Simply put, Public Health has its origins in and is focused upon preventing the spread of disease and illness, whereas Medical Care is focused on treating conditions, disease and illness. While there is some overlap (more so at the community level with the Health Department model), Public Health’s attempts to cross more prominently into Medical Care in this country since the early 20th century have been met with great opposition by medical professionals and their trade organizations, who did not want the government to reach further into the provision of health services in a way that might lead to a national healthcare program and thus make all practicing medical professionals government employees (Williams & Torrens, 2008). Conversely, providers of Medical Care, in recent years, are being pressured more and more to engage in wellness and preventive medicine and demonstrate positive outcomes but alignment of incentives has not advanced as quickly as the need would dictate.
Public Health thus evolved in ways that are focused on the population at large, with the following key responsibilities, noted by Sommers & Heiser (2013):
1. Monitor health status to identify and solve community health problems.
2. Diagnose and investigate health problems and health hazards in the community.
3. Inform, educate, and empower people about health issues.
4. Mobilize community partnerships and action to identify and solve health problems.
5. Develop policies and plans that support individual and community health efforts.
6. Enforce laws and regulations that protect health and ensure safety.
7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
8. Assure competent public and personal health care workforce.
9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
10. Research for new insights and innovative solutions to health problems (p. 35)
In terms of its evolution, Pittman (2014) explains that Public Health faced its first modern crisis during 1980s and 1990s with HIV, out of which a healthy communities and cities movement was borne. This movement further evolved in response to 9/11 and Hurricane Katrina and resulted in better efforts to quickly coordinate and dispatch multiple local, state and government resources following a catastrophic event. However, Pittman asserts:
“The current challenge facing public health leadership is to determine how to link the social determinants of health and the lessons from healthy communities with health reform. The key challenge is how to bridge the gap between the public health focus on preventing disease and creating a healthy environment with the need for preventive and restorative health care. There is a reference in the Affordable Care Act (ACA) to improving population health by focusing on the triple aim of better health, better care, and lower cost, but the specific details on how to achieve these...