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Chapter 3 defined “health” as a state of complete physical, mental, spiritual, and social well-being and not merely the absence of disease or infirmity. This chapter focuses on “public health.” While there is no standard definition, public health has been described as “what we as a society do collectively to assure the conditions in which people can be healthy.”1

So, what is it that public health does to assure the conditions for people to have health? According to the Centers for Disease Control and Prevention (CDC), public health does the following:

  • Prevents epidemics and the spread of disease

  • Protects against environmental hazards

  • Prevents injuries

  • Promotes and encourages healthy behaviors

  • Responds to disasters and assists communities in recovery

  • Assures the quality and accessibility of health services

Another way to describe public health is to contrast it with allopathic medicine. Allopathic physicians save lives one at a time; public health saves peoples’ lives a million at a time.


Public health is directly concerned with several of the major causes of death in the United States. These include cancer, accidents, and intentional self-harm, as well as health promotion activities that can address several other causes (heart disease, diabetes). Below are the death rates per 100,000 population for the top 10 causes of death in 20182:

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• Heart disease 163.6
• Cancer 149.1
• Accidents (unintentional injuries) 48.0
• Chronic lower respiratory diseases 39.7
• Stroke (cerebrovascular diseases) 37.1
• Alzheimer disease 30.5
• Diabetes 21.4
• Influenza and pneumonia 14.9
• Kidney disease 12.9
• Intentional self-harm (suicide) 14.2

It is important to point out that the recent spread of COVID-19 catapulted the virus to the number 3 cause of death in the United States by August 2020, just 8 months after the first case was diagnosed. It is unclear at this point how long it will remain in “the top 10” going forward.

Many people are unaware of public health’s contribution to health status. Consider the great public health achievements during the 20th century:

  • Vaccinations

  • Safer workplace

  • Safer and healthier food

  • Motor vehicle safety

  • Control of infectious diseases

  • Decline in deaths from coronary heart disease and stroke

  • Fluoridation of drinking water

  • Family planning

  • Recognition of tobacco use as a health hazard

  • Healthier mothers and babies

Also consider some of the recent threats to public health during the current millennium (apologies for not listing everything that has happened):

  • COVID-19 (2020)

  • Border-crossing deaths of migrants (2017-)

  • Orlando night club shooting (2016)

  • Opioid crisis (2015)

  • Drinking water in Flint, Michigan (2014)

  • Hurricane Sandy (2012)

  • Salmonella in peanut butter (2011)

  • H1N1 epidemic (2009)

  • Hurricane Katrina (2005)

  • Anthrax attacks through the mail (2001)

  • 9/11 attack (2001)

These events required responses from ...

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