Defining Health And Public Health - Nursing Assignment Help

Assignment Task

Defining Health and Public Health
Chapter one of the prescribed text, Fleming and Parker (2015) describe how the concept of health means different things to different individuals. Various definitions of “health” and “public health” are considered. 

The World Health Organisation's (WHO) (1947) defines health as: "A state of complete physical, mental and social well being and not merely the absence of disease or infirmity". This extends the definition of health beyond descriptors of disease and has been an important statement contributing to current thinking about public health.

Health is defined differently according to circumstance and context – thus a person with a chronic disease can still self-assess as ‘healthy and well today’ despite the chronic disease. It is worth considering that definitions of health are too often from a health professional perspective, often within a biomedical, pathological structure.  What aspects should be considered in a public health definition?

Public health can be seen as a multidisciplinary set of activities which look to protecting and promoting health in communities as well as the delivery of services to communities. The Public Health Association of Australia (PHAA) states that 'Public health is the art and science of preventing illness and promoting health through the organised efforts of society'.
The National Public Health Partnership [2000] of Australian Commonwealth, State and Territory governments, provided more details and although this is no longer in existence their outline of public health still provides a definition of how Australian views public health integrating within their health system:
The art and science of public health practice in Australia today seeks to improve health and wellbeing through approaches which focus on whole populations. Priorities are to reduce disparities in health status between social, economic, physical and biological determinants. Public health practice informs and empowers individuals and communities, creates healthy environments through the use of evidence-based strategies, best practice and quality improvement approaches, and effective governance and accountability mechanisms.
The World Health Organisation (WHO) is a vital provider of public health across the world and in Australia, they set the baseline standards for many global public health incentives.  
They are also amongst the leaders of public health research and you will find excellent evidence based studies within their web site.  WHO have defined public health as:

Public health refers to all organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole. Its activities aim to provide conditions in which people can be healthy and focus on entire populations, not on individual patients or diseases. Thus, public health is concerned with the total system and not only the eradication of a particular disease. The three main public health functions are:

• The assessment and monitoring of the health of communities and populations at risk to identify health problems and priorities.
• The formulation of public policies designed to solve identified local and national health problems and priorities.
• To assure that all populations have access to appropriate and cost-effective care, including health promotion and disease prevention services.  
Please read Chapter 1: Fleming, ML & Parker, E 2015. Introduction to public health 3E. Take note of the core functions of public health in table 1.2 and the outline of the public health workforce in Box 1.1. This is a quick chapter  to read and it will help put public health into perspective- as you will notice this aspect of health management takes you away from the acute care/ bedside practice of nursing and puts you in the wider community with a focus on maintaining health, use of prevention strategies and health promotion.
Make sure you review how the Australian government contributes to public health at each level.

History of Public Health
Fleming and Parker’s chapter two (2015) describes how public health has developed over time in Australia, of particular interest is the identification that Australian society has begun as a convict colony, the concept of colonisation will be re-visited in topic 5 in this unit. Within this chapter you don't need to focus too much on the initial discussion, start around page 27 which looks more at how public health has developed.

Political influences on public health are obvious when examining the history of public health and its evolution. In the past, the purpose of protecting the health of populations or groups and was not for health reasons at all, it was for social and political reasons. 

As emphasised by Fleming and Parker (2015), removing environmental hazards and protecting the environment marked the first public health revolution. The focus from infectious/communicable diseases has moved in recent years to the "New Public Health" paradigm which has a strong focus on prevention, sustainability, health promotion and creating sound public health policy. 
Think about how public health has changed over the years and how this is represented in the health care system you are familiar with.  Please read the following: Fleming, ML & Parker, E 2015, Introduction to public health, 3rd edn Elsevier Australia

The World Health Organisation (WHO) defines health policy as:
Health policy refers to decisions, plans, and actions that are undertaken to achieve specific health care goals within a society. An explicit health policy can achieve several things: it defines a vision for the future which in turn helps to establish targets and points of reference for the short and medium term. It outlines priorities and the expected roles of different groups; and it builds consensus and informs people.(ref: http://www.who.int/topics/health_policy/en/)
In developing health policies it is anticipated that a series of informed decisions have been made and will be implemented to enhance the overall health outcome of a population. One of the first steps in initiating a policy is highlighting the need for the policy development by presentation of an identified problem and gathering of supportive information. Good health policy is based on sound research.
Don't be distracted by the underlying political face of health policy, this is a very interesting and relevant area that forms the foundations of Australian health. It includes aspects such as mandatory reporting and considers where health care demands are most required, policy helps to direct positive health behaviours such as vaccination schemes and can also be quite controversial.
In relation to health policy, it is also vital to have a sound understanding of the Australian health care system. Do you really know how our health system is networked and financed? Who governs our public health care system? Where is the most money spent on health care? Time to find out. Complete the education module on the Australian Health Care System, this provides foundational knowledge that you can build on.
For many nursing students entering the Australian health care system (AHCS) there can be a lack of understanding of how this system functions.
The following module is to bridge this knowledge gap and ensure you have a sound understanding of the main components of the AHCS. Consider you are starting your career as part of this system and you need to have a basic knowledge of how it all works.
Click on the image below to get started. This does contribute to continuing professional development hours and provides a certificate of completion to add to your professional portfolio. 
Our country relies on good health policy development to keep its population healthy and to achieve this there needs to be research, investment and evaluation to ensure the greater need of the public is met.  You have now reviewed how the Australian health care system is set up and it is vital as  health care professionals to have a sound understanding of the foundations of your practice. Although politics and policy may not be that interesting to you, there are many aspects that you will find empower you as a nurse.  
Heather Garnder (Barraclough & Gardner 2008)  outlines in her chapter on Population Health, that in the past the health system and policy developments has tended to be a representation of a "sickness system". This means it is not necessarily focused on the health and wellbeing of a population but rather one designed to treat individuals when they become ill. Government and non-Government Association's such as those who represent the National Strategic Framework for Chronic Conditions and the Australian Institute of Health and Welfare (AIHW) are creating new trends in health policy development to represent the greater aspects of public health.  It is not focused just on illness but more on maintaining health and disease prevention, stemming from a focus to promote a healthy lifestyle at all ages.  A large amount of evidence-based health policy is focused on addressing risk factors and include health determinants such as socio-economic factors (more on health determinants is covered further in this unit).
One recent example of a health policy is Gayle's Law, which was passed through South Australain Parliament late 2017.  This law resulted after an extremely unfortunate and preventable murder of a nurse in a remote community. It is now enforced that health workers will  no longer be permitted to work alone in remote areas.  To find out a little more about this read the ABC news brief found here:  Gayle's Law: Better protection for remote nurses passes SA's Parliament
There are many examples provided in the set text of health policy at work.

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