Domains of public health: health improvement versus health protection
Public health has three domains (broad areas of activity): health improvement (helping people change habits), health protection (shielding people from threats) and healthcare public health (planning the services).
Remember
Ask what the intervention acts on. Changing behaviour is health improvement, shielding people from a threat such as an infection or a chemical spill is health protection, and planning how services are run is healthcare public health.
Public health work is usually split into three domains. Ask what the intervention acts on: a person's behaviour, a hazard or infectious threat, or how services are organised.
Health improvement is the effort to improve the health of the population (the whole community) and quality of life. It works on behaviours and lifestyle. Typical examples are smoking cessation services (helping people to stop smoking) and weight loss programmes.
Health protection aims to prevent disease developing in a population. It covers vaccination programmes, screening programmes, epidemic control and protection against environmental hazards (harmful things in people's surroundings, such as chemical spills). Air pollution is an environmental hazard, so controlling it is health protection.
Healthcare public health concerns how health services are planned, funded and run, along with research into improving healthcare. Funding and organising access to urgent care is an example.
Health improvement and health protection are both preventive, so the exam trap is to choose protection for a service that changes behaviour.
Key facts
- Three domains
- health improvement, health protection and healthcare public health.
- Health improvement
- works on behaviours and lifestyle, for example smoking cessation services and weight loss programmes.
- Health protection
- aims to prevent disease developing in a population, for example through vaccination and screening programmes.
- Healthcare public health
- concerns how services are planned, funded and run, along with research into improving healthcare.
- Cost of protection
- health protection can be expensive in the short term but can save the healthcare system money in the long run.
- Levels of prevention
- primary, secondary and tertiary prevention are a separate classification, describing the stage at which an intervention acts.
Exam traps
- A stop smoking service to reduce chronic lung disease is not health protection through vaccination, because it targets smoking behaviour as a cause of the disease, not an infectious threat.
- A community weight management programme is health improvement, not health protection, because it aims to change lifestyle and does not shield a population from an infectious or environmental hazard.
- Primary, secondary and tertiary prevention are the three levels of prevention, not the three domains of public health.
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