Skip to main content

Advertisement

What is the “New Public Health”?

Article metrics

  • 17k Accesses

  • 35 Citations

Abstract

The New Public Health is a contemporary application of a broad range of evidencebased scientific, technological, and management systems implementing measures to improve the health of individuals and populations. Its main objectives are the political and practical application of lessons learned from past successes and failures in disease control and the promotion of preventive measures to combat existing, evolving and re-emerging health threats and risks. We address present and anticipated health problems in a complex world with great inequalities with specific targets which would help to achieve higher standards of health and a more just and socially responsible distribution of resources.

We present some examples of achievements in public health and clinical medicine, particularly from the past half century, that have resulted in improved disease control and increased health and longevity for populations. Many remaining challenges must be overcome in order to reduce the toll of avoidable morbidity and mortality and to achieve improved and equitable health nationally and internationally. The tools at our disposal today are much more effective than they were even just ten years ago. Promoting wider application of these tools and greater awareness of achievements and failures in public health will improve our capacity to affect greater change in population health in the future.

The New Public Health is a moving target, as the science and practice of public health grow in strength. It is relevant to all countries, developing, transitional, or industrialized, all facing different combinations of epidemiologic, demographic, economic and health systems challenges. A greater understanding of these issues is vital to both a European and a wider audience of policy makers, educators, students, health systems managers, and practitioners of public health to address these challenges.

References

  1. 1.

    Milstein B. Hygeia’s constellation: navigating health futures in a dynamic and democratic world. Atlanta (GA): GA Syndemics Prevention Network, Centers for Disease Control and Prevention; 2008. Available from URL: http://www.cdc.gov/syndemics/pdfs/Hygeias_Constellation_Milstein.pdf (Accessed 7 April, 2010).

  2. 2.

    Declaration of Alma Ata, 1978. International Conference on Primary Health Care. World Health Organization. Available from URL: http://www.who.int/ hpr/NPH/docs/declaration_almaata.pdf (Accessed 8 April, 2010).

  3. 3.

    Lawn JE, Rohde J, Rifkin S, Were M, Paul VK, Chopra M. Alma-Ata 30 years on: revolutionary, relevant, and time to revitalise. Lancet. 2008;372:917–27.

  4. 4.

    WHO European Ministerial Conference on Health Systems “Health Systems, Health and Wealth”, Tallinn, Estonia 25–27 June 2008: report. Copenhagen: World Health Organization Regional Office for Europe; 2009. Available from URL: http://www.euro.who.int/Document/E92150.pdf (Accessed 7 April, 2010).

  5. 5.

    Awofeso N. What’s new about the new public health? Am J Public Health. 2004;94:705–9.

  6. 6.

    Fielding JE, Teutsch S, Breslow L. A framework for public health in the United States. Public Health Reviews 2010;32:174–189.

  7. 7.

    Schlipköter U, Flahault A. Communicable diseases: achievements and challenges for public health. Public Health Reviews 2010;32:90–119.

  8. 8.

    National Cholesterol Education Program, National Heart, Lung, and Blood Institute. Detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel three). NIH Publication No. 01-3670. Washington: National Institutes of Health; 2001. Available from URL: http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3xsum.pdf (Accessed 7 April, 2010).

  9. 9.

    Getzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database of Systematic Reviews. 2009; Issue 4:Art.No. CD001877. Available from URL: http://www2.cochrane.org/reviews/en/ab001877.html (Accessed 7 April, 2010).

  10. 10.

    Hewitson P, Glasziou PP, Irwig L, Towler B, Watson E. Screening for colorectal cancer using the fecal occult blood test, Hemoccult. Cochrane Database of Systematic Reviews. 2007; Issue 1: Art.No. CD001216. Available from URL: http://www.cochrane.org/reviews/en/ab001216.html (Accessed 7 April, 2010).

  11. 11.

    Forbes CA, Jepson RG, Martin-Hirsch PPL. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database of Systematic Reviews. 2002; Issue 3: Art. No.CD002834. Available from URL: http://www.cochrane.org/reviews/en/ab002834 (Accessed 7 April, 2010).

  12. 12.

    Arguedas JA, Perez MI, Wright JM. Treatment blood pressure targets for hypertension. Cochrane Database of Systematic Reviews. 2009; Issue 3:Art. No.CD004349. Available from URL: http://www.cochrane.org/reviews/en/ ab004349.html (Accessed 7 April, 2010).

  13. 13.

    Halpin HA, Morales MM, Martin-Morenso JM. Chronic disease prevention and the new public health. Public Health Reviews 2010;32:120–154.

  14. 14.

    Office of Disease Prevention and Health Promotion. Healthy people 2010 midcourse review. Executive summary. U.S. Department of Health and Human Services. Available from URL: http://www.healthypeople.gov/data/ midcourse/html/introduction.htm (Accessed 7 April, 2010).

  15. 15.

    Goldman DP, Zheng Y, Girosi F, Michaud PC, Olshansky SJ, Cutler D, et al. The benefits of risk factor prevention in Americans aged 51 years and older. Am J Public Health. 2009;99:2096–101.

  16. 16.

    Collaborating Centers of Excellence Set to Combat Chronic Diseases in Developing Countries United Health and the NHLBI Collaborating Centers of Excellence. Reducing chronic diseases must be a global priority. The National Heart, Lung, and Blood Institute (NHLBI) Global Health Initiative. Available from URL: http://www.nhlbi.nih.gov/about/globalhealth/ (Accessed 7 April, 2010).

  17. 17.

    Ncayiyana M, Goldstein G, Goon, Yach D. New public health and WHO’s ninth general programme of work: a discussion paper. Geneva: World Health Organization; 1995. Available from URL: http://whqlibdoc.who.int/hq/1995/ HRH_95.6.pdf (Accessed 7 April, 2010).

  18. 18.

    Fischer A. A new public health policy in the European Union, 1999. Eurohealth. 1999;5:2–4. Available from URL: http://www.euro.who.int/document/obs/ EuroHealth5_1.pdf (Accessed 7 April, 2010).

  19. 19.

    De Vos P, Malaise G, De Ceukelaire W, Peres D, Lefevre P, Van der Stuyft. Participation and empowerment in primary care: from Alma Ata to the era of globalization. Soc Med. 2009;4:121–7. Available from URL: http://www.socialmedicine.info/index.php/socialmedicine/article/view/269/633 (Accessed 7 April, 2010).

  20. 20.

    Tulchinsky TH, Varavikova EA. The new public health: second edition. San Diego: Academic Press; 2009.

  21. 21.

    Fairchild AL, Rosner D, Colgrove J, Bayer R, Fried LP. The exodus of public health: what history can tell us about the future. Am J Public Health. 2010;100;54–63.

  22. 22.

    Lundberg O, Yngwe MA, Kölegård Stjärne M, Elstad JE, Ferrarini T, Kangas O, et al. For the NEWS Nordic Expert Group. The role of the welfare state principles and generosity in social policy programmes for public health: an international comparative study. Lancet. 2008;372:1633–40.

  23. 23.

    Marmot M. Social determinants of health inequalities. Lancet. 2005;365:1099–104.

  24. 24.

    Boddy D, editor. The evidence of health promotion effectiveness. Shaping public health in a new Europe. A report for the European Commission by the International Union for Health Promotion and Education. Luxembourg: European Commission; 1999. Available from URL: http://ec.europa.eu/health/ ph_information/documents/health_status_en.pdf (Accessed 7 April, 2010).

  25. 25.

    Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Geneva: World Health Organization; 2008. Available from URL: http://www.who.int/ social_determinants/thecommission/finalreport/en/index.html (Accessed 7 April, 2010).

  26. 26.

    Curfman GD, Morrissey S, Drazen JM. Tobacco, public health and the FDA. N Engl J. Med. 2009;361:402–3.

  27. 27.

    Evans DB, Tandon A, Murray CJL, Lauer JA. Comparative efficiency of national health systems: cross national econometric analysis. BMJ. 2001;323:307–10.

  28. 28.

    World Health Organization. World health report 2000 — Health systems: improving performance. Geneva: World Health Organization; 2000. Available from URL: http://www.who.int/whr/2000/en/whr00_en.pdf (Accessed 7 April, 2010).

  29. 29.

    Harrison GG. Public health interventions to combat micronutrient deficiencies. Public Health Reviews 2010;32:256–266.

  30. 30.

    Holick MF. Vitamin D deficiency pandemic: a forgotten hormone important for health. Public Health Reviews 2010;32:267–283

  31. 31.

    Oakley GP. Folic acid and vitamin B 12 fortification of flour: a global basic food security requirement. Public Health Reviews 2010;32:284–295.

  32. 32.

    Lalonde M. A new perspective on the health of Canadians. Ottawa, Canada. Government of Canada. 1974. Available from URL: http://www.hc-sc.gc.ca/ hcs-sss/com/fed/lalonde-eng.php (Accessed 7 April, 2010).

  33. 33.

    Ottawa charter for health promotion. Ottawa: World Health Organization; 1986. Available from URL: http://www.who.int/hpr/NPH/docs/ottawa_charter_hp.pdf (Accessed 20 March, 2010).

  34. 34.

    Stahl T, Wismar M, Ollila E, Lahtinen E, Leppo K. eds. Health in All Policies: prospects and potential. Helsinki, Finland; Ministry of Social Affairs and Health and European Observatory on Health Systems and Policies; 2006. Available from URL: http://www.who.it/document/e89260.pdf (Accessed 7 April, 2010).

  35. 35.

    Wismar M, McKee M, Ernst K, Srivastava D, Busse R. Health targets in Europe: learning from experience. Geneva: World Health Organization on behalf of the European Observatory on Health Systems and Policies; 2008. Available from URL: http://www.euro.who.int/document/e91867.pdf (Accessed 7 April, 2010).

  36. 36.

    World Health Organization Regional Office for Europe. The Health for All policy framework for the WHO European Region: 2005: update. (European Health for All series, No. 7.) Copenhagen: World Health Organization; 2005. Available from URL: http://www.euro.who.int/document/e87861.pdf (Accessed 7 April, 2010).

  37. 37.

    Pushka P. Successful prevention of non-communicable diseases: 25 year experiences with North Karelia project in Finland. Public Health Med. 2002;4:5–7.

  38. 38.

    National Heart Lung and Blood Institute and Boston University. The Framingham heart study. Framingham MA. Available from URL: http://www.framinghamheartstudy.org/ (Updated 15 December, 2009 and accessed 28 December, 2009).

  39. 39.

    Ferrie J., editor. Work stress and health: the Whitehall II study. CCSU/Cabinet Office. London, UK: International Centre for Health and Society/ Department of Epidemiology and Public Health, University College; 2004. Available from URL: http://www.ucl.ac.uk/whitehallII/findings/Whitehallbooklet.pdf (Accessed 8 April, 2010).

  40. 40.

    Tulchinsky TH, Varavikova EA. Addressing the epidemiologic transition in the former Soviet Union: strategies for health system and public health reform in Russia. Am J Public Health. 1996;86:313–20.

  41. 41.

    McKee M, Nolte E. Lessons from health during the transition from communism. BMJ. 2004;329:1428–9.

  42. 42.

    Department of Health. Health inequalities: progress and next steps. London: Department of Health, United Kingdom; 2008. Available from URL: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/ documents/digitalasset/dh_085312.pdf (Accessed 8 April, 2010).

  43. 43.

    Mackenbach JP, Stirbu I, Roskam AJR, Schaap M, Menvielle G, Leinsalu M, et al. Socioeconomic inequalities in health in 22 European countries. N Engl J Med. 2008;358:2468–81.

  44. 44.

    Stuckler D, Basu S, McKee M. Public health in Europe: power, politics and where next? Public Health Reviews 2010;32:213–242.

  45. 45.

    Blas E, Gilson L, Kelly MP, Labonte R, Lapitan J, Muntaner C, et al. Addressing social determinants of health inequities: what can the state and civil society do? Lancet. 2008;372:1684–9.

  46. 46.

    Frenk J. Reinventing primary health care: the need for systems integration. Lancet. 2009;374:170–3.

  47. 47.

    World Health Organization, Regional Office for Europe. The European health report 2005: public health action for healthier children and populations. Copenhagen: World Health Organization Regional Office for Europe; 2005. Available from URL: http://www.euro.who.int/document/e87325.pdf (Accessed 7 April, 2010).

  48. 48.

    World Health Organization. The World Health Report 2006: Working together for health. Geneva: World Health Organization; 2006. Available from URL: http://www.who.int/whr/2006/whr06_en.pdf (Accessed 7 April, 2010).

  49. 49.

    Bernier NF. Quebec’s approach to population health: an overview of policy content and organization. J Public Health Policy. 2006;27:22–37.

  50. 50.

    Shortell SM, Gillies R, Wu F. U.S. Innovations in health care delivery. Public Health Reviews 2010;32:190–212.

  51. 51.

    Centers for Disease Control. Achievements in public health, 1900–1999: control of infectious diseases. MMWR Morb Mortal Wkly Rep. 1999;48:621–9.

  52. 52.

    Centers for Disease Control and Prevention. Achievements in public health, 1900–1999. impact of vaccines universally recommended for children — United States, 1990–1998. MMWR Morb Mortal Wkly Rep. 1999;48:243–8.

  53. 53.

    Health for All Data Base, WHO European Region, June 2009. Available from URL: http://www.euro.who.int/HFADB (Accessed 12 March, 2010).

  54. 54.

    Report of a WHO Expert Consultation. Rheumatic fever and rheumatic heart disease. WHO Technical Report Series, No 923. Geneva: World Health Organization; 2004. Available from URL: http://www.who.int/ cardiovascular_diseases/resources/trs923/en/ (Accessed 8 April, 2010).

  55. 55.

    American Heart Association. Rheumatic heart disease statistics. Available from URL: http://www.americanheart.org/presenter.jhtml?identifier=3066049 (Accessed 9 March, 2010).

  56. 56.

    Centers for Disease Control and Prevention. Achievements in public health, 1900–1999: decline in deaths from heart disease and stroke — United States, 1900–1999. MMWR Morb Mortal Wkly Rep. 1999; 48:649–56.

  57. 57.

    Thompson KM, Radboud J, Tebbens D, Pallansch MA, Kew OM, Sutter RW. et al. The risks, costs and benefits of possible future global policies for managing polio viruses. Am J Public Health. 2008;98:1322–30.

  58. 58.

    Centers for Disease Control and Prevention. Global measles mortality 2000–2008. MMWR Morb Mortal Wkly Rep. 2009;58:1221–6.

  59. 59.

    Department of Economic and Social Affairs, United Nations. The Millennium Development Goals report: 2009. New York: United Nations; 2009. Available from URL: http://www.un.org/millenniumgoals/pdf/MDG%20Report%20 2009%20ENG.pdf (Accessed 7 April, 2009).

  60. 60.

    Centers for Disease Control and Prevention. Achievements in public health, 1900–1999: safer and healthier foods. MMWR Morb Mortal Wkly Rep. 1999;48:905–13.

  61. 61.

    Tulchinsky TH. Micronutrient deficiency conditions: a global health issue. Public Health Reviews 2010;32:243–255.

  62. 62.

    Victora CG. Nutrition in early life: a global priority. Lancet. 2009;374:1123–5.

  63. 63.

    Brannon PM, Yetley EA, Bailey RL, Picciano MF. Overview of the conference “Vitamin D and Health in the 21st Century: an Update”. Am J Clin Nutr. 2008;88 (suppl):483S–90S.

  64. 64.

    Allen L, de Benoist AI, Dary O, Hurrell R, editors. Guidelines on food fortification with micronutrients. Geneva: World Health Organization and Food Agricultural Organization; 2006. Available from URL: http://www.who.int/nutrition/publications/guide_food_fortification_micronutrients.pdf (Accessed 7 April, 2010).

  65. 65.

    Centers for Disease Control. Trends in wheat-flour fortification with folic acid and iron — worldwide, 2004 and 2007. MMWR Morb Mortal Wkly Rep. 2008;57:8–10.

  66. 66.

    Centers for Disease Control and Prevention. Ten great public health achievements United States, 1900–1999. MMWR Morb Mortal Wkly Rep. 1999;48:241–3.

  67. 67.

    World Health Organization. WHO Framework Convention on Tobacco Control. Geneva: WHO; 2003. Available from URL: http://whqlibdoc.who.int/ publications/2003/9241591013.pdf (Accessed 21 March, 2010).

  68. 68.

    Nobel Prize for Medicine. BJ Marshall and R Warren, 2005. Available from URL: http://nobelprize.org/nobel_prizes/medicine/laureates/2005/press.html (Accessed 28 March, 2010).

  69. 69.

    National Cancer Institute. H. pylori and cancer: fact sheet. Bethesda MD: National Institutes of Health; 2006. Available from URL: http://www.cancer.gov/cancertopics/factsheet/risk/h-pylori-cancer (Accessed 7 April, 2010).

  70. 70.

    National Cancer Institute. Stomach (gastric) cancer prevention summary of evidence. Modified 30 June 2009. Bethesda MD: National Institutes of Health. Available from URL: http://www.cancer.gov/cancertopics/pdq/ prevention/colorectal/HealthProfessional (Accessed 7 April, 2010).

  71. 71.

    Kamangar F, Dawsey SM, Blaser MJ, Perez-Perez GI, Pietinen P, Newschaffer CJ, et al. Opposing risks of gastric cardiac and noncardiac gastric adenocarcinomas associated with Helicobacter pylori seropositivity. J Natl Cancer Inst. 2006;98:1445–52.

  72. 72.

    Flahault A, Fried L. Editorial. Why a new journal called Public Health Reviews? Public Health Reviews 2010;32:15–17.

  73. 73.

    Tulchinsky TH, Bickford MJ. Are schools of public health needed to address public health work force development in Canada for the 21st century? CJPH. 2006;97:248–50.

  74. 74.

    Education Committee. MPH core competency model — version 2.3; 2006. American Association of Schools of Public Health. Available from URL: http://www.asph.org/userfiles/version2.3.pdf (Accessed 7 April, 2010).

  75. 75.

    Calhoun JG, Ramiah K, Weist EM, Shortell S. Development of a core competency model for the master of public health degree. Am J Public Health. 2008;98:1598–1607.

  76. 76.

    Declercq E, Caldwell K, Hobbs SH, Gyer B. The changing pattern of doctoral education in public health from 1985 to 2006 and the challenge of doctoral training for practice and leadership. Am J Public Health. 2008;98:1565–9.

  77. 77.

    Kreuter MW, Bernhardt JM. Reframing the dissemination challenge: a marketing and distribution perspective. Am J Public Health. 2009;99:2123–7.

  78. 78.

    Tulchinsky TH. It is not just the broad street pump. J Public Health. 2010;32:134–5.

  79. 79.

    Meeting of the International Task Force for disease eradication, June 2009. World Health Organization, Wkly Epidem Rec. 2009;44:458–66. Available from URL: http://www.who.int/wer/2009/wer8444.pdf (Accessed 7 April, 2010).

  80. 80.

    Centers for Disease Control and Prevention. Global Measles Mortality, 2000–2008. MMWR Morb Mortal Wkly Rep. 2009;58:1321–6.

  81. 81.

    Centers for Disease Control. Prevention and Control of Seasonal Influenza with Vaccines. Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009. MMWR Morb Mort Wkly Rep. 2009:58:1–52.

  82. 82.

    Rivetti D, Jefferson T, Thomas RE, Rudin M, Rivetti A, Pietrantoni C, et al. Vaccines for preventing influenza in the elderly. Cochrane Database of Systematic Reviews. 2006; Issue 3: Art. No. CD004876. Available from URL: http://www.ncbi.nlm.nih.gov/pubmed/16856068 (Accessed 6 April, 2010).

  83. 83.

    Laaser U, Epstein L. Threats to global health and opportunities for change: a new global health. Public Health Reviews 2010;32:54–89.

  84. 84.

    Institute of Medicine. Shaping the future for health. Who will keep the public healthy? Educating public health professionals for the 21st century. Institute of Medicine. Washington, (DC): National Academy Press; 2002.

  85. 85.

    Garrido MV, Kristensen FB, Nielsen CP, Busse R. Health technology assessment and health policy-making in Europe: current status, challenges and potential. Copenhagen: World Health Organization on behalf of the European Observatory on Health Systems and Policies; 2008.

  86. 86.

    World Health Organization. The World Health Report 2007: A safer future: global public health security in the 21st century. Geneva: World Health Organization; 2007. Available from URL: http://www.who.int/whr/2007/ overview/en/index.html (Accessed 7 April, 2010).

  87. 87.

    American College of Physicians. Achieving a high-performance health care system with universal access: what the United States can learn from other countries. Ann Intern Med. 2008;148:1–20.

  88. 88.

    Allin S, Mossialos E, McKee M, Holland W. Making decisions on public health: a review of eight countries. Copenhagen: World Health Organization on behalf of the European Observatory on Health Systems and Policies; 2004. Available from URL: http://www.euro.who.int/document/E84884.pdf (Accessed 7 April, 2010).

  89. 89.

    Baum FE, Begin M, Houweling TAJ, Taylor S. Changes not for the fainthearted: reorienting health care systems toward equity through action on the social determinants of health. Am J Public Health. 2009;99:1967–74.

  90. 90.

    Lewin S, Lavis JN, Oxman A, Bastias G, Chopra M, Ciapponi A, et al. Supporting cost-effective interventions in primary health-care systems in low-income and middle-income countries: an overview of systematic reviews. Lancet. 2008;372:928–39.

  91. 91.

    Gilson L, Doherty J, Loewenson R, Francis V. Challenging inequity through health systems: final report — knowledge network on health systems — June 2007. WHO Commission on the Social Determinants of Health (CSDOH). Geneva: World Health Organization; 2007. Available from URL: http://www.who.int/social_determinants/resources/csdh_media/hskn_final_2007_en.pdf (Accessed 7 April, 2010).

  92. 92.

    Thomson S, Foubister T, Mossialos E. Financing health care in the European Union: challenges and policy responses. Geneva: World Health Organization on behalf of the European Observatory on Health Systems and Policies; 2009. Available from URL: http://apps.who.int/bookorders/anglais/detart1. jsp?sesslan=1&codlan=1&codcol=34&codcch=87 (Accessed 7 April, 2010).

Download references

Author information

Correspondence to Theodore H. Tulchinsky MD, MPH.

Rights and permissions

Reprints and Permissions

About this article

Key Words

  • New Public Health
  • Public Health
  • population health
  • community health
  • health promotion
  • health systems management
  • diseases prevention