Public or community health can be defined as an array of measures, both of private and public nature, that are targeted at preventing diseases, fostering health and trying to prolong life in general as well as make it more healthy. The goals of these activities are creating healthy conditions of life for the entire society which can positively reflect on personal health of each given person, focusing on overall trends in the health stance of the entire population of a given state or globally (Public Health). This leads us to the idea how public health differs from private health. Whereas the latter deals with every specific case, every disease each given person has, the former rather deals with the entire healthcare system, what threats there are, what diseases should be combatted first, what threats to massive societies in terms of healthy conditions of their lives exist.
There are several principal functions that elaborate better and further elaborate on what public health does. These are assessment as well as monitoring of health problems that threaten certain communities, elaborating policies the goal of which is to solve health issues locally, regionally and globally and ensuring that everybody in each given community can easily enjoy the due level of medical care (Public Health).
Public health assessment has various and multidimensional benefits. Before everything else, the statistical activities carried out within the framework of the assessment process – i.e. identifying factors of risk, charting life quality, the conditions of life that contribute to health level, income rates that speak eloquently about cost opportunities of people for healthcare, morbidity and mortality indicators – reinforce the other two functions of public health. This means namely that creating public health policies and verifying the effectiveness of existing healthcare system depends on the success of this first function of public health. The results of the assessment define who are target groups that should be affected by the newly elaborated public health policies, how the prioritization of health problems needs to be made, how community health improvement plans should be developed and implemented etcetera (Elligers, 1).
What touches upon disadvantages of public health assessments, they relate in a bigger part to the imperfection of some methods of assessment rather than to the process of public health assessment per se. For instance, such information-collecting methods as surveys, notwithstanding whether they are telephone, face-to-face, postal or of any other kind, may have distorted data because in all of these types of surveys people loose anonymity which becomes an incentive for them not to be honest in every detail with surveyors. Another methodological problem is the too general a nature some methods have. For instance, observation is incapable of giving precise (not even statistical, just precise) data and can be used to learn pattern of trends in the field of study but not to provide robust data that would create a clear and detailed image of what problems societies deal with. Likewise, the method of considering certain focus groups very often smashes against the obstacle of impossibility to accurately define the groups to focus on (Community Health Assessment and Group Evaluation (CHANGE) Action Guide: Building a Foundation of Knowledge to Prioritize Community Needs, 2010, pp.14-15).
The very striking example of a potential conflict within the community that could arise as a result of public health assessment is the matter of light drugs usage as painkillers. The matter of marijuana has been within hearing for decades now because of the fact that it is prohibited on federal level in the United States as a narcotic substance but is allowed by some states as a medicine. In fact, the topic goes broader than it is meant to discuss it within this paper in the legal sphere, but generally comes down to the following. After the relevant bodies carried out a research in the sphere of public health on the wake of which marijuana was added to the group with the paramount indicator of addiction risk this narcotic substance was banned on the federal level. However, some states, like New Mexico or Colorado or Washington have made the use of marijuana legal for medical purposes since it is a strong and effective painkiller. The problem is that the “supremacy clause” from the United States Constitution explicitly states that federal legislation is above the states’ legislation which means that states’ laws on making marijuana legal are good for nothing as they come into collision with federal legislature (The Public Health Consequences of Marijuana Legalization, 2010). Managing such conflict is special because it should be managed through namely legal work, not through public health policy per se. To the contrary, public health policy, namely assessment, is what has caused this problem – researchers have proved that marijuana is both good and bad for organism when used for different circumstances. That is why, it is vital not to reinvent anything in medicine to give up on the use of marijuana for medical purposes but rather just to eliminate the legal collision from the legislature of the United States.
Now, let us refer to how public health assessment influences public policy in the field. As for me, all ways to use public health assessment to form public policy come down to several things: raising awareness and lobbying. These two ways are general but unique because they cover the two groups that the assessment is targeted at: those for whom the assessment is being made (meaning, for protection of whose health) and those who are responsible for creating legislature that is namely the mechanism that reinforces the scholar findings into caring for public health. That is why findings of public health assessment do not need to be made for scientists alone but they need to be delivered to the public, they need to be made aware of in order to make people support specific policies that will improve their health because if they don’t all the research will be good for nothing. The same goes for legislators – lobbying process is what makes them aware of the need to adopt specific legislature the population badly needs.
As we speak about legislation, analyzing a particular case would be useful to understand how public health assessment spills over into public policy formation. Since I talked already about marijuana legalization above here is the federal legislation that touches upon this sphere (I omit states legislature, because in accordance with the supremacy clause it cannot be unequivocally considered actual):
1937 - The Marijuana Tax Act., t prohibited the use of cannabis on a federal level.
1970 - The Controlled Substances Act which prohibited cannabis federally together with several other narcotic substances. This act replaced the previous one.
The first thing that comes to mind with respect to the indicated legislature is that it is obviously out of date, which means that it may be negatively affecting my community and needs to be updated or replaced. The reason is simple: fourty six years ago marijuana was still not proven to be useful in medicine, therefore there was ambivalence as per whether it had or had not to be allowed for usage. Such old legislature does not reflect the modern findings of public health assessment and, therefore, is definitely making the progress process slower. Therefore, the obvious way of improving this legislature in order to make it have a better and more effective impact in my community (which is reasonable for any community, in fact) is to eliminate the already mentioned collision with the “supremacy clause.”
References
“Public Health.” (N.d.). World Health Organization. Retrieved at: http://www.who.int/trade/glossary/story076/en/.
Elligers, Julia Joh. (N.d). “Community Health Assessment and Improvement Processes.” The National Connection for Local Public Health. Retrieved at: http://archived.naccho.org/topics/infrastructure/CHAIP/upload/CHA-and-CHIP-Processes-JJE.pdf.
Centers for Disease Control and Prevention. (2010). Community Health Assessment and Group Evaluation (CHANGE) Action Guide: Building a Foundation of Knowledge to Prioritize Community Needs. Atlanta: U.S. Department of Health and Human Services. Retrieved at: http://www.cdc.gov/nccdphp/dch/programs/healthycommunitiesprogram/tools/change/pdf/changeactionguide.pdf.
“The Public Health Consequences of Marijuana Legalization.” (2010). The White House. Retrieved at: https://www.whitehouse.gov/sites/default/files/ondcp/issues-content/marijuana_and_public_health_one_pager_-_final.pdf
U.S. Centers for Disease Control and Prevention. (2013). Community Health Assessment for Population Health Improvement: Resource of Most Frequently Recommended Health Outcomes and Determinants, Atlanta, GA: Office of Surveillance, Epidemiology, and Laboratory Services. Retrieved at: http://wwwn.cdc.gov/CommunityHealth/PDF/Final_CHAforPHI_508.pdf.
