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Around the turn of the 20^th century, Frederick McKay, a dentist, researched the mottled, brown teeth of people around Colorado Springs, Colo. a condition known as Colorado Brown Stain. Despite their less than perfect appearance, the teeth proved surprisingly resistant to decay. McKay, along with fellow researchers, eventually discovered the cause of Colorado Brown Stain was fluorosis, a condition caused by high levels of fluoride in the local drinking water. 

Through the 1930s and 40s, researchers determined there was a sweet spot of fluoride concentration in water that was high enough to help prevent dental caries, but not so high as to cause significant fluorosis. Dental caries, or cavities, are caused by bacteria in the mouth such as Streptococcus mutans, and have been associated with a variety of adverse health conditions (in addition to tooth decay).

By the 1960s, water fluoridation became widespread in the United States. Today, over two-thirds of the U.S. population drink fluoridated water. Fluoridated water is considered by many to be one of the public health triumphs of the 20^th century.

What is Public Health?

Public health is the sector of healthcare involved in promoting and preventing disease in communities and populations, as well as studying disease trends and using the resulting data to affect positive health outcomes. While public health initiatives include the health of individuals, it does so with an eye to the overall population.

For example, vaccinations are a common public health concern. Vaccinations are given to individuals, but it’s the cumulative effect of the individual vaccinations across populations which impact the public health of communities.

Importance of Public Health

There are several historical milestones which have resulted in the high standard of living we have today. Two of those, sanitation systems in cities and vaccines, drastically reduced severe illness and death in their respective populations, resulting in an overall increase in productivity and life expectancy.

In modern times, public health initiatives can result in positive health outcomes for individuals and populations, reducing healthcare and associated costs. Population health and disease surveillance can help identify health inequities in populations, as well as track pandemics such as COVID-19 pandemic.

Examples of Public Health in Action

Perhaps the most famous example of public health is the development and implementation of vaccines. By some accounts, wouldn’t make it to their 5^th birthday 200 years ago, mostly due to communicable diseases. Because of vaccines, water safety and sanitation, and advances in healthcare, that number today is less than 1% in the United States.

A more recent example is the public health impact of smoking and tobacco use. Smoking tobacco was widespread through the late 20^th century. In the 1950s, the link between cancer and smoking began to be more well-known, and in 1964 the Surgeon General of the United States published a linking smoking and cancer. By the 1980s the link between tobacco and cancer was widely accepted by the health and scientific community, and tobacco products are required to carry warnings about their detrimental effects to health. As a result, the number of smokers and smoking associated diseases has drastically decreased since 1965.

Currently, diseases associated with obesity, such as diabetes and high blood pressure, results in a in the United States. Public health research, health education and policy must come together to help mitigate the adverse effects of the so-called obesity epidemic. Health education and access for nutrition and physical activity are cornerstones of current public health initiatives to reduce obesity and the diseases associated with it.

Core Areas of Public Health

Epidemiology

Epidemiology is the research and analysis of patterns and causes of disease within a population. Disease causes and transmission, surveillance and outbreaks, and environment and occupational epidemiology are some of the key areas of epidemiology. Perhaps the most famous example is disease surveillance, where a disease and its spread through a population is monitored and studied to determine causes and patterns. For example, infectious diseases such as COVID-19 and Ebola are monitored, with the goal to mitigate spread and impact.

Environmental Health

Sanitation and clean water have been major factors responsible for increasing population health and outcomes, such as child mortality and life expectancy. Many other environmental factors, such as clean air, affect public health. For example, in the 1970s, smog – a haze consisting of particulates and nitrogen and sulfur oxides – caused respiratory issues in some large cities in the United States. Even today, especially in developing nations, air quality can adversely impact public health. Organizations like the Center of Disease Control (CDC) and Environmental Protection Agency (EPA) can influence policy to reduce environmental pollutants which can be deleterious to health.

Health Promotion and Education

At the individual level, if someone doesn’t know about proper nutrition, hygiene, exercise or general healthy habits, they will have greater difficulty making positive informed decisions. Health promotion and education initiatives can educate the population, so individuals within the population can make healthier decisions, which in aggregate can positively impact public health and deter from chronic diseases like heart disease and other health problems.

Policy and Advocacy

Public health initiatives can be supported by policy at the local, state and federal levels. To give health promotion and initiatives the greatest impact, they can be reinforced in policy at the local, state or federal level. Prior to 1968, for example, cars weren’t required to have seatbelts. After the passed, cars were required to have seatbelts, but the occupants weren’t required to wear them. In the 1980s, states began to pass laws requiring the use of seatbelts. Now, seatbelt use is widespread and has contributed to a reduction of fatal accidents.

Global Public Health

While federal, state and local public health initiatives and policy mostly impact people in the United States, global public health organizations play a role in public health worldwide. Organizations such as the World Health Organization (WHO) work to educate and promote health, as well as influence policy, to positively impact public health worldwide.

How Public Health Impacts Your Daily Life

The combination over time of public health research and policy has resulted in a much higher life expectancy, cleaner air, reduced disease impact and a higher standard of living. At the turn of the 19^th century, life expectancy was , compared to . The result of this increased life expectancy is generally due to initiatives led by public health professionals through the years.

Challenges Facing Public Health Today

Public health issues today are in some ways like the historical public health challenges, including education, funding, access and communicating with the public. Ensuring access to healthcare and public health resources are available for all individuals in a community is currently a big challenge. For example, pediatric vaccines have drastically improved the health of children, but they only work if administered. Ensuring parents are educated on the importance of vaccines and that they are readily available is important to health outcomes.

Why You Should Care About Public Health

Everyone benefits from public health. Modern sanitation facilities contribute to clean and healthy cities. Healthier habits contribute to better health. A healthier public results in lower healthcare costs for everyone. Vaccinations help reduce the spread of communicable diseases. A strong healthcare infrastructure and improved health outcomes increases productivity and standards of living for society.

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