Building healthier communities collaboratively with an integrated societal approach

The time-honored purpose of public health practice is the improvement of health status and the reduction of diseases, injury, and disability in the population at large and in specific populations-at-risk. At issue is implementation of methods of intervention before the fact to prevent disease/injury, restore health and function, and -- failing that -- restoration of health status within the limits of what is possible. The means of carrying this out is reflected in the scientific discoveries of microbial causes of disease, unsanitary conditions, risks of injury, hazardous work conditions, malnutrition, low income, risky exposures of consumers of goods and services, etc., and the consequent advent of organized public health deparatments and Boards of Health as the principal means of improving health.

It has become apparent that the breadth of threats to health and the parallel range of preventive and/or corrective interventions extend well beyond the scope and capability of the organized public health system. In response, health departments have increasingly sought and established partnerships with other sectors of society to extend the range of possible corrective interventions. The broadening of health threats beyond traditional public health concerns, as social determinants of health, opens the range of targets of health status intervention.

The implication for public helath interventionists is to achieve working collaboration with other sectors of society, whose business it is to address the broader range of determinants, and to do with the familiar public health scenario of intervening as far "upstream" from the negative health events as possible.