences include proper subject-verb agreement. In other words, if the subject of a sentence is plural, the verb should also be plural. For example, use “The boy and his sisters are eating breakfast” instead of “The boy and his sisters is eating breakfast.”

Writing Resources for Public Health Students

• Guide to Improving Scientific Writing in Public Health : This guide from the World Health Organization and the Pan American Health Organization teaches students how to write about complicated scientific material in a way that’s easy for readers to understand. The guide includes tips on vocabulary and format.
• Argument, Structure, and Credibility in Public Health Writing : Written by a professor at Harvard’s School of Public Health, this essay breaks down how to make effective arguments in public health writing. The page includes flow charts and figures to help illustrate exactly how public health essays should be organized.
• Purdue Online Writing Lab APA Style Guide : Purdue’s Online Writing Lab includes style guides for all writing and citation styles, including APA. The style guides help students understand how to format papers, use in-text citations, and create reference pages.
• Award-Winning Health Articles : One of the best ways to improve your writing is to read good examples. This page lists nine award-winning public health writing samples.
• The Women’s and Children’s Health Policy Center Writing Skills Guide : This website links to several modules on writing public health documents. Lessons include policy briefs and memos.

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Strengthening the Connections Between Health Care and Public Health

Why it matters.

When an eight-year-old with a history of asthma presents to the emergency department (ED) with wheezing, some ED clinicians just see a child with an exacerbation of their condition. When Nana Twum-Danso, MD, MPH, FACPM, saw such a patient as an ED physician — in addition to addressing the clinical diagnosis and treatment — she would also wonder about where the child lived, about their family and neighborhood, and whether there was mold or smokers in their household.

“In this day and age, a child with asthma should not need to be seen in the ED,” explained Twum-Danso, Institute for Healthcare Improvement (IHI) Senior Vice President, Global. “We have good treatments to control the inflammation and rescue inhalers. We’ve done lots of education about how to prevent an asthma attack.”

In other words, social context matters. As a practicing physician, Twum-Danso wondered about health care’s role in addressing the underlying issues influencing her patients’ lives. “We treat the asthma, but then we send the child back home and maybe within a month they might come back [to the ED],” she continued. “Those types of cases used to wear on me. Are we doing enough? Could we be doing more?”

Twum-Danso’s interest in tackling the social determinants of health and being born and raised in Ghana — where she saw many deaths due to preventable diseases — eventually compelled her to pursue specialty training in preventive medicine and public health. “I decided to follow my passion and try to address the systemic reasons some people are more likely to get sick than others,” she recalled. “I loved the one-on-one interaction of individual patient care and the immediacy of diagnosis and treatment in the ED, but there was another part of me that was even more interested in thinking about population-level health and the preventive things we needed to do more of as a society.” She added, “Improving air quality, water quality, sanitation, nutrition, the safety of people’s homes, roads, transportation, etc., can have a huge impact on millions of people’s lives. I was excited about the potential to work at that scale.”

In the following interview, Twum-Danso draws upon her experience in both medicine and public health to describe COVID-19’s influence on the relationship between health care and public health and what it could mean for the future.

On making good use of data

In countries where clinical care is primarily provided by the public system, you’re going to see fairly good data-sharing between clinical care and public health because it’s one system. In countries where health care is primarily private, there hadn’t been as much of an effort to integrate data systems before the COVID-19 pandemic, and that makes sharing data harder. In the US, during the first few months of the pandemic, it was hard to keep track of what was happening clinically and to integrate the data with the public health data systems. I think the pandemic has created bridges — or in many ways, forced [the creation of] bridges — between clinical care and public health in settings where it wasn’t already happening.

Now that we’re in the third year of the pandemic, many countries are using the more timely data collections systems to track the number of cases, deaths, and hospitalizations developed because of COVID. I’m hopeful that we can learn from how they built the muscle for frequent data collection and analysis and apply it to other areas of public health and health care.

On the pandemic as both a clinical and public health issue

Those of us in health care and public health need to row in the same direction to improve the quality of health , not just health care. In the first year of the pandemic, as we were learning about COVID-19, it became clear that people who were obese, had high blood pressure, and diabetes were more likely to get very sick from COVID and to die from it. Those are clinical conditions, of course, but in the US, for example, more than 40 percent of the population is obese . That means it’s no longer just a clinical problem when someone morbidly obese has COVID in the ICU on a ventilator. It’s also a public health problem. And, when you dig deeper into this problem, you find that these chronic diseases are more common in lower-income populations. These are the same populations that are most likely to be in customer-facing, in-person jobs — such as grocery workers and bus drivers. They couldn’t work from home when the pandemic started. And as we saw in the US, these populations were disproportionately people of color. So, when we expand our lens from the individual COVID-19 patient in the ICU struggling to breathe, we start to see the confluence of macro issues such as socioeconomic status, job opportunities, and institutional racism determining who is likely to be exposed to the virus due to work and get sick enough to be hospitalized due to chronic diseases such as diabetes and obesity. That’s the kind of bridge between clinical medicine and public health that I am talking about.

On addressing chronic illnesses as both clinical and public health issues

We knew how devastating diabetes, high blood pressure, and obesity can be to one’s health long before COVID. Think about people who end up on dialysis because of poorly managed diabetes or middle-aged people suffering a stroke because of untreated hypertension. These situations are devastating for individuals and families, but they are also tragic for society because they are preventable. Just as there have been benefits to viewing COVID from both public health and clinical perspectives, shouldn’t we address contributors to diabetes, hypertension, and obesity in a population in a preventive way? Shouldn’t we, for example, look at the structural designs of people’s neighborhoods, public transport, and the affordability of the food available on local store shelves and whether people have healthy options?

On the risks of prioritizing clinical care while neglecting public health

As a public health professional, I found the discussions about “non-pharmaceutical interventions” during the first year of the pandemic very concerning. The phrase rankled me a lot because it essentially pits clinical medicine against public health. Calling interventions [like masks and social distancing] non-pharmaceutical suggested that the default is clinical medicines or other pharmaceutical products, and that these other things are less of a priority while we waited for the medicines to come along. But since it’s only a very small proportion of the population that will need clinical care for COVID, fortunately, non-pharmaceutical interventions are important for all of us. Of course, vaccines fit into the category of pharmaceutical interventions but as we see now, in the third year of the pandemic, vaccines do not necessarily eliminate the need for the basic preventive strategies of masking, hand hygiene and respiratory hygiene.

To value public health as much as we value clinical care, words do matter. Research dollars matter. Investments in data systems matter. If we have good data systems in hospitals, for example, but poor data systems in the public health systems, or inadequate connections between our various data systems, how can we expect good outcomes? We can’t improve what we can’t see, right? We have to make the public health data just as visible as the clinical data if we want to improve the health of populations, not just individuals.

Another thing that concerns me is how a lot of public officials appear to be titrating the public health restrictions to what goes on in the hospitals. Our health system is being crushed. The hospitals are getting full. So, let’s institute mask mandates. Once the hospital volumes ease, you can take off your mask. It feels like such an arbitrary way to manage a public health problem that is so big and pervasive. We need to do both. We cannot de-emphasize public health just because the hospitals are not full. There has to be a better balance.

On the need for a more holistic approach to health and health care

A public health person in charge of a district, state, or country is very clear about who is included in the population they serve. Health care, on the other hand, for the most part sees the people who come through the doors as their population. We need to find ways to bridge those gaps. Because, if health care is thinking only about those who walk through their doors, and public health is thinking only about prevention and health promotion in communities and not enough of about the whole spectrum of care, we won’t achieve our collective goal of improving people’s health. Each of us may need clinical care every so often to cure an illness or screen for a preventable disease, but health care is only a small subset of what contributes to overall health. So, the more bridges we can build between clinical medicine and population health, the better we will be able to serve the public.

We need to create a systems view of the population. We need to make sure incentives are aligned to achieve that population-level view. This would require a complete paradigm shift on how we think about health care and public health, what people are willing to pay for, and how we find the balance between prevention and promotion of health and clinical care. It can be done. It requires bold thinking and rigorous measures to hold ourselves accountable. If we monitor the data and keep adapting and learning as the data come in, we can achieve population-level aims.

Editor’s note: This interview has been edited for length and clarity.

You may also be interested in:

On the Quintuple Aim: Why Expand Beyond the Triple Aim?

If COVID-19 Never Goes Away, Can It Help Shape a Better Health System?

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Essay on Health Awareness

Students are often asked to write an essay on Health Awareness in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Health Awareness

Understanding health awareness.

Health awareness is about knowing and understanding health issues. It’s like learning about different diseases, their causes, and how to avoid them. Health awareness helps us make better choices for a healthier life.

Importance of Health Awareness

Health awareness is important because it can save lives. It helps us know what’s good and bad for our health. With this knowledge, we can avoid harmful habits like smoking and eating junk food, and adopt healthy habits like exercising and eating balanced meals.

Health Awareness and Disease Prevention

Health awareness helps in preventing diseases. It tells us about vaccines and regular check-ups that help catch diseases early. Also, it teaches us about hygiene practices like washing hands to prevent disease spread.

Role of Schools in Health Awareness

Schools play a big role in health awareness. They teach students about nutrition, physical education, and hygiene. Schools also organize health camps and invite doctors to talk about different health topics.

Health awareness is a key to a healthy life. It helps us make wise choices, prevent diseases, and lead a happy, healthy life. So, let’s all be aware and spread health awareness for a healthier community.

Also check:

• Speech on Health Awareness

250 Words Essay on Health Awareness

What is health awareness.

Health awareness is about knowing and understanding health issues. It helps us make the right choices for our health. It is about learning how to stay fit, eat right, and take care of our bodies.

Why is Health Awareness Important?

Being aware of health is important for many reasons. It helps us live longer and better lives. When we know about health issues, we can prevent them. For example, knowing that smoking is bad for our lungs can stop us from starting to smoke.

How Can We Improve Health Awareness?

There are many ways to improve health awareness. We can read books, watch videos, or talk to doctors. Schools can also help by teaching students about health. Parents can set a good example by eating healthy food and exercising regularly.

Role of Media in Health Awareness

Media plays a big role in health awareness. TV shows, news, and social media can spread information about health. They can tell us about new research or health risks. But, we must be careful to check if the information is correct. Not all information on the internet is true.

In conclusion, health awareness is very important. It helps us make good choices for our health. We can improve health awareness by learning and sharing information. Let’s all try to be more aware of our health.

500 Words Essay on Health Awareness

Health awareness is knowing about the state of your body, how to keep it healthy, and what can harm it. It is like a guide to help you live a healthy life. It tells you about good habits like eating right, exercising, and getting enough sleep. It also warns you about bad things like smoking, drinking too much alcohol, or not getting enough exercise.

Health awareness is very important for everyone. It helps you stay healthy and avoid diseases. If you are aware of your health, you can take steps to prevent illness. For example, if you know that eating too much sugar can lead to diabetes, you can choose to eat less sugar. This can help you avoid getting diabetes in the future.

Health awareness also helps you know what to do if you get sick. If you are aware of the symptoms of a disease, you can recognize them early and get treatment. This can help you recover faster and prevent the disease from getting worse.

Ways to Increase Health Awareness

There are many ways to increase health awareness. One way is to learn about health from reliable sources. You can read books, watch videos, or talk to health professionals like doctors and nurses. You can also learn about health in school or at health awareness events.

Another way to increase health awareness is to practice healthy habits. This means eating a balanced diet, exercising regularly, getting enough sleep, and avoiding harmful substances like tobacco and alcohol. By doing these things, you can improve your health and learn more about how your body works.

Schools play a big role in health awareness. They teach students about health in science and physical education classes. They also provide healthy meals and opportunities for physical activity. Some schools even have health clinics where students can get check-ups and treatment.

Schools also organize health awareness events. These events can include health fairs, where students can learn about different health topics and get free health screenings. They can also include campaigns to promote healthy habits, like eating fruits and vegetables or walking to school.

In conclusion, health awareness is very important. It helps us stay healthy and avoid diseases. We can increase our health awareness by learning about health and practicing healthy habits. Schools play a big role in health awareness by teaching students about health and organizing health awareness events. By being aware of our health, we can live healthier, happier lives.

That’s it! I hope the essay helped you.

If you’re looking for more, here are essays on other interesting topics:

• Essay on Health Promotion On Diabetes
• Essay on Health Promotion On Alcohol
• Essay on Healthcare Affordability

Apart from these, you can look at all the essays by clicking here .

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Health Awareness Essay

Introduction.

When our children fall sick, we immediately call a doctor or rush to a nearby hospital. These children are lucky because they have ample means and resources to get themselves treated. Do you know that some unfortunate ones do not realise that they are ill and deny treatment? Here lies the importance of the health awareness essay, as it will help our kids to understand the issues that revolve around health.

Although we have an efficient healthcare system, it is disheartening to know that every citizen does not get access to it. People fail to comprehend health issues in them and eventually do not receive treatment on time. Through this short essay on health awareness, we can familiarise ourselves with such issues and see how we can create health awareness.

Related essay: World Health Day essay

Importance of Health Awareness

Even while we do not have any illness or injury, it is essential to do a thorough checkup to identify any serious problems in our health. Maintaining good health is important for all, which is emphasised in this health awareness essay.

Though we stress that health is wealth, not everyone pays much attention to it. A slight delay in treatment or simple carelessness could cost your life, and this is why people should have proper health awareness. The short essay on health awareness focuses on how we can prevent the issues of lack of treatment or healthcare facilities.

Some people do not know if they have any diseases, and they continue living in ignorance till their health situation turns severe. Hence, it is necessary that we educate them about different diseases, their symptoms and treatment options, as well as raise their awareness about health. In this way, they will be motivated to make the right decisions regarding their health.

Ways to Raise Health Awareness

As we have discussed the importance of health awareness in the previous section, we will now see how we can raise awareness of this topic through the short essay on health awareness. We might have come across many awareness days like World AIDS Day, World Polio Day, World Hepatitis Day etc., each year, which are aimed to promote health and call attention to various health problems. These awareness programmes impart a better understanding of several communicable diseases and how we can prevent them.

The health awareness essay also highlights the significance of making people realise the value of physical, mental and social health. While it is easy for us to discover physical health problems through symptoms, mental health awareness is often overlooked. Organising campaigns is an effective way to raise awareness among people. Through vaccination drives and by arranging workshops and seminars, we can reach people and inspire them to improve their lifestyles and habits for their good health.

The short essay on health awareness can be a learning tool for children to understand more about the topic. To discover more interesting essays from BYJU’S, keep an eye on our website.

Frequently Asked Questions on Health Awareness Essay

What is meant by health awareness.

In basic terms, health awareness is the knowledge regarding one’s health. It can be described as the awareness of various health problems, symptoms and treatment options.

What is the significance of the health awareness essay for children?

The health awareness essay will be useful for children to know about various health concerns and preventive measures, which will empower them to keep themselves healthy by following the right regime.

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Master Public Health Essay Sample

Here is a sample that showcases why we are one of the world’s leading academic writing firms. This assignment was created by one of our expert academic writers and demonstrated the highest academic quality. Place your order today to achieve academic greatness.

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Introduction:

This report mainly concerns the intervention of E-health in current healthcare conditions, specifically diabetes. We have the effort to create awareness and promote extensive knowledge concerning technology usage in managing and treating diabetes. The title of the report is ‘Intervention of E-health on diabetes.’

General Objective:

The objective is to promote strength and decrease the burden on the National Health care system by analyzing the role of E-health, its accountability, and intervention. Moreover, our objective also includes generating attention and investment towards E-health and promoting the UK health system worldwide.

Specific Objectives:

1)To propose how E-health can be introduced.

2)To acknowledge how e-health can benefit the people, society, and the National health system.

3)To discuss any drawbacks or problems concerning e-health.

Statement of the Problems:

Acknowledging the pros and cons of implementing technology in the vast field of medicine concerning diabetes.

Scope and delimitation:

This is limited among the people who know how to use technology and young individuals, specific respondents, or specific organizations as one of the factors might be that older patients might have difficulty using technologies.

Methodology:

This report is based upon studies done by the researchers, analyzing the current usage, advantage, and disadvantage of technology usage in this regard through a questionnaire, data collection from respondents, sampling, and statistical application.

E-health is an evolving subfield of medical informatics that uses the internet and well-developed technologies to treat, manage, and prevent healthcare diseases and problems (G. Eysenbach, 2001). Numerous diabetes concerning apps can be used on mobile phones, which help diabetic patients adjust medical doses, adopt a healthy lifestyle, and monitor glucose levels (G.A. Fleming, 2020). According to recent studies, using e-health for about 12 months has resulted in a significant lowering of blood glucose levels compared to usual health care and treatment (K. Harno et al. J. Telemed Telecare, 2006). The outdated healthcare approaches involve expensive practices. At the same time, e-health technologies enable rapid insulin delivery, and continuous glucose monitoring opportunities, which decrease costs, and time burden and provide convenience to patients worldwide (D. Kerr, F. king, D.C. Klonoff, 2019).

In the UK, Cellnovo and uMotif are the most valuable companies in this field. They help the patients self-monitor their conditions, improve communication with the doctors, and reduce the burden on healthcare systems. Moreover, these services provide information regarding all related and appropriate diabetes-associated sources instead of a single source which helps the general population to have a record for emergency and self-management opportunities for their health condition (S.G. Cunningham, M. Brillante, B. Allardice, 2019)

The challenges faced by using technology might include insufficient evidence for the accuracy of the apps, technical faults, inadequate security for data, and underprivileged or older patients’ inability to use the apps (G.A. Fleming, 2020). Therefore, these may require higher healthcare professionals, authorities, and policymakers to ensure these apps follow standardization. Moreover, engaging a telecommunicator might be a big problem.

Cunningham, S.G. et al., 2019. My Diabetes My Way: supporting online diabetes self-management: progress and analysis from 2016. Biomedical engineering online . Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368718/ [Accessed March 13, 2021].

Eysenbach, G., 2001. What is e-health? Journal of medical Internet research . Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1761894/#__ffn_sectitle [Accessed March 13, 2021].

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