Definition of Public Health Public health is the science and art of organized societal efforts to ensure [and create] the conditions for the highest possible level of health and wellbeing of the population[s] consistent with the values of social justice and human rights. Adapted from: Gostin: Public Health Law: Power, Duty, Restraint (University of California Press and Milbank Memorial Fund, 2nd ed. 2008);

The following slides explain different components of the proposed definition and indicate the required further work to develop a consistent framework of public health

”science and art” Public health is an academic discipline, a policy process/domain and set of actions in its own right, distinct from medicine or other disciplines, policy processes and domains and actions. Public health generates, interprets and applies evidence correctly, but also pursues reasonable course of action in the face of no or limited evidence. In its policy domain, public health acts informed by evidence, but also considers political elements such as values, ethics, etc which are not necessarily evidence based. The art of public health is a ballancing act between different sources informing the decision making process. Requires: defining the borders and overlaps with other disciplines and policy domains;

”organized societal efforts” Clearly defines the boundaries of public health as an organized collective effort as opposed to a simple sum of individual efforts by individual actors. Requires: definition of public interest vs. individual interests, principles of organizing the societal effort, core functions and necessary infrastructure of public health, and of different actors and stakeholders and their roles and responsibilities.

”to ensure [create] the conditions” Directs the focus of public health towards health promotion and prevention to reduce the risks and reduce harm from diseases, conditions and injuries; Requires: further clear definitions of health protection, health promotion, health risk, harm reduction, and of diseases, injuries and conditions that are of concern for the population as a whole.

”highest possible level of health and wellbeing of the population(s)” Aligns the definition of public health with the WHO definition of health; Defines the population (the community), not an individual, as the subject, object and measure of public health, and the health interest of the collective community as the primary objective of public health. Requires: delineation between legitimate interests and rights of individuals and of the society; definition of principles for measuring and evaluating the health and wellbeing of the population and of the performance of the public health systems.

”consistent with the values of social justice and human rights” Specifies the ethical framework for public health theory and action; Accepts the notion that right to health is a human right, and that addressing social and political determinants of health is an essential and legitimate public health action. Requires: elaboration of public health ethics and of public health law.