Core Principles of Public Health in Health Protection Practices

Health protection is a core technical competency in public health and for its practitioners. It is a term used to encompass activities that ensure robust health security at local, national, and global levels. Its activities aim to protect the public from avoidable health risks and minimize the health impacts of these risks. These may include the strengthening of capacity in climate change and sustainability, emergency preparedness, communicable disease control, and environmental and planetary health. This chapter describes the key basic public health concepts, principles, and approaches and provides an overview of health protection: health, public health, health protection, health improvement, health services and management, determinants of health, indicators for the burden of disease, epidemiology and demography, disease burden, development and health risk transition, life-course approach, pathway of care, hierarchy of prevention, health promotion, health system, and levels of care.

Health Protection and Health Risks in a Changing World

Human beings in the twenty-first century are facing major pressure to manage a rapidly expanding repertoire of health risks and are experiencing various major transitions. To protect health effectively, practitioners and workers in health protection, regardless of being health- or non-health-based, must learn about terminology, acquire knowledge and skills, and understand the frontiers of other disciplines that may facilitate their efforts in improving health. Due to the dynamic changes that influence modern living, the scope and nature of health protection will only become more complex. Mutual learning and collaboration among disciplines and sectors will be essential to enable formulation of effective cross-disciplinary policies and actions to protect health and well-being. Beside the major health protection themes of emergency and disaster preparedness, climate changes, infectious disease control, environmental risks, and issues of sustainability and planetary health, dynamics and transitions that may contribute to major changes in health profile and risks deserve careful monitoring and public health policy reconsideration.

Challenges and Opportunities of Health Protection in the Twenty-First Century

Globally, changes of macro-determinants of health occur as consequences of population movement, urbanization, globalization, technology advancement, and globalized living environments in the twenty-first century. Rayner and Lang (2012) argue that these transitions have changed the dynamics among humans, their activity patterns and the living eco-system. Regardless of development status, these health transitions change the human health determinants and outcomes. One of the latest frontiers in public health protection is to understand how these macro transitions might affect human health risks, disease outcomes, and the ecosystems that support and sustain living creatures. This chapter discusses current understanding of how some of these transitions, including globalization, demographic, epidemiological, economic, ecological, energy, technological, nutrition, and urban transitions, may be associated with health and well-being.

Planetary Health and Sustainability

In the twenty-first century, globalization of trade, travel, and culture is likely to impose complex effect on health protection: increased trade is likely to improve material access and services but also bring harm to health and the environment; travel and human migration enrich human experience but also exacerbate health threats such as the rapid dissemination of communicable diseases; and globalized food production and ineffective regulation of food production have led to adverse human health outcomes. This chapter discusses ideas that bridge traditional public health disciplines and concepts to enable multidisciplinary actors to examine, plan, act, and implement together to protect human health and well-being. This chapter also explains how health protection might be linked to some important global policies such as Sustainable Development Goals and the New Urban Agenda. Specifically, ‘One Health’, ‘planetary health’, and ‘sustainable development’ allow the conceptualization of the relationship between human, other living organisms, and eco-system.

Emergency Preparedness and Disaster Response

Emergency preparedness to health risk and disaster response to health needs are essential health protection skills and competencies to protect community health and well-being in times of crisis. Emergencies and extreme events may disrupt the environmental context and destroy essential life- and health-sustaining infrastructure and environmental context. Crisis often renders a health system ineffective to protect a community from health risks and provide for the overwhelming health and medical needs associated with the disruption. In addition, in the twenty-first century, many of the emergencies and disasters transcend national boundaries and require transnational cooperation. Such a response requires global involvement and collaborations to respond effectively and efficiently. Natural disasters (e.g. hurricanes/typhoons), global disease outbreaks of old and emerging infectious diseases, and population displacements as a result of war, famine, or natural disaster often require just the response capacity of more than a single nation.

Climate Change and Health

Climate change poses one of the biggest threats to public health in the twenty-first century. Climate-related disasters include extreme temperature events, extreme precipitation, sea-level rise, flooding, and drought. According to estimates by the World Health Organization, climate change may lead to an annual death rate of 250,000 between 2030 and 2050. The direct health impact of climate change includes mortality and morbidity associated with extreme temperature (e.g. heat stroke) and changing patterns of respiratory and cardiovascular diseases, as a result of more frequent and severe extreme temperature events. Climate change also has indirect health impacts by facilitating the breeding of mosquitoes to spread vector-borne diseases such as malaria and dengue fever, reducing access to clean water and food supplies resulted from drought or flood, and leading to forced migration associated with the loss of economic livelihood of communities. Adaptation and mitigation are the two main approaches adopted to alleviate and manage the health risks of climate change to achieve climate-resilient pathways for sustainable development.

Environmental Health

Human health is closely linked to the natural environment, behavioural patterns, and policy context. The World Health Organization (WHO) defines environment, as it relates to health, as all the physical, chemical, and biological factors external to a person, and all the related behaviours. Environmental health is the branch of public health that focuses on the interrelationships between people and their environment, as well as how to foster healthy and safe communities. It addresses the societal and environmental factors that increase the likelihood of exposure and disease. Poor environmental quality has its greatest impact on people whose health status is already at risk. Environmental threats to health frequently require rapid and urgent action to protect the environment for both present and future generations. This chapter describes key concepts in environmental health and related risks.

Communicable Disease and Control

Control of communicable diseases is one of the core components in health protection practice. This chapter describes key concepts and principles related to communicable diseases and their management. According to World Health Organization, the number of deaths due to communicable diseases reduced from 12.1 million in 2000 to 9.5 million in 2012. However, malaria, tuberculosis, HIV/AIDS, and neglected tropical diseases remain the major health challenges for the global community. Moreover, new emergent and re-emerging diseases constantly present new health risks. For the coming decades, globalization, changing behavioural patterns, lifestyle, and technological outcomes will pose major challenge to communicable disease control and management. The increasingly urbanized lifestyle and high-density-based living will also render most city-based communities vulnerable to living environmental pressure and communicable disease risks. Effectiveness and success in future communicable disease control rely on global coordination and cooperation.

Introduction

This chapter provides an overview of the background and objectives of the book and an overall description of the book structure. It introduces health protection as a major knowledge area in public health to prevent, protect, and manage health risks, highlights its international and multidisciplinary nature, and points out the book’s aims to provide key health protection concepts in a multidisciplinary way and discuss new frontiers of health protection to fill the current gap in the availability of relevant textbooks. Lastly, it outlines structure of the book and the key themes of the chapters including health protection core principles, climate change, emergency and disaster, Health Emergency and Disaster Risk Management (Health-EDRM), communicable disease, environmental health, planetary health and sustainability, and health protection challenges and opportunities.