The best idea of what public health medicine is comes from the Faculty of Public Health Medicine. The following is taken from its handbook for training. This is a comprehensive set of guidance for entrants to the specialty, and is usually called the ‘Red Book’. It is currently being re-written and you should obtain a copy of the most recent draft. The Faculty of Public Health Medicine defines public health as "the science and art of preventing disease, prolonging life and promoting health through organised efforts of society". Public Health Medicine is defined as the branch of medical practice which specialises in public health. It is concerned primarily with health and disease in populations, complementing clinical medicine with its concern for the health of individual patients. Its chief responsibilities are monitoring the health of a population, the identification of its health needs, the fostering of policies which promote health, and the evaluation of health services. It is an exciting and growing specialty which is widely recognised as having an increasingly important role in serving the health of society.

Epidemiology is the science fundamental to the study and practice of Public Health Medicine. It furthers our understanding of the determinants of health and disease and our knowledge of their occurrence in local populations and groups. Such information will indicate what actions could be taken which may prevent disease and promote health, for example, by health education or social policies which aim to modify behaviour; prophylactic procedures like immunisation; screening for early identification of those at special risk or in need of special care; and protection against specifice nvironmental hazards. Preventive programmes also need to be monitored to determine whether they are achieving their objectives, at what cost, and how they may need to be modified. Public Health Physicians thus have executive functions as well as responsibilities for research and inquiry into the causes of disease and preventive medicine practice. Equally, they have a duty to educate and give leadership in matters related to public health, and to advise and guide on all those social programmes and policies which, intentionally or not, affect and often determine people's health.

Another function of Public Health Medicine is to study the nature and extent of disease and disability in the population, and how this varies with age and sex, with economic and social circumstances, occupation and environment. Information on the patterns of disease is essential in defining health needs and tasks for health services and in setting priorities. It also allows the review of the services as they now are, and the identification of those who do and do not use them, so that the need for new services, or for modification of the present ones can be judged.

Beyond this, Public Health Physicians have to try to evaluate how effective the services are in helping the community - in measurable cure and care, in the relief of suffering, the maintenance of working capacity, rehabilitation of the disabled, and lowering of death rates. They must also try to assess how efficiently the services are using the community's resources. Both aspects are critical in assuring value for money, and they are an integral part of health services management and resource planning; the more since technology is ever offering expensive new options.

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Last modified: December 09, 1999