According to the Texas A&M Health and Science Center, the marriage of public health and preventative medicine into a field sometimes labeled “population medicine” is relatively new.
The goal is for physicians to not simply focus upon the individual and some malady that has brought them to their doctor but to work with other physicians and even politically in order to help reduce and prevent factors associated with disease and illnesses in the general population as well as in sub-populations.
For example, doctors in the public health and preventative medicine fields will not only help individuals to stop smoking cigarettes and treat any illnesses that may arise from smoking, but they will also assess the population who are at risk for addiction to tobacco and identify the determinants of this behavior.
They will then address and tackle the factors in the population that encourage and promote smoking, such as advertising, and they will also support public policies to ban smoking in public places and educate the public about the dangers of cigarette smoke.
According to the American Medical Association Journal of Ethics, public health physicians work with epidemiology, biostatistics, health policy, environmental health and health behavior change communication. They use statistics, modeling and mapping in order to augment their work in finding the underlying causes and risk factors for diseases, illnesses and injuries.
To find out more about this growing field that has contributed to the elimination of major factors for disease, injury and illness, we spoke with Dr. Clarence Clottey. Dr. Clottey holds a fellowship in Public Health and Preventive Medicine from the Royal College of Physicians of Canada (FRCPC), and a certification in Family Medicine from the College of Family Physicians of Canada (CCFP). He also received his Masters in Public Health from Harvard University. He has the unique perspective of having worked at the federal, provincial, regional and municipal levels of government in Canada and has practiced public health internationally.
Canada – A Leader in Public Health
According to Dr. Clottey, Canada has been a leader in public health globally where many public health issues are still being resolved. For example, according to Rowan, Hogg and Huston, there is still not a good method in place for coordinating efforts between primary care physicians and public health doctors and officials that would accelerate the reduction of risk factors in the population. Rowen, Hogg and Huston suggest that one possibility for better coordination, especially in times of pandemic outbreaks, is for there to be more public health doctors who are salaried as leaders that work from a defined list of public health policies and coordinate with primary care physicians for the purposes of monitoring health risks and biostatistics as well as for the purpose of coordinating efforts to curtail population risk factors.
Cohen, Huynh and Seybold conducted a study with just such public health leaders and found some common themes emerging in Canadian public health and prevention. Some of the same problems that challenged public health in the past are beginning to re-emerge. These problems include teen pregnancies, alcohol and drug addiction and sexually transmitted infections. These public health leaders are beginning to work outside of the medical profession to work with professionals in other sectors to find unique solutions to minimize health risks. These leaders are also beginning to see that the solutions must help and aid the at-risk populations on their terms.
An example Cohen’s study provided was of disease and illness due to malnutrition. Some of the poorest citizens in Canada live in third-world conditions. They lack the transportation and economic resources for access to safe, whole foods throughout the month. The term in the public health sector that has emerged is “food desert,” meaning a place where access to wholesome food is lacking.
Public health leaders have become acutely aware that it is no longer acceptable to simply state that they cannot help populations who lack access to nourishing food throughout the month.
Public health officials in a large Canadian city used mapping tools to identify where people were living who had a high likelihood of diabetes. They examined the local area and discovered that the availability of grocery stores and other sources of whole foods was very low in the area. They worked with businesses in order to help provide more healthy food choices in the target area.
Besides teen pregnancies, alcohol and drug addiction, sexually transmitted infections, diabetes and malnutrition, some of the other public health and preventative medicine issues that public health physicians are attempting to address today in Canada are cancer, heart disease and lower respiratory tract infections. Dr. Clottey advises that the answers to those diseases and illnesses also lie in a multi-sector approach that helps eliminate the risk factors for the population and vulnerable sub-populations.
Dr. Clarence Clottey is a consultant in public health and provides advise on promoting public health.