Why Are Some Countries Healthier Than Others? Prevention or Care?

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A Sad Depiction of Reality
There are concrete differences between the fields of public health and health policy. When considering options for improving societal health, decisionmakers and policy analysts often make the mistake of focusing solely on health policy. It is important to remember that public health can play an equal or greater role in improving the quality and longevity of life for society. While it has been shown that America lags behind other industrialized countries in BOTH public health AND health policy, I want to use this page to highlight the major differences between the two disciplines.


Public health primarily focuses on society and prevention while health policy primarily focuses on the individual and the diagnosis/treatment cycle of medical care. We need both of these health tools to work more effectively if we want to improve standards of health in America. Improved medical care and health policy are not a substitute for convincing our society to eat less, exercise more, quit smoking and undertake other preventative measures that lower the need for much more costly medical treatment.


Public health standards are much more difficult to enforce in society than changes in health policy but the costs can be cheaper and lead to much better societal health outcomes. We must emulate Socialized standards of public health, as well as health policy, if we want to see the maximum benefits of truly reinventing the American health system.


Below is an outline of the two fields of public health and health policy. I like using this classic breakdown from the Association for Schools of Public Health.


Public Health

  • Primary focus on population
  • Public service ethic tempered by concerns for the individual
  • Emphasis on prevention, health promotion for the whole community
  • Public health paradigm employs a spectrum of interventions aimed at the environment, human behavior and lifestyle, and medical care
  • Multiple professional identities with diffuse public image
  • Variable certification of specialists beyond professional public health degree medical degree
  • Epidemiology
  • Occupational Health
  • Nutrition
  • Policy Development and Assurance
  • Biologic sciences central, stimulated by major threats to health of populations; move between laboratory and field
  • Numeric sciences as essential feature of analysis and training
  • Social sciences an integral part of public health education
  • Clinical sciences peripheral to Professional training

Health Policy

  • Primary focus on individual
  • Personal service ethic, conditioned awareness of social responsibilities
  • Emphasis on diagnosis and treatment, care for the whole patient
  • Medical paradigm places predominant emphasis on medical care
  • Well-established profession with sharp public image
  • Uniform system for certifying specialists beyond professional
  • Organ group specialization
  • Patient group specialization
  • Technical skill specialization
  • Etiology
  • Pathophysiology
  • Biologic sciences central, stimulated by need of patients; move between laboratory and bedside
  • Numeric sciences increasing in prominence, though still a Relatively minor part of training
  • Social sciences tend to be an elective part of medical education
  • Clinical sciences an essential part of professional training