Overview of Public Health
Although only a minority of veterinarians report primary public health employment, virtually all veterinarians contribute to the overall public health effort. According to the World Health Organization, “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Public health can be defined as the totality of all evidence-based public and private efforts that preserve and promote health and prevent disease, disability, and death. The concept of One Health is the collaborative effort of multiple health science professions, together with their related disciplines and institutions—working locally, nationally, and globally—to attain optimal health for people, domestic animals, wildlife, plants, and our environment.
One Health can be thought of as having three major subcomponents: basic sciences, clinical medicine, and public health. Major components of public health include population health, community health, mental health, environmental/ecological health, and occupational/recreational health. The differentiating variables among these components are the dynamics of the population(s), changing social/health behaviors, and, perhaps most importantly, the selection of the population to study/surveil. A relevant, frequently debated question is the definition of the “environment.” Typically, it is equated with the “physical” environment and implies all influences other than social, economic, cultural, and genetic. An additional underlying theme in One Health is the economic environment in which it (and all professions that contribute to it) is pursued. Therefore, an understanding of basic economics is key to understanding the most practical application of (and opportunity for) One Health in a particular community, country, or region.
A generally accepted definition of a public health practitioner does not exist. However, for practical purposes, any health professional who sees and acts beyond the single patient is functioning in a public health capacity. Most typically, this includes physicians, veterinarians, dentists, nurses, epidemiologists, laboratorians, industrial hygienists, public health inspectors, and regulatory agency administrators. Allied health professionals, including optometrists, physician assistants, psychologists, pharmacists, entomologists, etc, also contribute according to the scope of their respective practices. No medical profession exists in a vacuum.
Many public health practitioners possess specific training, and various board-certifying bodies, accrediting entities, and professional societies bolster this training by requiring experience and fostering collaboration. These include the American College of Preventive Medicine, the American College of Veterinary Preventive Medicine, the American Public Health Association, the American Society of Public Health, and the Association of State and Territorial Health Officials.
Several overarching public health organizations have jointly developed a set of core competencies that reflect skills appropriate to the effective delivery of public health services. Core competencies are divided into the following eight domains: 1) analytic/assessment skills, 2) policy development/program planning skills, 3) communication skills, 4) cultural competency skills, 5) community dimensions of practice skills, 6) public health sciences skills, 7) financial planning and management skills, and 8) leadership and systems thinking skills.